"No place to be ending but somewhere to start...."

There has been much publicity recently about the work of the charity PlayList for Life and their work

encouraging the use of personally meaningful music on iPods in the care and treatment of people with dementia. They are currently collaborating with Glasgow Caledonian University and other academic partners on a research project to measure the efficacy, constraints and economic advantages of offering personal music on iPods to people with dementia in different care settings.

 The idea was developed 2013 by broadcaster Sally Magnusson following the death of her mother after a long struggle with the condition.
Read more 

 

"Evidence suggests that the personal nature of the music is what triggers autobiographical memory, renews a sense of identity and gives someone who spends a lot of time feeling ‘out of it’ a wonderful feeling of belonging".

 

"Compiling a playlist of a person’s life requires you to get to know them better and sharing it with them – through listening together – makes conversation gloriously possible again, even if it remains one-way. Human interaction is what people with dementia desperately need and so frequently lack, often because those who love them become increasingly stumped at how to engage them. Sharing a playlist brings people together.  That in itself is a therapy for dementia.  For those in the healthcare sector this approach embodies all the principles of person-centred care."


They go on to offer some really helpful tips to decide what to use and how to compile a playlist for life (click here) with someone who is already experiencing dementia with some really useful ideas for starting conversations or doing a little detective work for example:

• Did your relative go dancing in their youth? What songs or bands might they have listened to?
• Did he or she go to the cinema and enjoy particular films?  Some of the old ones have memorable theme tunes.
• Did he or she ever mention a particular radio or television show? A theme tune could prove evocative.  Some people have also responded to dialogue from familiar old programmes.
• Did, or does, your relative go to church and enjoy hymns?  What are the favourites? A minister or priest, past or present, might have some suggestions.
• What music did your mum or dad walk down the aisle to?  What hymns were sung at their wedding? Which songs did they dance to afterwards?
• Did he or she go to Sunday School as a child, or was a member of the Boys’ Brigade, the Guides or Brownies, or the Scouts? They all have songs associated with them.
• Did your relative sing in a choir – a church choir, perhaps – with a repertoire that others in the choir would remember if he or she does not? The current choir leader would know the perennial favourites.
• Was there a school song that an old school-friend might remember?
• Is your relative of an age to have been in the war, either at home or on the front, and familiar with wartime songs?  Which in particular?
• Did your relative play the piano or another instrument?  Might there be old sheet music around to give you clues?
• Did he or she play in a band ever? What did the band play?
• Do you yourself remember any records being played at home?  Do you have them still? Might a relative or friend have records in the attic you could ask to see?

Why leave this until someone may be experiencing memory loss and dementia? How about we use some of these tips to have a conversation now with relatives/family/friends to help us understand the things that have helped shaped identity and that are still valued today?

In case you were wondering - the title of this post comes from Sade, Smooth Operator

Bell Ringing and Occupational Therapy

 Thanks to our own Dr Jackie Taylor for this interesting post:

Bell-ringing and occupational therapy

I have a friend who is one of the bell-ringers at her local church. The other Sunday I was privileged to be able to sit squashed up in a corner of the bell-tower, watching the bell-ringers in action for 45 minutes, calling the congregation to the church.

Have you ever watched people ring bells? It’s fascinating. 

As an occupational therapist and occupational scientist I find it particularly fascinating because I have a set of concepts that help me to explore what is going on, and I have a language to describe what I see. So I don’t just see a group of people pulling on ropes, making a lot of noise; I see people engaged in a common occupation, which has an identifiable form and which invites a range of performances from the individuals thus engaged.

The form of bell-ringing

As I sat squashed in my corner (“sit very still, and we advise you not to cross your legs, as you don’t want your foot to get caught in a rope as it swings up”) I reflected on my total ignorance about this activity and yet, as someone interested in occupation, I was mentally filing aspects of the occupational form under headings of ‘human’, temporal’, ‘environment’, ‘objects’.  There were physical artefacts:  tools and equipment that the bell-ringers were very familiar with. There were the 8 long ropes hanging down from holes in the ceiling, each apparently controlling a huge bell. The bells, however, were invisible and I struggled to imagine the process of rocking and turning them which I was told was happening. In the centre of the room was a table with old books on it, and also some bottles of liquid which the ringers used occasionally on their hands, though, as an outsider, I don’t know the reason for this. You will see that the form of a complex occupation such as this cannot be fully understood by an outsider; true understanding comes through engagement. 

