Pressing pause …

Dear Reader

As you may recall, TaysideHealth was launched in January 2015.  In the 31 weeks that have since passed the blog has attracted 290 followers, received 3,620 hits and been viewed in 44 countries around the world; an achievement of which we are very proud.

Credit for this early success is undoubtedly due to the individuals who kindly accepted an invitation to contribute a blog in which they shared their knowledge, skills and experience of health topics for which they have a passion.  Thank you to each and every one.

From today however, TaysideHealth is pausing publication of its weekly blog.  Instead, you may wish to consider following AHPscotblog (Mondays), Ayrshirehealth (Wednesdays), Letstalkaboutdementia (Thursdays) and, or, DGhealth (Fridays).

Thank you for reading TaysideHealth.

‘Til we meet again …

 

 

Terrence Higgins Trust Scotland by Kevin Ditcham

Terrence Higgins Trust (THT) is the UK’s leading HIV and sexual health charity. Founded in 1982, THT has been at the forefront of the HIV epidemic for the past 30 years.

When Terry Higgins died with AIDS on 4th July 1982, his friends and partner took the love they had for him and the anger they felt at what he had gone through, and decided to make a change. They founded Terrence Higgins Trust in his name so that others wouldn’t have to suffer the way he had suffered.

From just a handful of people, our charity has grown to become the UK’s leading voice on HIV and sexual health. We have staffed phone lines, stuck up posters and visited schools. We have launched clinics, counselling services, youth groups and websites and we have held the Government to account. For a time we helped people to die with dignity, but for the last 15 years we have helped those with HIV to live their lives to the fullest.

Today there are more people living with HIV than ever before and the latest figures show that there are now over 107,000 with the condition in the UK alone. Of these, a quarter are unaware that they’re infected.

For many people, HIV is perceived as something which has either gone away, is not relevant to them or is something that happens thousands of miles away in developing countries. The reality is that men and women from all walks of life are living with the virus and many more are at risk of infection. It is therefore vital that THT continues to deliver targeted prevention programmes, particularly for young people, and continues to raise awareness of HIV and other STIs, as well as providing direct services to people living with HIV.

Our vision is a world where people with HIV live healthy lives free from prejudice and discrimination, and good sexual health is a right and reality for all.

Terrence Higgins Trust’s mission is to:

• Maximise sexual health in the UK, and minimise the spread of HIV and STIs, by encouraging people to value their sexual health and by leading innovation to increase access to local sexual health services;
• Empower everyone living with HIV in the UK to maximise their health and wellbeing by working to ensure the best possible HIV treatment and support services;
• Lead public and political support for HIV and sexual health issues, and campaign to eradicate stigma and discrimination.

A national organisation helping improve the lives of people in Scotland:

Much has changed since the early days of HIV and as the shape of the epidemic has changed, so has the Trust. Our existing services across Scotland have been developed and we have introduced new services which are modern and innovative, thus meeting with the changing needs of people living with or affected by HIV and poor sexual health.

We are  a national organisation with stability and infrastructure but have local roots, embedded within communities all across Scotland. We are confident that this ensures a long-term response to the HIV and sexual health needs of the people of Scotland.

THT offer a range of practical, community-based services in Scotland, which include:

• Support services, such as mentoring for people living with HIV
• Counselling, advice and information
• Health promotion work targeting key at-risk groups
• HIV and STI testing services

We have a strong track record of delivering a successful programme of services in Scotland and with limited statutory income; most of our services in the country are funded through voluntary charitable donations. Voluntary donations recently enabled us to launch a postal HIV testing service for anyone, living anywhere, in Scotland. This was the first of its kind and was only made possible thanks to the generous support of our donors.

This new project, Fastest Direct, was developed following extensive research carried out by THT which showed that some people at risk of HIV would be more likely to test, or to test more regularly, if they could test themselves at home. There are 6,000 people living with HIV in Scotland and it’s estimated that 24% of this population remain undiagnosed. People who are diagnosed with HIV today can expect to live a long and healthy life. However, late diagnosis can make it harder for treatment to work effectively and increases the risk of onward transmission due to lack of knowledge of one’s HIV status. It has been estimated that a large proportion of overall HIV transmission is due to people who are not aware of their diagnosis. By improving the availability of testing, THT hopes to reduce the levels of undiagnosed HIV in Scotland and in turn reduce the chances of further onward transmission.

Research shows that reluctance to test in a clinical setting can typically be down to time pressure, the stigma of being seen at a GUM clinic or discomfort when talking about sexual history with a medical practitioner. THT developed the postal testing service to enable all people, including those in rural locations and young people, to access HIV testing. So far, it has helped us to access people who have previously been difficult to reach with conventional testing services and health promotion activities, from Shetland to the Borders.

Launched in November 2014, Fastest Direct has been a huge success, with around 700 test kits already sent out,  and we think it is a strong example of the amazing things we can achieve through being efficient with our funds and by being innovative and needs-led. Anyone in Scotland can order an HIV test from www.tht.org.uk/fastest. We’d encourage you to order one and take a test for yourself!

We recognise assets!

