SERVICE DEVELOPMENT FEATURE
• 32 per cent did not feel confident to refer to the service;
• 18 per cent were not aware of the self-management role of
occupational therapy;
• 13 per cent were not aware of distraction techniques; and
• 5 per cent thought that occupational therapy volunteers were
used to entertain day services patients.
Patient benefits
The IPOS scores suggest an overall reduction in patients’
perceptions of their anxiety, their carer anxiety and practical
problems on occupational therapy-led weeks, although this
cannot solely be attributed to the occupational therapy input.
An individual patient was quoted to say that ‘being able to try
things in a safe environment, gives me the confidence to then
attempt them at home, easing the pressure on my
husband’.
This could correlate to why patients perceive
their carers’ stress reduces on the weeks the
practical interventions are delivered by the
occupational therapist. It could be hoped that
by encouraging patients to be more independent
with daily tasks, their dependence on carers could
decrease and consequently reduce the need for
respite for their carer.
Increased capacity of hospice services
Another patient was quoted to say that ‘the practical
sessions boost my self-esteem, giving me a feeling of
purpose and I feel less anxious as a result’. This same patient had
been referred to the counselling team. However, it was decided, in
conjunction with the counselling team, that due to the occupational
therapy intervention this input was no longer required.
Seven of the 22 patients (31 per cent) analysed in the study
required a prescription for equipment as a result of the practical
group sessions.
As patients were assessed using the equipment, it allowed the
occupational therapy team to prescribe the equipment directly
from community stores, rather than referring to a local authority
occupational therapist for an assessment, as was the traditional
procedure.
Finally, a patient who was in the inpatient unit participated in a
practical cooking group. This avoided the occupational therapist
having to assess her in the unit, which gave the occupational
therapist time to see other patients.
Staff awareness
There was 28 referrals from day services in the three months prior
to the project starting. This increased to 49 during the project,
which is a 75 per cent increase.
In addition, the occupational therapy caseload increased from
129 (21 average per month) over a six-month period to 143 (47 a
month) during the three-month project.
Limitations and success
It is not possible to claim whether the decrease in IPOS scores on
occupational therapy weeks was solely due to the occupational
therapy intervention or not. It was felt not to be fair to patients to
have to complete another form in addition to the IPOS, therefore a
standardised occupational therapy outcome measure was not used
in this project.
Due to the order of the themes set in day services, the
occupational therapy-led weeks were not in alternate order. For
example, sometimes they were over two continuous weeks and
other times there was a gap of a couple of weeks between them.
This made it difficult to compare the IPOS scores from week to
week for individual patients.
Lastly, the data collected was relatively small due to the number
practical
sessions boost my selfesteem,
giving me a
feeling of purpose and I
feel less anxious as
‘‘...the
a result.
of patients who do not attend day services
continually for the 12-week period.
Most patients tend to miss some
weeks due to illness or alternative
appointments.
However, this study showed
that with little extra costs
and simply through service
redesign, with the addition
of practical group sessions,
patients can have increased
confidence and self-esteem,
reduced anxiety and more practical
problems addressed.
It has been suggested that this change
can increase capacity of not
only the occupational therapy services,
but also counselling and local authority
occupational therapy teams.
Further,the project showed that by delivering
the service in this way, referral rates increased,
consequently allowing the occupational therapy
service to reach more people who are living with a life
limiting illness.
References
Mills K and Payne A (2014) Enabling occupation at end of life.
Cambridge University Press, 13(6). DOI: https://doi.
org/10.1017/S1478951515000772
Tiberini R and Richardson H (2015) Rehabilitative palliative
care: Enabling people to live fully until they die. Hospice
UK [online]. Available at: www.hospiceuk.org/what-we-
offer/clinical-and-care-support/rehabilitative-palliative-
care/resources-for-rehabilitative-palliative-care
[accessed 29 July 2020]
Lynsey Cameron, senior occupational therapist,
Ayrshire Hospice, email: lynsey.cameron@
ayrshirehospice.org
OTnews August 2020 47