FEATURE ADAPTATIONS
Cognitive impairment and stairlifts
Ailsa Dow describes an integrated partnership assessment project in Fife , to better inform clinical decision making and risk management when considering stairlifts for people with cognitive impairment
For people unable to safely use their stairs , a stairlift adaptation can be a lifeline to enable them to maintain their occupational performance in their home environment . However , people experiencing cognitive challenges from conditions such as dementia continue to be at risk of being denied stairlifts based on diagnosis and not ability .
Some aspects of cognitive impairment may impact on stairlift use , while others may not , and cognitive assessment is important for informing occupational therapists ’ decision making .
Some occupational therapy services may apply a riskaverse approach of declining stairlift assessment based on a dementia diagnosis . In one key 2016 guidance document , Our dementia , our rights , one local authority was found to be discriminatory under the Equality Act ( 2010 ) by refusing to assess for a stairlift on this basis .
RCOT emphasises that we must embrace a positive risk-enabling approach to practice , rather than enforce risk-averse service policies and criteria ( RCOT 2018 ). It is essential to assess individuals ’ cognitive strengths and capabilities , balanced with the level of support required to enable a stairlift to proceed . This requires a thorough and personalised assessment .
Background to the project A group of occupational therapists from Fife Council and NHS Fife have worked together since 2016 on applying standardised cognitive screening assessments to local authority occupational therapy practice .
Fife Council Occupational Therapy Service had found the practice of cognitive assessments challenging to implement , despite recognising their importance .
Social care occupational therapists have a central role in supporting people to live well at home . A significant responsibility within this role is assessment to meet required outcomes of improved safety and / or independence . Interventions to meet those needs often include recommendation of equipment and adaptations .
Assessments should be person centred , strengths based and holistic , accounting for individuals ’ physical , psychological , social and environmental needs .
52 OTnews November 2021