#Occhat Nov 20th- Using equipment to facilitate occupation


I’m in the hotseat for the #occhat Twitter discussion tonight- and it’s been a while since I was able to facilitate, so I am looking forward to it and feeling anxious about it in equal measure!

Why are we looking at equipment?

One of our core skills as OTs is the prescription of environmental adaptations including adaptive equipment, so of course, we’re always interested in gadgets and things to make life easier.

As a disabled woman, I’m very grateful for some of the equipment that has become part of my everyday life, like my mobility scooter, or my bed stick. But equipment is much broader than just the stuff you can get through your local equipment store.

I consider my eye-Pad to be one of the best bits of adaptive equipment I have. It’s a multi-functional entertainment system, so if I’m ill, I can watch TV in bed, or catch up with my friends on social networks. If I have light sensitivity, I can alter the settings to make using it more comfortable. If there is nothing for it but to keep my eyes firmly closed, I can switch to listening to radio comedy or drama. This is brilliant for keeping me entertained and distracted from the pain when I am ill!

My children are able to use the features of the tablet to pinch, select, turn and type emails to their family, using a simple email app. They also play with their Moshi Monsters, dance to films on YouTube, and draw and make videos. They can do all this with me in my bed, when I’m ill- there is no bit of kit in the equipment store that you could say that about! So a tablet computer can help me to perform the life role of “Mum”, even when I have a disability that makes some activities very difficult indeed.

Image

I know people who use Siri as speech recognition software- where they have spasm or pain in their fingers, for instance. (p.s. if you have Siri, do ask him/her “Who let the dogs out?”- it’s very funny!)

But this isn’t an advert for Apple, and yes, other tablet computers are available (my partner loves his Google Nexus). We’re thinking about equipment in it’s broadest sense, and how it enables us to perform occupations and life roles.

COT partnering with Boots

We’re also prompted to consider this topic in the light of the recent announcement by the COT of the new partnership they have developed with Boots- please see http://www.cot.co.uk/homepage/new-partnership-puts-occupational-therapy-high-street

Do we think this promotes the benefits of OT to a wider audience?

Are there concerns related to this?

Does it help or hinder the public perception of OT to be linked so explicitly with equipment provision- after all, we do so much more?

I know you will have lots of brilliant examples of how equipment helps you to live life your way. You may also have opinions about COT partnering with Boots. To join in the conversation, please join us for our Twitter chat tonight at 8-9pm.

Just add #occhat to your tweets, so we can all see them. And do please remember your responsibilities related to your HPC registration when you Tweet.

See you there!

What would a “Recovery Hub” look like?


I’m currently starting to ask people in online spaces that I visit what would be useful tools for them in their recovery from periods of mental distress.

I want to post a copy of some conversations going on in groups I’m a member of on Facebook, where some really interesting points have been made. Do join in with this discussion- the question posed is:

I wondered if you would be interested in helping me to start a conversation about what services and resources are useful to people who are in recovery after experiencing mental distress?

I’m hoping to be able to prove that service users and carers have some great ideas that they should try to develop- can I ask you to share any ideas you have?

Some initial thoughts-

  • Physical space in a non nhs setting to meet up for a coffee
  • Education/self management resources available to look at or take away
  • Computers and online access to search for your own resources, or build your support networks
  • Staff could arrange to meet you there for appointments, if you didn’t want to go to an nhs building
  • Training for you to develop and run your own groups to support each other
  • Help with getting funding for mental health projects you’ve thought of
  • Access to volunteering
  • Access to paid work, delivering training, speaking about mental health, as peer support workers
  • An online resource, maybe a social network? you could log in from your phone or at home?

None of these solutions would be right for everyone, and I’m sure you’ve got your own ideas- what do you think would be helpful?

