Supporting people to be independent

Posted on: 17 March 2017

The CEO of the College of Occupational Therapists has heard how Devon OTs are supporting people to regain independence to such an extent that they need little or no further help.

Julia Scott, of the soon to be Royal College of Occupational Therapists, visited Devon recently to talk to OTs about promoting independence.

She heard how growing numbers of people in the county are leaving hospital and are returning home, or they’re avoiding hospital altogether, with support from OTs that are part of Devon County Council’s social care workforce.

The service is not only supporting people to regain their ability to look after themselves, but it’s also saving authorities thousands of pounds each year.

“It’s just a fact that the more people are helped to a point where they can look after themselves, with a bit of help perhaps from friends, family or local groups if necessary, the more we’re able to focus spending on meeting people’s more complex social care needs,” said Councillor Stuart Barker, the Council’s Cabinet Member responsible for adult social care.   “That’s what people want – to not have to rely on the social care system if it can be avoided.”

One of messages to fellow OTs from the national body was the importance for them to evidence their work in terms of outcomes for the individual and cost savings.

Julia Scott  said:

“I was delighted to visit Devon to see for myself how people in the county are benefiting from occupational therapist support. All the evidence shows that where occupational therapists are deployed in social care they help people to retain or regain their independence and continue to do the things that are important to them. This is better for the people concerned and, because it reduces their dependence on expensive social care services it is also good for tax payers. We are highlighting the work here in Devon nationally, as an example of best practice.”

The College’s CEO heard examples where occupational therapy had prevented the need for ongoing social care, saving the council thousands of pounds.

In one case, Mary (not her real name), was admitted to hospital following a fall and subsequent spinal fracture.  She had been a carer before retiring, and was diagnosed with Parkinson’s disease 13 years ago.  She had low confidence, was low in mood and reluctant to leave her bedroom.  She took a passive approach to regaining independence, feeling that she’d get better “in her own time.”

Before hospitalisation, Mary, who lives with her husband and son in their own home, had been fully independent.  She’d previously been reluctant to engage with health and social care services, and there remained doubt that she would, even after her fall.  Mary told her Occupational Therapist that she was staying in bed because she was worried about falling.

But speaking to Mary the therapist concluded that she had the physical ability to undertake daily tasks.  Mary agreed two specific personal goals with the Occupational Therapist; to be independent with washing and dressing and to be able to go downstairs again.

Within a relatively short time the therapist and Social Care Reablement support workers increased Mary’s involvement in her washing and dressing, and she was doing more for herself each week.  The Occupational Therapist involved a physiotherapist to work with Mary about getting downstairs again.

The OT advised the visiting support workers of approaches that Mary responded well to and explained to Mary the importance for her to maintain her strength.

And with that, Mary’s confidence and motivation slowly returned.  By the end of the Social Care Reablement service, Mary was fully independent, and she’s had no social care referral since.

The alternative for Mary, with her reluctance to engage and to leave her bedroom, would likely have been an ongoing care package at home at a significant cost.

Instead, Mary’s back on her feet, she’s regained her confidence, and she’s not needing any further help from the council.

“The evidence is there,” says Cllr Barker.  “Time taken to work with a person to regain their independence is time well-spent.  It’s what people would prefer wherever possible, it encourages a better quality of life, and it costs the council less which means we can spend more on more complex cases.”

That’s one example and the council has many, involving people who have been supported by the Social Care Reablement team after leaving hospital, or through the support have avoided need for a care package, hospital admission or residential care.

The council believes it could be helping more people regain independence in this way.  It recently increased its budget for adult social care by an additional 19 million for vulnerable adults, and it wants to work with the NHS to prioritise the extra funding for Devon announced in the Government’s budget last week to support people towards independence.

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