We are a huge believer in asset-based approaches in all aspects of what we do. Whether this is about one to one support with individuals, empowering them to take greater influence in managing their health, or working with volunteers; releasing their potential and capabilities. We recognise that everyone has assets, even if they don’t realise it yet. It’s our mission to work with people in providing the best outcomes for individuals and communities. Volunteers play a huge part in what we do and we really couldn’t achieve so much without them! Volunteers in Scotland support us in working with communities, health promotion work, staffing clinics, doing HIV testing, working on our phone line (THT Direct) as well as talking about HIV with their peers – one of the best ways to challenge the stigma!

If you’d like to find out about our work in Tayside, visit www.tht.org.uk/scotland. Follow us on Twitter or Facebook. You can also email info.dundee@tht.org.uk.

Samaritans by Jo Ahern

For over fifty years, Samaritans of Dundee has been there for people who are in distress and in need of someone to talk to and non-judgemental, unconditional support. Opened in 1962, our branch now has 50 volunteers offering round the clock support via telephone, email, text message and even face-to-face, to anyone who may be struggling to cope.

What is remarkable is that the service is delivered entirely by volunteers, with over a 1000 in Scotland joining the 20,000-plus members across the UK and the Republic of Ireland. The charity is always looking to recruit more volunteers to help us continue this crucial service, and Samaritans of Dundee is no exception. Our volunteers are the lifeblood of Samaritans, and each member of the branch plays a vital part in helping us to support people who are struggling, from those answering the phones, texts and emails, to those who help us by raising money for us at local events and promoting our work in the community. We are a charity, and we hold those people who support us, in many, many wonderful ways, very close to our hearts indeed.

Some of our Samaritans are non-listening support volunteers, and these lovely people help keep our service living and breathing by taking care of our finances, building maintenance, and even kindly making sure that we have teabags, coffee and the ever-essential biscuits for the times that we are on shift, listening to our callers. However, when the phone rings, the coffee goes cold and the tea is forgotten . . . The callers and the calls are what we are there for.

Our trained volunteers are ordinary people from all walks of life; they listen and, because our service is totally confidential, it allows our callers to talk about things that they might be too worried about to share with friends or family. They appreciate a safe, non-judgemental environment to explore their options and how they feel – without having to worry about upsetting the other person. For many of our callers we are a sounding board, a place where they can ‘test-run’ their lead up to conversation that they need or want to have. Sometimes, the callers talk to us about events, feelings and subjects that they have never talked about before and may never mention again, but for many people who contact Samaritans, knowing that they have someone they can talk to helps.

For many of our callers, we can be the first port of call when they are feeling low. By giving them the time to talk, they can sort through their feelings and find a way forward that is right for them. Some callers contact us when obstacles, hurts and and painful events have taken a toll on them, but in talking to us, we always hope to reassure them that we are there for them – no matter what . . .

Although best known for offering a 24 hour helpline, Samaritans’ work extends beyond the branches. Dundee Samaritans support a Prison Listener Scheme at HMP Castle Huntly, training prisoners to become Listeners, so that they can offer confidential support to fellow inmates. Samaritans also head out into the community with ‘Feet on the Street’. We visit shopping centres, supermarkets, community centres, wellbeing fairs, make ourselves available outside nightclubs – and basically anywhere else we are invited to attend or feel that we might be of some use. We have had stalls at freshers’ fairs and colleges and universities, visited with rotary clubs and rural groups, and we have spoken with university groups and societies. Our talks team are always happy to respond to invitations and are always so well looked after by our hosts!

Spreading the word that we are here to support people in distress is so important to us, and our national and local campaigns reflect this. Our Talk To Us campaign, which runs annually throughout July, is as genuine and as straightforward as it sounds. We are encouraging people to talk to us. We want to let people know that anyone can contact Samaritans, whoever they are, however they are feeling, and whatever life has done to them. They can talk in confidence by phone, email, text or face to face, about whatever’s troubling them.

You don’t have to be suicidal to talk to Samaritans . . . Everyone struggles at some point, or feels overwhelmed by what’s happening in their lives. It can feel difficult to talk, even to people you feel close to. Our volunteers are here to listen, round the clock, every day of the year, to help you work through your problems.

It might be a life-changing event like a relationship breakdown, redundancy or bereavement. But work, study, family, friends, finances, housing, health, sexuality and loneliness are just some of the things you can talk to us about. You can talk to us, and we will listen.

During July, on the 24th of the 7th month, we also take the opportunity to remind people that they can talk to a Samaritan 24/7, that is every hour of the day and night, every day of the year . . . There is always a Samaritan there to take your call. So please phone. Talk to us . . .

You can contact Samaritans at any time of the day or night by calling 08457 90 90 90 or contacting Dundee Samaritans on 01382 832555. You can also email Samaritans via jo@samaritans.org. If you would like to learn more about Samaritans, their work and their campaigns, visit www.samaritans.org.

If you are interested in volunteering with Dundee Samaritans, we would love to hear from you. Contact the Dundee Branch on 01382 832555.

Jo Ahern is the Chairperson at Samaritans of Dundee.