The results in so far:

if you suffer with social anxiety the thought of being placed in a group with other people is enough to put some one back in hospital.

me:  if someone has social anxiety, is it helpful to have a range of resources online rather than recommend them come to a physical group?

more services that do home visits would be good – if you have social anxiety, for example, it would help to get to know someone in a “safe” place like your own home, talk about barriers to getting out and then have support (for as long as needed) to go out and meet people.

me:  like a “parachute” service that could be called out to visit at home? would this be mental health staff, or trained peer workers?

main thing would be consistency so you can learn to trust someone and they can take you to different places – maybe with the aim of being able to meet up with people who have similar problems in future

One of my bugbears is the lack of recognition that if you are chronically sick you are more likely to be socially isolated and suffer from depression

me: And equally, people with mental health diagnoses have poor physical health- perhaps we could include this too?

i live in a part of the city where there are very few facilities if you have mental health problems apart from GPs. the support groups, charities, outreach centres etc are mainly on the other side of the city which don’t necessarily have direct bus routes from where i live. buses are difficult when you have social anxiety, going to places you don’t know can be too frightening, and i can’t drive because i have epilepsy. The churches don’t provide much if you’re under 60 but don’t have young children. it’s easy to lose touch with friends when you don’t go out to work and can’t cope with going to the pub.

A consortium of employers in the regional areas that can come together and universally employ an individual in that the individual isn’t committed to a single one employer. This would benefit those employers during there occasional busy days or seasonal times and have a higher success rating for actually being able to maintain some form of employment for the individual.

me: this is exactly what mobility DLA is for to cover costs due to your disability such as taxis for trips to support centres (I know it’s a rotten time to be a DLA applicant, btw) So, for people with social anxieties, it’s important to either have safe ways to travel to a physical centre or hub- or there could be “parachute” visits out into community, or there could be a certain amount of online support for days when physical travel is just too hard? Does that reflect what you’re saying well enough?

me: That’s interesting, xxxxxx, so in your model, people would be “signed up” a bit like signing up to an employment agency? Then they could be allocated work for days that they feel able to do work? Like, sign in by 10 am for today’s work? I’m guessing those people would have to keep records- would they be self-employed, or employed on zero hours contracts?

a friend of mine said a couple of weekends ago there must be loads od small, medium and large companies that have all manner of tasks on projects that someone working from home could do that are hugely time critical but in alarge project needs doing at some point, but project workers, managers etc wouldnt employ someone to do one task,l but if lots of employer could do to an agency that is task focused with all manner of people with skills and knowledge. they work for the agency and the agency make sure the work is done…

I’m against be forced to do work I don’t want just because I feel well on a good day, I want to work but it has to be stuff I want to do other wise my mental state suffers, and being poked and prodded to do work is just putting pressure on people which they don’t need when they are ill, they need to get well first.

me: Yes, the power should sit with the person who has the difficulty as they are best placed to know their own limits. But lots of people want to get back into it- even feel that forced inactivity makes them worse, so lets not assume that this is all part of a sinister way to shove everyone off benefits- I genuinely want to have this conversation and hope to develop a DPULO to respond to this.

me: A bit like this, http://www.taskrabbit.com/?

I make stuff at home I have about one good week in 3 where I manage to do stuff, the rest of the time I’m away with the fairy’s with anxiety much of the time or just resting as I suffer burn out. I would love to make money with my creativity, I have the skills but don’t produce enough of anything to make a living at this time.

Not an employment agency Claire they are a cost to the employers but a consortium of employers themself’s. More in the lines of a sponsorship employment.

yes in effect but for projects, businesses etc . My friend is a project manager, he has a tutorial guide to write, he doesn’t have time to do it but it has to be done before the project goes live. so he thought if he could assign it to an agency, who then finds the right person or offers it up to its clients and they say yes. then as long at is done by the end of the project say in 1 months time it doesn’t matter how long it takes as long as its done. there must be loads of tasks that need doing but no point employing 1 person for what is ordinarily a half-day job but to us is a big thing..

me: I was thinking WE could develop our own “agency” and supply people to work on projects? as part of the recovery process? would have to check out with DWP etc how it would work- but there should be a way of ensuring self-employment as a way for people to do some limited work, with Working Tax Credits as a back-up?

i have mobility DLA, but atm i’m too anxious to go somewhere that i don’t know at all. we could also do with drop-in centres for people who are fighting self-harm urges where they can get support and company. they could also have the ingredients to make that cake that the care team suggested you try …

an agency run by and for people with physical and mental health problems would be great.