                                

In terms of environment, the bell tower was small and ancient. Reader, I want you to know that I felt the tower sway as the bells rung! I believe this is quite normal, and it has been happening for a 350 years or so, but nonetheless  ...... (I’m told that, if the tower were absolutely rigid, it would be damaged by the action of these heavy bells, all swinging together).

There were rules and formalities involved in the bell-ringing, and sequences of events that were important (five minutes at the beginning and the end of the session were devoted to getting the bells up into position and bringing them back). It was difficult to differentiate between the roles played by each person, but I could see that there was someone in charge (the Tower Captain, I later discovered) who called instructions, and who gently reprimanded those who had rung wrongly. My friend had explained that the eight bells are not rung to play tunes, but to ring out ‘methods’, based on number patterns.

Bell-ringing is an ancient occupation serving a town’s formal Christian worship, and helping to mark occasions such as weddings, funerals and national celebrations. The walls of the bell-tower held lists of successful peals rung from this tower (a peal is 3 hours of non-stop ringing without mistakes, I am told). There were also other intriguing documents and records that the outsider finds difficult to understand. This is an occupation embedded in a broader culture, history and community, whilst this particular team of bell-ringers also has its own micro-level culture, history and community.

Take a look at their website http://bingleybells.btck.co.uk/ and while you’re there, look at the two youtube videos to hear the bells and see the occupational performance.

Individual performance

The eight people who were pulling on the bell ropes had similarities and differences. They were maybe between 18 and 70 years old, half men and half women with different heights and physiques. They appeared to have different levels of experience. It is not my field of expertise, but I tried to assess which were the main muscle groups being employed as the ropes were pulled down to swing the heavy bells. Different techniques were used. I could see arms (triceps?, deltoid?), backs (trapezius?), abdomens and legs brought into play.

More intriguingly to me, I could see different techniques being used for keeping counts and rhythms when ringing the methods. Some watched each other, some watched the Captain, some moved their lips as they recited numbers or something else. The level of concentration was palpable. This occupation requires techniques and abilities that are physical, cognitive and subtly social.

And what else?

Being interested in occupational form and performance can be very distracting and all-absorbing. I made sure, during my short visit, that I listened to the bells and experienced their glorious noise. It is important to appreciate, as well as analyse.

I could continue my analysis for another 2000 words, after all, my own research interests lie with the meanings of occupations, but to access those, I would need, I think, to talk to the bell-ringers themselves. I won’t do that just now. Instead I’ll stop here and offer 2 thoughts. (1) Next time you hear church bells ringing, consider the efforts, skills and enjoyment of those responsible. (2) Next time you encounter an activity that you haven't thought about before, think about it deeply.

Dr Jackie Taylor

Guest Blog Post ; The Therapeutic Value of gardening

A few weeks ago I was working with a group of our first year students who were completing a trigger for one of their modules. The trigger required them to consider a specific leisure activity and the therapeutic value of this activity for a range of occupational needs.

The group worked on swimming, gardening and creative writing. They presented in both a creative and thorough way that I was so impressed I asked each group to contribute to our blog with their findings and thoughts.

Here is  the post from the Gardening group:
What they haven't mentioned is the creative way they collected people's thoughts on gardening - they asked each one to write their thoughts on a paper 'leaf' and this was hung on a twig tree for the presentation and for the rest of the group to read and enjoy.

 

The therapeutic value of gardening

PBL Group: Rachael, Lucy, Fran, Elise & Keeley

Written by: Lucy & Rachael

Diamant & Waterhouse (2010) conducted research with Thrives , a national UK charity who run a social and therapeutic horticulture project to examine how gardening facilitates health and wellbeing through belonging. Findings suggested  that gardening has positive effects on members of the project and in turn in improving health and well-being of the individuals.

Whilst in PBL, trigger three gave us the challenge to look into gardening and its therapeutic value further. This posed the question "what is the general perception of gardening amongst the general public?"  . By asking family, friends and the general public what their personal views were on the topic, it enabled us to gain a broader view on the value of gardening. Below represent a couple of direct quotes that we gathered:

• ‘Gardening takes you in the moment; you are not worrying about the past or future’
• ’A relaxing feel while working with plants and a excellent workout’

We also looked at how accessible gardening is for all types of people regardless of ability, function or circumstance. This proved to us that there are a wide range of gardening possibilities from groups that target specific ages or conditions to a wide range of adaptive equipment available, for example long reach tools and even numerous methods to carry out the activity!