Listening to Music – a behavioural immunogen? by Jeff Hooper

I am a music therapist working with adults who have a learning disability. For thirty years, I have observed the physical, social and psychological benefits of making music (singing and playing instruments) with often very withdrawn and isolated people. Music therapy is about reaching out and the most special moments are when people connect with me, and with each other, through music. It still thrills me when sharing a guitar draws a moments eye-contact from a very withdrawn person, or when, by first supporting their music-making and then by encouraging them to explore new ways of expressing themselves, there in a growing sense of synchronicity as I play music either with one or with a small group of clients.That’s an active approach to music therapy, but I have always been very aware of the treatment potential of something as relatively simple and, with the advent of MP3 players, remarkably inexpensive as listening to music (or, to give it its correct title, receptive music therapy).

During my postgraduate training (1984-85) I was immediately struck by the way music therapy changed behaviour. It was then I first became aware that music could engage withdrawn and unmotivated people. It was then I first became aware that both singing and playing an instrument provided ways of developing non-musical skills that enhanced social, communicative and physical abilities. At the time (1985), I wrote this about Christine.

“Christine had been a patient in a large institution for mentally handicapped adults for over twenty years, and lacking stimulation from and effect on her environment she had become unmotivated and withdrawn. In music therapy I found that she responded to nursery songs and sang with me as I played on the piano. She had suffered a road traffic accident at six years of age which accounted for this response. It was interesting to observe how her behaviour changed when given a microphone to increase the volume of the sound she produced. Suddenly aware that she was having some affect and success in this situation a volte-face occurred – she became very motivated and less withdrawn”.

However, an afternoon with Mark on my first placement in a large psychiatric hospital made the greatest impression. On that occasion, I noted how people often became more relaxed and less agitated as they listened to music. At the time (1984), I wrote this about Mark.

“Mark was on an admission ward, he was about twenty-years-old and amazingly tense – like a coiled spring in fact. Nevertheless, it was encouraging to see him relax as the therapist played Bach’s ‘Jesu Joy of Man’s Desiring’ on the piano. His hands, that had been rigid, curved naturally. All the tension left his face and with his eyes closed he moved from side to side in time with the music”.

I was convinced then that receptive, listening, music therapy was a valuable intervention, and I remain convinced. Consequently, I have used receptive music therapy throughout my time as a clinician. I have found that it can alleviate an individual’s anxiety as they first become involved in music therapy and that it can have a calming influence when someone is over stimulated or agitated. I have completed several investigations examining the impact of music therapy, both active and receptive, on people with a learning disability. These investigations culminated in a substantial piece of work that demonstrated some value in introducing calming music into the mealtime environment at a time when people with a learning disability are more anxious.

I am an advocate of receptive music therapy and, as such, I have been encouraged to read how music listening is being used with people at both ends of the age spectrum. At one end of the scale lullabies are being used to reduce the pain experienced by babies with cardiac and/or respiratory problems, while at the other Playlist for Life is transforming the lives of people with dementia and their carers. It helps rebuild relationships by using MP3 players to relay carefully chosen music of special significance to the dementia sufferer. Furthermore, although effectiveness data is mixed, there is a growing belief that post-operative pain can be eased by the distraction of listening to your favourite music and consequently it is recommended in acute pain management guidelines as a way of managing moderate postoperative pain in conjunction with opioids.

The study of health behaviour has focused on behaviours that protect health. These behavioural immunogens are lifestyle choices or patterns of behaviours associated with greater longevity and decreased risk for illness. They are things like not smoking, brushing your teeth, getting regular exercise, using safety belts, good sleeping habits and so on. I wonder, given the widening application of music listening, should it be added to this list so that the interventions presented in these pictures become more common place?

Togs for Tots by Jordan Butler

What is Togs for Tots?

Togs for Tots is a non-profit organisation serving Dundee and the surrounding areas. The aim is to be the ‘go-to’ service for families struggling to provide essential clothing and equipment for their children (any baby or child classed as a dependant).

How does it work?

Togs for Tots runs similarly to the foodbank concept: Donations are collected from the general public then matched up with referrals from professional bodies that we work with. Clothes are accepted for all ages of children, in addition to maternity wear, bedding and essential equipment such as prams, cots and high chairs.

How can I refer?

Togs for Tots endeavour to ensure that the right people know about this service so they can refer as they need to. We accept referrals from :

• Healthcare professionals
• Charities
• Non profit organisations
• Toddlers/ kids group leaders
• School and nursery staff
• Volunteers/ befrienders
• Council staff who work with families
• Job and government advice centres
• Social and Support workers

The referral form is online and very user-friendly.  It can be filled out and submitted from any mobile device, without having to attach to email.  All referrals are processed in the strictest of confidence.

Success of the Project

This new project has quickly built momentum in Dundee with hundreds of donations received and a facebook page with 2000 followers. Most importantly, 50 children across the area have been provided for. The project is confident that many more can be helped, by way of spreading the word of this service. Some feedback from our completed referrals:

“Thank you so much! The service was so great and the delivery was super efficient. Will definitely use this referral again.”

“Absolutely delighted with the service you deliver. The referral was quickly received and then distributed. Good quality equipment and clothing was passed over to the family who were over the moon and very grateful.”

“On behalf of the family I am working with, thanks again. A small act of kindness goes a long way :- )”

Where can I find out more information?