Much of those things are already in place from the point of being a hospital patient to work therapy especially in my area any ways.

Not sure self-employment is the way forward especially with all the complexity of paperwork. Many simply wont be able to handle that.

if you have a problem with authority of any sort be self-employed, is an option, you can always get other people to do the paper work

The costs involved in forming agency’s will out weigh purpose and eventually fail.

At least if employers themself’s set this up people will have confidence that those employers are going to provide supportive environments from the outset.

me: I hope it’s okay with you guys, I’m capturing this (anonymised) conversation to keep it on record on my blog at claireot.wordpress.com

me: I agree, there are costs involved. It would be important to ensure we got funded to cover those costs. I think you’re right, we would have to get “sign up” from employers to provide work, but perhaps this would be an extension of the “Mindful Employer” project, or simply as part of their drive to reflect the diversity of the populations they work with?

An example. 33 employment positions I’ve been through in the past maintaining employment due to illness has been the biggest barrier. 18 of those employment positions had been with the same employer this despite walking out on that employer each of those 18 times due to having an illness. In between each of those employment positions faced sanctions of benefits time and time again. On the balance due to the sanctions it wasn’t actually worth carrying on with trying to gain employment as monies over the year balanced out no more than benefits any way.

me: yes, I think this experience is one many people will have shared. We started to work on this at the “Benefits Camp Hackday”. Our team were prototyping an app to use to enable people to show on a weekly basis what work they were able to do, and get their benefits calculated for weeks when they needed more support.

some where that would help do their paper work would encourage more people to start-up for themselves, and if someone failed to earn enough one week and some sort of system that paid and made up for the bad weeks would be good.

Very difficult to calculate an illness Claire one can be ill for months on end with no break then maybe only have a couple of good days. especially if part of the illness is that one is not able to measure time or unaware of time going by.

me: Yes, it is xxxxx and that’s why I think flexibility, and not “pushing” people before they’re ready would be important. But equally, it is important to set a “just right” challenge for people (e.g. as an OT that’s what the rehab would be aiming for) to help people along in their recovery. Perhaps what you’re picking up here is another, separate need, for early access to increased support when you feel like it’s slipping back again? Is that an accurate interpretation of what you’re saying?

Employer sponsorship at minimum based on existing individuals levels of benefits as an outset. With further sponsorship being paid above an achieved hours gained. With all sponsorship based on the level of minimum wage.

me: Hmm, I think this would need some thinking through. I’m not clear what employers would see that as a “good deal” for them, and it sounds a bit like “Workfare Plus”, can we have a bit of a think about how that would be attractive to employers to sign up?

I’d love to help in anyway I can and I think it’s a fantastic idea x

Far from workfare. If a group of employers came together and employed one individual in a coup sponsorship it would actually be cheaper for them all round paying the rate of minimum wage.

In another group, asking the same question,

having bosses who are supportive when you are going thru depression i had to walk from my job because i was not getting any support at all it was on ly when i did what i did then the support came but it was little bit late

me: That’s a great point. So, could a service be provided that helps employees to approach their mental health needs with their employers/ and a complementary service that educates employers how to manage sickness/ support for employees with mental health be part of the package (and stuff about Equality Act etc)? Could it be this is delivered by people who have been through it, who could call on staff expertise as needed? Or just staff? Or just peers?

i think bosses need to be sent on awareness courses to pick up on the first signs of depression it would have helped me big style if i was given the help from the get go i really would like to help others who are going thru what i went thru would like some more info claire it’s so good that your able to help people i wanna do the same maybe volunteering

me: I think for anyone with long-term illness or experience of mental distress, there’s so much we can offer to others who are going down the same road. And you’re right, there’s so much we could do to raise awareness for employers about how to retain staff who become well. Or better still, how to put things in place to protect their workers from becoming ill, if at all possible! So, I see there being a training need (we could deliver to employers) an advice need (for people going through it or carers) and a peer support or “buddy” need (to keep you going when times are tough)- but access to volunteering and even paid work opportunities to get involved with this stuff, not just sharing our stories for free.

