1. Staff Launch Event

2. 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.”

3. 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)

4. 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)

5. 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....

6. 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

7. 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

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

9. 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.

10. 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.

11. Timetable Monday Tuesday Wednesday Thursday Friday Morning Admin time
Monday
Tuesday
Wednesday
Thursday
Friday
Morning
Admin time
Seated Tai Chi Intermediate
4-6 weeks
Gym Buddies
12 weeks Rolling
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 – Walking Group
Drop-in Rolling
11.30
Enjoyment afternoon
Afternoon
13.00 – Seated Tai Chi
13.15 – 15.00
Breathing for Wellbeing
4/5 weeks
Fatigue Management

12. Exercise Groups
Seated Tai Chi
Walking Group
Gym Buddies

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

14. 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

15. 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.

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

17. 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.

18. 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

19. Any Questions