Sign up to our Facebook page or email togsfortotsdundee@gmail.com

#WhyWeDoResearch Campaign by Michael Keeling

Well here goes … my first attempt at writing a blog and what better subject than the power of social media and the #whywedoresearch campaign.

I was definitely a non-believer with all things social media.  I did not get Friends Reunite, why would I want to be back in touch with people that I haven’t kept in touch with?  I was on Facebook, but I did not really get it, and the thought that social media could be used positively as a professional tool, well it made no sense to me.

All that said, I was persuaded to take a look at Twitter and its use to me professionally.  My professional role is that of a Research Nurse, a role that has been invisible to many, and yet so integral to the development of evidence based practice.  So with the help of my daughter, I set up my Twitter account, @keeling_michael and the rest as they say is history!  What a fantastic forum I had discovered, to learn, share and connect with individuals, not just in the same office, the same ward, the same hospital, the same city … But all around the world … and to do this in 140 characters or less!  This was a struggle as I am prone to waffling!

Anyway, there I was, tweeting away, when I came across a tweet from @clairegibbsuk.  Now I knew Claire through Twitter, a fellow research nurse, however this tweet was different.  It had a picture attached, with the #whywedoresearch, and immediately caught my eye as it was a simple concept, a photo of the individual holding a placard explaining in their words, why we do research.

The concept was simple.  Claire, and colleague Abby, came up with the #whywedoresearch with the aim to raise awareness of research and the research team locally within their workplace at the James Paget University Hospitals Foundation Trust.  I was excited!  I could see the potential of the #whywedoresearch and joined in, tweeting from both my account and the Stroke Research account at @strokeythft, asking individuals involved with stroke research locally to share their #whywedoresearch.  The Stroke team embraced the campaign, all members of the team joined in, sharing their words.  In December, I was kindly invited by Claire to become a national collaborator for the campaign.  My answer was a resounding “YES!”

The #whywedoresearch started gaining momentum, more individuals, trusts, charities and organisations got involved.  What started as a local campaign quickly spread nationally.  At which point we decided to create a video and post it on YouTube .   This was a great success and received 400 views in its first week and at present just over 1200 views.

#whywedoresearch continued to grow and further its reach internationally with 14 countries to date involved.  To build upon the momentum generated by the last video, we decided to produce another, showing the development from a local campaign to a global campaign, and similar to the previous one Local to Global was launched on YouTube .

As the campaign has grown, we have recruited more collaborators, with the role to champion the campaign in their country, and have recently introduced the ambassador role to champion the campaign locally within the individuals’ organisation.

What has the campaign achieved?  Many positives.  Personally what I feel is amazing is the sense of community #whywedoresearch has created.  Twitter has allowed hierarchies to disappear, for patients, public, individuals, families, organisations, staff all to contribute and join the conversation, and have a voice in why we do research.  It has even been used in a school for learning about research.

We recently had an article published in the Nursing Times; I’ve never been published before!

Nearly 3000 separate accounts have joined in with #whywedoresearch; it now has over 25,000,ooo impressions on Twitter worldwide.  I have been completely bowled over by the enthusiasm for the campaign and humbled by peoples’ generosity in sharing what are often very personal thoughts.  Friendships have developed, as well as professional networks, connecting like minded individuals across the globe.  But above all, #whywedoresearch has created a fun way for all to get involved with raising the profile of research.

It has been an amazing journey, one that has been undertaken in our own time, one that is far from over, so please, feel free to join in the conversation and help raise awareness of research … oh and have some fun in doing so!

Michael Keeling is a Research Nurse working in stroke research developing patient centred services.  He is also a co-administrator for @resnurse @strokeythft #crnurse and National Collaborator for #whywedoresearch

Follow Michael on Twitter: @keeling_michael and join in the campaign at #whywedoresearch

STOP PRESS: Register for the Scottish Research Nurses and Coordinators Network (SRNCN), 30 October 2015 in Dundee #crnurse @SRNCN1  fb.me/71mFiv0eB

Bumblebees: Making the Impossible Possible by Teresa Chinn MBE RN

I recently came across this on my Facebook page and felt immediately drawn to it, not only is the picture what some might describe as “colourful content” but also I feel that it’s a very wise little quote.

The reason it caught my eye was that I am starting to believe that the use of social media in health and social care is a little Bumblebee-esque (I’m not sure if that’s a real word, but I am going with it!) in that it works but I am not sure it should!

I’m a nurse, and I have been a nurse for some (ahem) 19 years now and the reason I started tweeting and blogging is purely because of my love of nursing.  5 years ago I was working as an agency nurse and feeling pretty disenchanted, although agency nursing worked for my family (with three children and a husband who worked away having a full time role was pretty impossible) it didn’t really work for me professionally.  All the coming and going, hopping in and out and filling in here and there meant that I really never had anyone to hold a professional conversation with and professional support was non existent.  Then there was the CPD, or lack thereof, CPD was really down to me to source, access and pay for – which at times was tough.

In order to connect with other nurses, and after some gentle persuasion from my husband, I started blogging and tweeting, my first blog was “Is there anybody out there?” and rather poignantly reached out and asked if there were any nurses out there like me. Through Twitter conversations and blogging I slowly discovered that there were lots of nurses out there, who, like me, wanted to connect and share ideas, knowledge, information, expertise, resources and support.