I’m serious about this project. It’s clear to me that people with experiences of distress have every right to be involved in service re-design and they have valuable skills and experiences to contribute. I’m actively continuing to continue this conversation, and I would love to hear your views in the comments. Do feel free to comment anonymously if you prefer.

#benefitscamp hack day at Westminster Hub @FutureGov


I was intrigued to see the hack day advertised through my networks, hosted by the Westminster Hub and Future Gov, and the invite list looked like it contained a good mix of people from all different walks of life. I knew I wouldn’t be able to attend in person, so I thought I would test out my theory that it would be possible to participate in an event like this entirely online. The advertising led me to believe I wouldn’t be the only one participating in this way, so I thought it would be a great experience.

I also believed that my dual perspective as a healthcare professional and as a person with a disability and limiting condition meant that my insight might be of value to the group, although I wasn’t sure I was expert in any particular area. I thought that at the very least I could contribute my skills in group facilitation and help the other participants voices to be heard. So, with a mixture of excitement and trepidation, I waited for the day to approach.

I feel strongly that the population of this country support the right of its citizens to fair treatment and a basic level of income no matter what our personal circumstances are. It is my concern that we are facing a political narrative that the economic crises we face are as a result of an “overindulgent” welfare state. I disagree with this opinion. I believe that the welfare state guarantees the basis of many of our freedoms in this country, and is a marker of our civilization.

As a person with a disability, it is important for my self-esteem to work. However, I am unable to work in the way that I did before I became disabled. My situation is not unusual, I have met many people online who wish to have the right work- work which suits their personal circumstances, the adjustments they have to make to accommodate their health and disability, work that is supportive of their recovery and which promotes self-esteem and societal regard. This may, or may not, include paid work. Volunteering and community work, caring responsibilities, childcare, study, all these activities are grouped under the heading of “productivity” for occupational therapists, and when I discuss work, these activities are all implicit under that description.

The hack camp decided on several themes that were important to the people in the room and the people online. These were:

1. Money saving and sharing

2. Personal data

3. Local impact

4. Better communication / information

5. Collaboration and peer to peer support

6. Skills and volunteering

7. Jobs, flexible working and enterprise

8. Better admin

Through conversations with the people involved, I decided that the group that I most naturally belonged in was the jobs, flexible working and enterprise group.

Here is a little further description of the group aims:

7. Jobs, flexible working and enterprise: be allowed to get income from work around benefits system, home working for people with disabilities, support for people to start their own business, post a profile of yourself and make employers find you, new types of jobs as old work models outdated, confidence-building to encourage people to have confidence to apply for jobs

  • Home Work Net – “Bring your service back in house – Literally!” – Home Working
  • Bring in an enterprise scheme, reduced or no rate for 2/3 years.  Possible tax concessions
  • People allowed to work flexibly on benefits – like consultancy
  • You should be so lucky – profiles to show skills, employers come and find people – reverse recruitment
  • Welfare/benefits sat nav.  Given skills, it plots path through to desired job outcome based on what other people with similar skills have done
  • How can the benefits system better reflect the changing patterns of work – FLEXIBLE
  • How can we reduce the stress of the application process?
  • @janetedavis: confidence-building to encourage people to have confidence to apply for jobs (using social media/web)
  • @CathyAitchison: the concept of ‘jobs’ is outdated – need a way of thinking which counts/values all areas in a person’s life via a paid job, freelence, voluntary, care (family) – could an electronic system manage a person’s ‘credits’ of all kinds?

