Staff Launch Event

Palliative Care “a support system to help patients live as actively as possible until death” “Palliative care is an approach that improves the quality of life of patients and their families facing the problem associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial and spiritual.” http://www.who.int/cancer/palliative/definition/en/

Rehabilitation “Rehabilitation is a personalised, interactive and collaborative process, reflecting the whole person. It enables an individual to maximise their potential to live a full and active life... Rehabilitation can take place at any time across a life course or in a continuum and may include habilitation, reablement and recovery” (NHS England 2016)

Life and living – Occupational beings Fear of functional decline frequently eclipses fear of impending death “ You don't stop dancing because you grow old, you grow old because you stop dancing” @MaggyPigott #COT2017 Twitter #LivingnotExisting (RCOT)

Context Increased disability and co-morbidities Increased dependence on carers Increased number of deaths Increased demand on health and social services Aging population 49.5% deaths 85+ by 2035 Who – pts, families, elderly, co-omorbidities. Which professionals? Where- PPC/PPD, Hospice, hospital, care homes How- financially, quality, equality When- should pall care / rehab be involved? How can we prepare now.... www.hospiceuk.org

Rehabilitative Palliative Care Patients priorities and wishes to maximise their quality of life Optimising patient abilities to actively manage their condition, including coping with loss Patients and their loved ones having choice and autonomy Meaningful participation in activities and relationships A holistic multidisciplinary approach

Overview of Wellbeing Occupational Therapy and Physiotherapy led Open 5 days a week, Monday - Friday 10 different sessions Increased variety of sessions 1:1 with therapist before joining a group Plans for further development and constant review based on patient and carer feedback

Assessment / Outcome measures IPOS Timed up and Go Modified Functional Reach Goal Setting

Criteria Adults over the age of 18 Patients with a life limiting condition for example advanced cancer, a rapidly progressive neurological condition, advanced respiratory or cardiovascular condition. Patients who would benefit from: self management advice and support managing symptoms Patients who require low level psychological support and peer support. Carers and family members of someone with a life limiting condition. Patients who are stable enough to attend sessions and are able to self-medicate and mobilise / transfer independently or with only assistance of 1.

Who the service cannot meet the needs of: Someone with acutely deteriorating or unstable physical or mental health. Someone who requires two or more people to transfers and/or manual handling equipment. No hoisting facilities are available. Someone who has significant cognitive impairment or behavioural needs. Someone who is a permanent resident in a nursing home or a residential home can access specific symptom management sessions in discussion with the team. They would not be eligible for enjoyment afternoons.

Timetable Monday Tuesday Wednesday Thursday Friday Morning Admin time   Monday Tuesday Wednesday Thursday Friday Morning Admin time Seated Tai Chi Intermediate 4-6 weeks 10.30 -12.00 Gym Buddies 12 weeks Rolling 10.00 -11.30 Wellbeing drop-in and carers group 2nd Wednesday of the Month 10.00 – 12.30 Patient Information Programme 12 weeks with 1 x break week every 6 weeks Rolling Individual Appointments and New Patients In Sept 2019 Heart Failure 8 weeks 11.00 – 12.30 Walking Group Drop-in Rolling 11.30 Enjoyment afternoon Afternoon 13.00 – 14.30 Seated Tai Chi 13.15 – 15.00 Breathing for Wellbeing 4/5 weeks Fatigue Management

Exercise Groups Seated Tai Chi Walking Group Gym Buddies

Symptom Management and Education Patient Information Programme – 12 weeks rolling Fatigue Management – group or individual Breathing for Wellbeing – group or individual

Enjoyment afternoons Lunch with group Relaxation Variety of social and therapeutic activities chosen by patients Supported by volunteers Complementary therapy Peer Support Ability to work on individual activity goals Use of Hospice gardens Group activities supported by staff and volunteers For example: gardening, baking, arts and crafts, music, quizzes, and more

Wellbeing Monthly Drop - in Patients Family and friends support group Drop-in Find out about Wellbeing / Specialist Palliative Care Staff available to discuss programmes See the Wellbeing room and gardens Information leaflets Opportunity to bring family / friend for carer support. Drop-in Practical support from Northamptonshire carers Ask questions and talk without ‘patient’ present Find out about Wellbeing / Specialist Palliative Care Ability to bring the patient if unable to safely leave at home.

Heart Failure New Programme planned for Sept 2019 8 weeks Specialist heart failure nurse and Wellbeing team providing information Education, exercise and relaxation

Housekeeping Patients to arrange their own transport in the first instance Volunteer drivers available – use their own cars, minimal supervision / manual handling Patients to bring their own medications and be able to self medicate. Patients are able to bring a relative or friend to sessions, except enjoyment afternoons unless care needs identified.

The Future Further condition specific groups – Heart Failure, MND Further exercise groups as well as social prescribing of activity and support to access community groups Development of a specific anxiety management programme Continued use of outcome measures Continued work with Northamptonshire carers – increase of drop-in to 2 x month from Sept 2019

Any Questions