Through a few discussions and email exchanges the need for something more structured and organised came to life and @WeNurses  was created – a regular Twitter chat around a pre determined subject in order to help share knowledge, ideas, experiences and support.  The first chat we held had 18 people take part and since then it’s just grown and grown and become a really vibrant community of nurses that now number over 34 thousand. The picture below is taken from Symplur’s Healthcare Hashtag Project and shows some of the big numbers behind the community.

However its often not the big numbers that really show the value of the community but the 140 character tweets that tell personal stories of how social media has helped nurses:

The wonderful thing about social media, and Twitter in particular, is that as communities grow more people become aware of them and want to join in or develop a similar thing for their own areas of interest.  The passion that is shared very openly by the WeNurses community has been seen by other professions and as a result there is now a community of professional communities – WeCommunities now includes: @WeMidwives, @WeCommissioners, @WeDocs, @WePharmacists, @WeParamedics, @WeAHPs and of course the many branches of nursing: @WeMHnurses, @WeLDnurses, @WeCYPnurses, @WeGPNs, @WeSchoolNurses and @WeDistrictNurses

I often hear myself saying to people that the reason why Twitter works so well for health care professionals is that it gives us access to global expertise in the palm of our hand and this really is the case.  We only have to look at @WeSchoolNurses to see evidence of this; school nurses are a very small branch of nursing, yet they have a strong voice on Twitter that is on a global scale.  The map below shows the extent and reach of @WeSchoolNurses followers.

                           (Map from Followerwonk)

Due to the open nature of Twitter a conversation is rarely hidden from view and the sharing of knowledge across geographical locations is commonplace. With “open space” conversations anyone from anywhere can join in .. and they do!

So is all this just chit chat? Does it have any real value? What about the evidence base? In a survey of WeNurses followers last year it was great to see that people did find value in Twitter and it affected practice.

(Graph from Survey Monkey)

In addition to this participants of discussions are now encouraged to use evidence to back up what they are saying, through the use of the hashtag #EBP but often what people are saying, their experience of practice is in itself evidence – practice based evidence.  However, we are always looking for new and different ways of doing things and one such opportunity came up recently to help bring more evidence and research into Twitter.  In conjunction with Cochrane UK, CASP and The Mental Elf we have now launched #WeCATS – which is a Critical Appriasal Twitter Session that aims to take a randomised control trial and do a speedy appraisal of it on Twitter over the course of an hour.  It’s quite exciting and we hope that it will de mystify the whole critical appraisal process.

Holding a conversation in 140 characters with up to 260 HCPs over one hour is amazingly powerful, inspiring and innovative stuff.  Connecting of people, sharing of stories, knowledge, information, resources and expertise and discussing that over an hour in limited text shouldn’t work, not only on a professional level i.e. the risk element of putting oneself in a very public space and the worry of “what if I say something wrong” but also it seems a lot like herding cats … totally impossible!

However it works!!  – my gut feeling is it’s like the bumblebee, if we don’t let on that it shouldn’t work then everyone will just keep on going anyway.  Social Media use within health and social care is all about making the impossible possible, so I applaud all of those un- aerodynamic but nevertheless flying bumblebees out there … lets keep innovating, lets keep exploring this space and lets fly high.

Teresa Chinn MBE RN can be followed on Twitter @AgencyNurse

Teresa is also the founder of @WeNurses

The 50th anniversary of The Winston Churchill Memorial Trust by Shelagh Creegan

Shelagh Creegan, an occupational therapist from Dundee, attended a special event at Sir Winston Churchill’s birthplace of Blenheim Palace, on Wednesday 27th May, to mark the 50th anniversary of his living legacy – The Winston Churchill Memorial Trust (WCMT), and 50 years since his passing.

 Shelagh went on her Travelling Fellowship in 1993 to USA and Canada to investigate vocational programmes for adults with a severe and enduring mental health condition.  Her visits to a range of programme models clearly demonstrated that employability is achievable if the person is provided with appropriate services and support.

From the institutionalised care of the 20th Century, fast forward to 2015 and Scotland’s dynamic health and care policy environment has focused its ambition on delivering integrated health and social care, reducing or removing the damaging impacts of health inequalities and ensuring the provision of safe, effective and person centred care for everyone accessing health and care services.  The strategic and operational contributions allied health professionals (AHPs) make to progressing this policy agenda is clearly set out in the national AHP delivery plan,  AHPs as Agents of Change in Health and Social care.

Mental health is a core component of this policy context, spearheaded by the Mental Health Strategy for Scotland: 2011-2015 and Scotland’s National Dementia Strategy 2013-2016.  Realising Potential, launched in 2010, explicitly set out the role AHPs can play in supporting people with mental health problems and their carers and improving mental health and wellbeing in Scotland.

The new ways of working Realising Potential promoted – co-production, intersectoral partnerships and collaboration, person centred approaches and self-management – are very much in tune with the wider policy agenda.  Notable success has been achieved in the promotion of vocational rehabilitation with AHPs adopting a range of creative approaches that are enabling people with a mental health condition to maximise their potential and achieve their aspirations.