Participation in this group was incredible. The members of the group were spread all over the country, from the Isle of Wight to Newcastle, (@creativecrip @claireot @nancyrowena @janetedavis with two members on-site at the Westminster Hub (@Lisybabes and @Lucy_Watt)

Incredibly, within the space of an hour, our team had developed a website (currently kindly hosted by @creativecrip) which used a bespoke logo and presented our findings in blog format.

The site is still under construction, but provides a space where we may return to our findings and refine them with reference to future funding opportunities or other ways to develop our ideas. Having a skeleton site up and running in the short time available is, in itself, testament to the currently underused skills and abilities of people with disabilities, who are currently excluded from making choices in the jobs market that fit their circumstances.

We worked on our presentation as a Google Doc, which meant that it was hosted in the cloud and accessible to all of us for editing and commenting.

We talked about our presentation using Skype chat facility, which meant we were able to share our opinions and improvements for the project as we went along.

Our presentation was a mock-up of a user interface for a website or mobile application which detailed how we thought we should develop the ability for the benefits system to accommodate the various different work patterns likely for those with fluctuating conditions.
If you would like to view it, it is available below.

I have to mention the amazing job that Lucy and Lisa did in facilitating this in the physical space of the workshop. We online participants felt as involved as if we had been there in person- we had as much influence on the project development as the people in the room. I felt it was an important model of inclusive practice, which still seems to be an alien concept for so many events when simple adjustments such as these made our participation possible.

Participants in the group were:

Lucy Watt (@Lucy_Watt)

Lisa Egan (@Lisybabe)  http://wheresthebenefit.blogspot.com/

Lisa Ellwood (@CreativeCrip) http://uk.linkedin.com/in/iconicimagery

Nancy Farrell (@nancyrowina) http://www.nancythroughthelookingglass.blogspot.com/

Janet Davies (@janetedavies)

Using Facebook to foster social interaction in older people after acquired brain injury. Anita Hamilton 2011


I have found a great example of how we can use Social Media (in this case, Facebook) to foster social engagement in older adults after acquired brain injury.

As can be seen, as Occupational Therapists we need to look at Social Media such as Facebook and adapt and grade the activity of engaging with them in the same way we would with any offline activity. By instilling another layer of support, of educating in digital literacy, in enabling our clients to use motivational activity such as computer gaming; by these mechanisms we may enable recovery through Social Media as we would through any other OT activity.

Anita Hamilton can be found on Twitter as @VirtualOT

Excuse me, I think I just did a MOOC.


I stumbled across this description of a MOOC when reading this OT blog last week.

Blimey. I thought. That’s what I’ve been looking for. In fact, that’s what I’ve been doing!

In fact, I haven’t. Not by a long chalk. Helen has been participating in an incredible event, called #eduMOOC2011, which is an eight week course now into it’s fifth week. So it’s not exactly what I’ve been doing, but rather, something I wish I’d been doing…

It really is a great concept aiming to develop networked learning. This reminds me of how knowledge is spread through insect colonies.

In a bee hive, for instance, the various worker bees go out to find food. On their return , they perform little bee dances to tell the other hive members about what the food is, where it is, how far you have to fly, and all the other stuff bees like to know. Excuse my rather vague handle on this- I’m no entymologist!

My point is, that this is how social media works. Like the bees, we tell others in our networks where the good information is, and others then follow our pointers to events, to URLs, to engage in “clicktivism”, whatever.

Gradually we develop trusted networks for curation of content and they become a short-cut- we know we can trust their opinion on how useful the content is.

(Question- do bees ever tell lies about food? or do they have better and worse bees/colonies for successfully transmitting information? I would love to know!)

Over time, we develop networks of people who are looking for similar content. Like the bee hive, we are greater than the sum of our parts, because we can utilise far greater “processing power” by collaborating together online than we can as individuals.

Okay, I’m going to leave the analogy there, and talk about MOOC.

As the video above explains, MOOC is just a way of describing the process of acquiring knowledge which, in previous times, may only have been available through learned institutions, and through diligent attention to books, journals, or lectures. People without access to these forms of learning could therefore be left behind. But as this clip from RSA shows, how we conceive of education now has to change, for several reasons.

