Carers
Carers
Feature
Addressing occupational imbalance , deprivation and injustice
Cat Brown and Ali Buchanan focus on the conception and evolution of an occupational therapy pathway for those who find themselves in a caregiving role .
T he value of unpaid carers – who are critical to enabling people to live at home – has been well documented , with figures estimating their financial contribution to the UK economy as being similar to the running costs of the NHS .
Services across health and social care consistently consider and value the role of unpaid carers , yet with their duty of care focused on the cared-for , unpaid carers rarely receive an occupational therapy assessment in their own right .
In 2021 , an opportunity arose within the East Lothian Health and Social Care Partnership ( ELHSCP ) to bid for funding to develop services for unpaid carers in East Lothian . Managed by an established Carers Strategy Board , with representation across the partnership including unpaid care-givers , their responsibility is to lead on the provision of services to meet the carer-specific strategic directions set out by our Integrated Joint Board ( ELHSCP 2023 ).
From an occupational therapy perspective , we felt there was a gap in the provision for unpaid carers , which when viewed from an occupational science perspective , highlighted the need to address occupational imbalance , occupational deprivation and occupational injustice .
Fortuitously , the clinical lead was undertaking a postgraduate masters degree and the module of study at this time was occupational science . This provided a theoretical underpinning that formed the foundation of our pathway .
The initial vision
A basic literature search identified a lack of occupational therapy-specific evidence-based practice models that acknowledge the value of unpaid carers , their contribution to the meaningful occupation of care giving and viewing them as an occupational being in their own right .
Against a backdrop of limited paid care capacity in communities , the vital role unpaid carers play in enabling people to remain at home as long as possible is magnified .
Our first challenge was to create a proposal without any ‘ blueprint ’ or similar service to base it on . Our initial aim was to suggest how an occupational therapy pathway could be delivered to unpaid carers , while acknowledging that further development , ideally co-created with unpaid carers themselves , would be essential .
What was particularly challenging was being asked to put numbers to the service , such as how many unpaid carers could be supported and what the outcomes would be . As a brand-new service , it felt like we were making an informed guess , which was both professionally and personally challenging .
The presentation itself lasted 10 minutes and required the articulation of the vision , the detail of the bid and the predicted impact and outcomes . Although conducted over MS Teams , as this took place during the pandemic , it felt terrifying . Despite feeling confident in presenting , it felt challenging to be proposing and predicting the unknown .
That said , we knew this was a fantastic opportunity to do something different and provide occupational therapy to a client group who are seen , but not fully appreciated in their own right .
This bid sought to provide occupational therapy assessment and intervention at a far earlier point in their care-giving journey , ultimately aiming to prevent the sudden and unplanned response to a crisis that we usually find ourselves having to respond to .
36 OTnews December 2023