For example, the national Strategic Mental Health AHP Leadership  Group has supported the creation of a national vocational rehabilitation network with an AHP vocational rehabilitation lead identified for each Health Board.  In Tayside, as in many Health Board areas, this has led to the development of a local vocational rehabilitation network which has focused on improving clinical governance and the development and implementation of evidence based practice including :

• creation of a Tayside page on the national Good Work: Good Health, Knowledge Network, VR Community of Practice
• training for all mental health occupational therapists in the standardised work assessment, the worker role interview (WRI)
• training of a small number of AHPs in the Individual Placement Support (IPS) model with the intention being to roll out IPS programmes across Tayside to support people with a mental health condition into paid employment
• development and testing of an employability pathway
• collaboration with local colleges to deliver supported education programmes improving access for people with a mental health conditon into further education
• supporting people in forensic and adult mental health services to develop employability skills through engagement with local social enterprise companies
• through volunteering, the development of work habits, routines and skills in preparation for return to work
• the provision of work placements for NHS Tayside Healthcare Academy students
• showcasing best practice at national conferences and publications

Returning to the special event and over 1000 Fellows and their guests, from every decade since 1965 attended the day, which was hosted by the Duke of Marlborough’s sister – Lady Henrietta Spencer-Churchill, who is herself a generational cousin of Sir Winston, and a member of the WCMT Advisory Council.

Shelagh joined a small gathering of Scottish Fellows at Blenheim Palace.  It was a wonderful opportunity to renew old acquaintances before going on to meet Fellows from all parts of the United Kingdom.  The rich diversity of Fellows travel experiences, the learning gained and the leadership displayed in translating evidence into practice was truly inspiring.

Members of the Churchill family, including Sir Winston’s grandson Jeremy Soames; and his great-grandson, Randolph, were also present; as well as many of the Trustees and Advisory Council from the WCMT.

Highlights of the day included presentations given by Fellows from 1968 to 2014, about how their Fellowship has shaped their lives and careers.  Internationally acclaimed Churchill experts, including historian Sir David Cannedine, also gave talks.

The special day was rounded off with a spectacular Spitfire Display, followed by Lady Henrietta Spencer-Churchill and Randolph Churchill taking the salute at a Beating Retreat given by a marching band.

Since 1965, over 5000 British citizens have been awarded Churchill Fellowships, from over 100,000 applicants, to travel overseas to study areas of topical and personal interest.  The knowledge and innovative ideas they bring back are widely shared, for the benefit of their profession, their community, and, in lots of cases, the nation.  For many people a Churchill Fellowship proves transformational, and they go on to achieve great things – effecting positive change within society.

To mark its half century, the Trust has awarded a record number of 150 Travelling Fellowships in 2015 – investing over £1.3m in British citizens.  This year’s Fellows will travel to 58 countries between them, across six continents, where they will carry out a wide range of projects.  The average length of a Fellowship is 6 weeks.

Many events are being held throughout the year to celebrate Sir Winston’s life and legacy.

“It is fitting to hold our 50th anniversary event at Blenheim Palace, and to come together with hundreds of Fellows from across the past 5 decades, to celebrate the life of this great leader.  Sir Winston’s legacy lives on through our Fellows – individuals who, like him, have vision, leadership, a passion with a purpose, and a commitment to help their fellow citizens” says Jamie Balfour, Director General of The Winston Churchill Memorial Trust.

For further information please contact:

The Winston Churchill Memorial Trust on 020 7799  1660 or http://www.wcmt.org.uk or @wcmtuk

Shelagh Creegan is the Associate AHP Director for Mental Health and Learning Disabilities with NHS Tayside.  Email: screegan@nhs.net  Twitter: @ShelaghAHP

References

AHPs as Agents of Change in Health and Social 2012-2015 Care  www.gov.scot/resource/0039/00395491.pdf

Mental Health Strategy for Scotland: 2011-2015 http://www.gov.scot/resource/doc/357051/0120639.pdf

Scotland’s National Dementia Strategy 2013-2016      www.gov.scot/Topics/Health/Services

Realising potential 2010 http://www.gov.scot/resource/doc/314891/0100066.pdf

Can you see what I mean? by Laorag Hunter

My definition of successful communication is broad. For me, successful communication is communication that works. Simply put, a message “works” when the person I am communicating with gets the meaning I intended. When you hear, read or see something and communication “works” you have a confidence that I call the “I see what you mean” feeling.

My closing the office routine includes checking the answering machine. On Friday I am glad there is only one message, thinking that it won’t take up much time. The message is from a female asking me to call her on a specific number. Perhaps she’s also in a rush to start the weekend as her message is delivered at high speed.

The message starts well enough, “Please can Mrs Hunter call…..” but then I am not sure if she says Liz, Louise, Lois or perhaps even Lesley on “01382……” I can only think it is numbers something, something, something and something as she reels the figures off so fast that there is no way I can remember them (especially while I am still trying to work out the Louise/Liz/Lois part). I don’t recognise the voice.