  • Cost. University education is now very expensive. For people who do not wish to become endebted, it could be the case that this form of learning is an effective way to continue to develop and learn without attending university. Perhaps universities will spot this and offer a discounted rate for people to sit qualifications without access to their limited spaces in lecture theatres?
  • Social exclusion. People who experience stigma because of mental illness or other reasons could find that they are able to learn removed from the pressures of the social environment of a university? I wouldn’t want to recommend this as an adaptive response to social phobia or fear of stigma, but I can imagine circumstances (Asperger’s?) where this would make accommodation for someone’s particular needs or sensory sensitivities.
  • Lifestyle. People who are looking after children or other family members may wish to work from home, in hours of their own choosing. This could offer a solution for those groups, much like the OU does, but again, at less cost.
  • Bad experiences in formal education. So many people have felt excluded from education due to their bad experiences at school. Some of them may not have been diagnosed with learning difficulties such as dyslexia, dyscalculia or dyspraxia until later in life, and suffered bullying in school from pupils or staff. Many people who have had poor experiences could be encouraged to gain basic skills, or update their knowledge ahead of trying out more formal routes of education, in a supportive network of people.
So what is my point?
What I am thinking of, as ever, is the application of this understanding to my OT practice and to the possibilities for growth it represents.
  • I love learning. I intend to continue learning all my life. I am determined to engage with the idea of a MOOC, just to see where it takes me.
  • I would love to see an OTMOOC event shape up- perhaps after this year’s virtual exchange we could plan one to culminate in next year’s virtual exchange? However, for the time being, I’m going to MOOC about using the online resources I already have.
  1. My network of OT blogs that you can see on the right hand side is a good place to start——–>
  2. And if you are dipping your toes in the water of online technology as an OT, I would strongly urge you to complete this short survey to provide us with more of an evidence base about how our profession is using online tech (add your email at the end if you want to be entered into the prize draw for an iPod!)
  3. Also, are you aware of the OT4OT blog? It’s a good place to share information about how OTs are using online technology.
  4. Coming up is the 24 hour OT Virtual Exchange- widely billed as the conference you can attend in your pyjamas- on 26th October 2011, 24 presentations from around the world highlighting a range of different OT approaches available at a computer near you, and at absolutely no cost. Check out the facebook group.
  • As ever, we need to remember that there are possibilities for practice within this model.
  1. One of the roles of the OT is in health education. We can offer our unique occupational perspective through this technique as much as any other.
  2. Education about aids and adaptations can be hugely useful. I have lost count of the numbers of people I have shown products to through websites when they would never have set foot into a mobility showroom. We could make great strides in ensuring our service users have access to this information online.
  3. Perhaps videos of people who are doing Occupational Therapy, to show how this benefits them? (With all appropriate consents etc.)
Once more, this doesn’t solve the problem of digital exclusion. That has to be tackled. But as more and more people have access to technology such as smartphones, we can hope that the day is not far off that we can ensure fair and equitable access to information.
On that day, we can all MOOC together.
I like the sound of that. Do you?

ATOS medicals- can we use tech to support our service users?


A good post here form @Quinonostante, regarding recording ATOS medicals. Be warned, service users, that the new guidance is going to make it harder than ever to meet the criteria for continued benefit support.

Virtual support space for amputees launched


Twitter provided a  link to this URL  (thanks @EnableOT), a virtual space for amputees to provide support. This is a great web 2.0 application for people who may find it difficult to get out and about and meet others in the same position in the physical environment. http://dusanwriter.com/index.php/2009/11/02/virtual-support-space-for-military-amputees/

I think this sums up how I feel about this, that we can use applications already out there- we don’t need to be doing anything different or special in order to be making good use of the internet for the benefit of people we deliver services to. There are so many things like this out there- it’s just a case of altering our head spaces to accommodate it. Hmm….it’s something to think about…now we just have to deal with digital exclusion…more on that another time!

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