When first approached with the trigger, collectively it would be fair to say we did not realise the values gardening could have upon an individual.  Through a combination of our own input, other people's perceptions and good old academic research it is now clear that we definitely underestimated the power of the plants!

PBL Group: Rachael, Lucy, Fran, Elise & Keeley

Written by: Lucy & Rachael

Reference:

Diamant E, Waterhouse A (2010)  Gardening and belonging: reflections on how social and therapeutic horticulture may facilitate health, wellbeing and inclusion
The British Journal of Occupational Therapy, Volume 73, Number 2, February 2010 , pp. 84-88(5)

A Gremlin check

Hello
Our blog appears to have rogue sentences appearing over our posts. This is annoying and I am trying to use my (limited) technical ability to resolve. If anyone has any ideas of what else I could try all hints and tips gratefully received.
Sometimes posting a new post resolves this - so this such a post. In the meantime please enjoy the Salford sunshine in our campus photo - and maybe take time to visit the 4OT suite of links to a whole host of OT groups shown in our News Feed (courtesy of David Nixon)
Thankyou

Values Based Recruitment

At the moment we are at one of the busy times within our undergraduate admissions cycle with the process of interviews and selection. I am always heartened by both the motivation and the high standard of the applicants we see during this process and it is often a difficult task to select only 56 from the 140 or so that we interview. We are constantly seeking ways of ensuring this process is fair and robust and offers a clear selection process for all involved - so one of the new changes I have brought to this process this year is the introduction of Values Based Recruitment.

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 Values Based Recruitment (VBR) works through identifying values and attitudes of the applicant and how they fit the organisation and/or nature of the business – in this case occupational therapy.VBR sits alongside skills, experience and competencies and can help an applicant to demonstrate how and why they make certain choices and identify attitudes and reasons that underpin behaviour. It is also suggested that VBR can lead to improved performance and better retention – new recruits enjoy the work and the culture and want to stay. Therefore we recruit those more closely aligned with professional values and organisation values.

There are, of course many drivers for introducing VBR which include:

• Code of Ethics and Professional Conduct (2010)
• The Francis Report (Mid Staffs 2013)

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This report contains a relatively low message for AHPs but there are clear messages to embrace.  Main training issues focuses on nursing, however they have resonance with Occupational Therapy.

185: There should be an increased focus on a culture of compassion and caring in nurse recruitment, training and education. Selection of recruits to the profession who evidence the:

·      Possession of the appropriate values, attitudes and behaviours;

·      Ability and motivation to enable them to put the welfare of others above their own interests;

·      Drive to maintain, develop and improve their own standards and abilities;

·      Intellectual achievements to enable them to acquire through training the necessary technical skill

• The NHS Constitution (2012) with the introduction of 

--> the 6 C’s of Care:

·      Care

·      Compassion (includes empathy, kindness, respect and dignity)

·      Competence

·      Communication

·      Courage (includes speaking up when things are wrong)

·      Commitment

During  consultations held last year with current students, service users and staff, a nominal group technique was used to produce a consensus for the top values amalgamated from all relevant drivers  Throughout the consultation period  I had a number of discussions  about expectations of an applicant in terms of values. Often it is proposed that professionals can learn and develop values through their educational and practice experiences as a student. However, Barker (2013:82) states “We can learn to understand the needs of individuals but not to be ‘sympathetic’ and have ‘concern’ for others. In addition values rated highly as being important for an occupational therapist included:

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1.     Respect each person as an individual

2.     Respect individual’s dignity

3.     Working Together

4.     Commitment to confidentiality and Being Ethical

5.     Being Kind and Knowing and complying with rules and regulations

We have now included ways within our interview process that will help applicants display these values to given scenarios and/or questions and will be conducting an evaluation of the entire process in due course. Watch this space for more news soon.......

 References:

Barker K (2013) Can Care and Compassion be taught? British Journal of Midwifery February 2013 Vol 21, No 2 82

  Mid Staffordshire NHS Foundation Trust Public enquiry (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Enquiry Executive Summary London:HMSO