Three listenings later I have finally got the number by writing each digit down as quickly as I can, but the name still eludes me. I am left feeling irritated at the time this has taken and mildly concerned that without knowing the name I have no clue as to what it is about. However, at least I think I have got the phone number and that might be sufficient to respond. Having got part of the message reminds me that understanding is not all or nothing, and that it comes in degrees or shades of grey.

My machinery for understanding is, as far as I know, only mildly impaired. I have some reduction of visual acuity (correctable by glasses). My hearing is good and my knowledge of word meanings is reasonable, above average in some topics (such as knitting) and poor in others (such as musical terminology). My speed of understanding is variable and I notice that I like radio presenters with a slightly slower speed of delivery (for example, Eleanor Bradford, the BBC health correspondent goes at a comfy speed for me). If I am tired, then I really don’t cope well with words coming thick and fast. It’s a double whammy if the subject matter is a difficult or unfamiliar one and causes the disturbing “in the dark“ feeling. And, I know that when I have something on my mind or my anxiety is raised I also can’t process messages so efficiently.

My capacity to understand is robust in comparison to the people with aphasia who I work with everyday. Aphasia describes difficulties using and understanding language and is a common consequence of stroke, head injury or brain illness. Recent mainstream publications have done much to improve recognition and understanding of aphasia. I recommend Grace Maxwell’s account of her husband Edwin Collin’s brain haemorrhage and rehabilitation, and neurologist Jill Bolte-Taylor’s personal account of her own stroke and aphasia. Jill Bolte-Taylor’s TED Talk has had 16 million views (please do watch this fascinating talk if you are not one of the 16M). Difficulty using language is the most obvious feature of aphasia. Communication partners can see and hear any struggle for words; mis-pronunciations; word substitutions such as saying “tiger” when meaning “cat” or replacing words with nods, sounds, gesture and pointing. Understanding cannot be seen; it is a private matter and the tendency for communication partners to over-estimate understanding leads to problems.

Some examples from patients who have recovered enough expressive speech to describe their problems with understanding help to illustrate this.

• “Judy said to me put on your armani. armani? What on earth is my armani? I don’t know what she means.”
• Jim puzzles over the word grapefruit. “Grapefruit? That word seems remote to me as if it is somewhere out there on a headland.”
• Susan is shocked when the waiter brings her a plate piled with various seafood (she hates fish). When Susan chose “fisherman’s platter”, in her mind she saw a plate of cheeses, breads and pickles. In her mental store of word meanings, she has connected Fisherman’s platter onto her entry for Ploughman’s lunch.
• Martin doesn’t understand the instructions the consultant has given him verbally at his recent consultations to increase one epilepsy medication and reduce another. The consultant is frustrated with what he wrongly perceives to be a lack of compliance.

Some people with aphasia are able to indicate they have difficulty understanding. One gentleman, Eddie, makes a sweeping gesture backwards above his head to express an idea along the lines of “the words are going over my head.” Not all people with aphasia are able or willing to admit they don’t understand. Jill Bolte-Taylor cautions partners to “be aware that I may want you to think I understand more than I do.” For any individual, with or without aphasia, admitting to being somewhere in “shades of grey” of understanding might be avoided in order to save face. Admission of comprehension failure can provoke feelings of shame and associations with lack of competence. Eddie has got it sussed. He recognises that the incompetence rests with an environment that doesn’t provide the support he needs for his communication, both his understanding and expression, to be the best it can be.

There is much you can do to increase the likelihood that the receiver “sees what you mean.” Another analogy from a patient likens this to cleaning a dirty window, “suddenly it cleans and I can see it.” Here are just 10 tips on how to clean up your communication so that more people get more meaning from your messages. You may notice these are all things that assist your own understanding.

1. Be unhurried. Communicate that you have plenty of time, give the individual your full attention, be friendly and behave in a way that puts people at ease.
2. If you are not sure, ask the individual if they need any special help with communication.
3. Say things more than once and chunk information into bits to avoid information overload.
4. Make the topic clear, perhaps even writing it down. Give a little extra information to help make sure the topic is understood, for example Judy quoted above could have said “wear your Armani, it smells wonderful.”
5. Write down key words while you speak or write down important information for people to take away and re-read. Even if reading is compromised a combination of hearing and seeing words helps many people with aphasia.
6. Use technology to assist, for example, make documents so that computers and digital devices can speak the text; use sub-titles on TV and YouTube videos. Record your instructions or messages into the person’s phone so they can listen to it as often as they need.
7. Add an illustration to your communication, a drawing, diagram, symbol, photograph or map. Use cameras in mobile devices to give people images they can take away to help them understand, such as an exercise sequence.
8. Show as well as tell when possible. Maybe you have an image on your phone of the event or place you are talking about? Can you mix up a thickened drink while you talk through the instructions?
9. Speak clearly and write legibly (have you ever been unable to read your own writing?).
10. Use clear signs in departments with symbols that are commonly recognised.

More detail with signposts to useful resources can be found at the Talk for Scotland Toolkit and the Stroke Association Accessible Information Guidelines.

There isn’t one solution and it is unrealistic to believe that strategies like those above guarantee understanding. The goal is to provide the support that best helps that individual to understand at the highest level of clarity they can.

Finally, if you do leave a message on my phone, especially if it is a phone number, a name or a CHI please speak Notlikethis But like this.

Laorag Hunter is a Speech and Language Therapist at NHS Tayside’s Centre for Brain Injury Rehabilitation.  You can follow her on Twitter @LaoragHunter

June is “Speak about Aphasia month”. If you would like to learn more about aphasia these are the books Laorag mentions in her blog.

Maxwell, Grace (2010). Falling and Laughing: the Restoration of Edwin Collins. Ebury Press.

Bolte Taylor, Jill (2009). My Stroke of Insight. Hodder Paperbacks.

The Home Based Memory Rehabilitation Programme by Emma Coutts

This blog was first published by our sister health blog, DGhealth in 2014.

When I took up my post as an Occupational Therapist (OT)  within the Mental Health, Substance Misuse and Learning Disability Service in NHS Dumfries and Galloway as a new graduate, I was unsure what to expect. Having had a placement within the service I was familiar with the client group and the team, however coming into this as an OT, is very different to being a student! And my first initial thought was ‘what will I be doing as an OT?’.

This is where the Home Based Memory Rehabilitation (HBMR) programme comes in! First suggested to myself and Corinna Sidebottom (OT, who started at the same time as me) back in 2012 as a possible piece of work we could develop within the service, who knew the success this would have?!

HBMR was originally developed in Belfast City Hospital in 2007 by Advanced Specialist OT Mary McGrath. It was developed as part of the cognitive rehabilitation approach for the treatment of people with acquired brain injury; however was found to be equally appropriate for the rehabilitation of cognitive deficits, including memory due to early stage Alzheimer’s disease.

It has been recognised that the main approach to helping people with memory difficulties to engage within their activities of daily living is to try to find ways to compensate for impaired memory, through memory rehabilitation strategies.

The idea of cognitive/memory rehabilitation interested me – we often associate rehabilitation with the likes of having had a broken bone and regaining the function within the specific limb, but we don’t commonly associate this in relation to Dementia (or at least, I didn’t!).

Cognitive rehab is defined as an individualised approach which should focus on real-life, functional problems a person experiences. Central to this, is an understanding of the person’s strengths, abilities and deficits from a holistic approach, which as a profession, incorporates our core beliefs.

So what exactly is the HBMR programme? And how as new band 5s, were we going to develop this and pilot it within our service? After various meetings we developed a modified version of Mary McGrath’s programme and we were then ready for a 6 month pilot.

Our HBMR Programme

The HBMR programme is a 4-6 week programme, delivered to the client, in their own home with caregiver/family support where appropriate. The pilot programme consisted of 4 sessions:

• Remember where you have put something
• Remember what people have told you
• Remember what you have to do
• Remembering people’s names and coping in social situations

Each session covered a range of memory strategies such as a memory book, memory board, post-its, safety checklist, using a calendar, medication checklist to name a few. These are all things any one of us could use within our daily lives to remind us of daily tasks.

The key to the programme is the structure and repetition of emphasis placed on the strategies and so each time a new session is delivered, all previous strategies are revisited to ensure the client is using these and is confident in doing so. It is this repetition that encourages new learned behaviours within people with early stage memory impairment and creates the habits that are more likely to be remembered as memory loss continues.

HBMR Programme – Pilot Results

Following our 6 month pilot, we compiled our evaluation – which in my opinion not only demonstrated the effectiveness of HBMR but also highlighted that people with early stage Dementia, can learn new skills!!

This graph clearly demonstrates that following completion of the programme, at 3 month review there was a significant increase in the number of memory strategies clients were using. And as a result, a slight decrease in the number of reported memory difficulties they experienced.

Our Success!

Since completion of our pilot we have been working on promoting HBMR and how we can further develop this.

A key highlight of the whole process for me has to be winning ‘Best Community Support Initiative’ at Scotland’s 2014 Dementia Awards in Glasgow. Although probably the most daunting, as this involved making a small speech!!

Our poster has also won at national events and was displayed within the poster presentation at Alzheimer Europe conference 2013.

The HBMR programme also features within Alzheimer Scotland’s ‘Allied Health Professionals Delivering Post-Diagnostic Support: Living Well with Dementia’ Publication.

The future of the HBMR programme

We are currently looking at how to develop the programme, with a view to sharing this locally and nationally. Since pilot completion, we have reconsidered the session topics and we have now created additional areas we feel are important to cover. The programme still takes place over 4-6 weeks however now covers the following areas:

• Remember your priorities
• Remember what people have told you
• Remember what you have to do
• Remember people’s names and coping in social situations
• Remember to keep your brain active
• Remember your bearings

We are also considering other possible ways to deliver the programme such as the use of technology.

We have also been looking into the branding of the programme and we hope to share this both locally and nationally.

I am probably very biased about the programme as I have been involved from the beginning but I hope reading about the effectiveness of HBMR has encouraged you to think about the ability to learn new skills in early stage Dementia and how this may impact on future practice … after all … Dementia is everyone’s business!!!

Emma Coutts is an Occupational Therapist in NHS Dumfries and Galloway.  You can follow her on Twitter @EmmaAHPDem or contact her at emma.coutts@nhs.net