by Sarah Clayton, Postural Care
The world has tilted not just on a personal or even a national level but globally. Never before have we seen such restrictions on our movement and daily life but also on our traditional working practices. It is a time of uncertainty, anxiety and huge stress as we all try to reimagine how we maintain our health, both physical and mental, and continue to support those we care for personally and professionally.
I have worked for over 20 years to support those with the most complex healthcare needs and in that time I can safely say the model has not changed in the slightest. When considering a piece of equipment for an individual with disability the vast majority of time the following would happen:
- Therapist identifies a need that could be met using specialist equipment – in our case simple night-time positioning.
- Therapist negotiates with the person, their family or those providing their support and a specialist company advisor experienced and trained to provide assessment for that particular piece of kit.
- This may take weeks – availability, school, medical appointments, part time working on the part of the therapist, family members that also want to be present… this negotiation is no mean feat…
- On the day the advisor travels to the assessment, as does the therapist and the assessment takes around an hour. This takes into account getting the person ready, in our case we need to see them in bed, people using the bathroom, having a cup of tea, generally catching up. The actual assessment is a sizing exercise, no one can tell in that hour how the person will respond in the medium to long term so it really is a case of the advisor checking to see what might work and wherever possible supporting the person to experience using the kit. Everyone then travels back to work, home or on to the next assessment.
- It is not uncommon for the therapist and advisor to arrive at the assessment to find that perhaps the family had forgotten about it, or that the person was admitted to hospital the night before – no one is at fault, in stressful situations people may forget to cancel. The negotiations then begin again to get everyone in the right place at the right time.
- Once the right kit is identified a request for equipment is then forwarded on into a system which again may take weeks if not months (we have known orders for equipment come in 2 YEARS after the original assessment…) By the time the person has the equipment they need, their needs have often changed and so the therapist, person, family and those providing support begin the complex dance to arrange to meet again to make sure the kit is being used most effectively…
This method of working is wasteful, inefficient and results in a huge carbon footprint. At the end of the day, the person who ultimately is let down by this system is the person at the centre of it; the person with complex needs themselves.
So – is there an alternative? Is there a way to work with people to find a more effective, less expensive, more environmentally friendly way of working that supports every player in this game to play their part? The modes of working we having to adopt during the current ‘lockdown’ suggest that there is. By drawing upon the methods we have employed for many years to support people and their therapists overseas, using secure, simple telehealth platforms that allow us to focus on the essential elements of the assessment process, we are now reaching people we would have otherwise visited face to face.
Of course there are key issues to bear in mind when considering a potential telehealth solution:
- Can we ensure everyone’s safety by offering 3-way telehealth from the comfort of everyone’s homes or places of work?
- What is the risk in delay – the individuals we are supporting are some of the most vulnerable and WILL see deterioration in their already fragile health if needs such as posture are ignored for 12 weeks.
- Is the system simple to use, can we arrange test calls to iron out any anxieties?
- Is the system secure – are we doing all we can to protect the data of all involved?
When we first looked at this option we asked ourselves:
- Is what we do important? Yes – if we don’t do it in a timely manner people deteriorate rapidly leading to secondary complications, increased care needs, pain and ultimately premature death.
- Is there a way to do what we do remotely? Yes – and we have proven this over many years successfully supporting people overseas.
- Are there additional benefits to us in working remotely? Yes – we will save time, costs (which could be passed on to funders) and massively reduce our carbon footprint. We can also offer real time assessment, imagine a therapist meeting an individual, realising they have a positioning need and being able to contact an advisor there and then.
- Are there disadvantages / limitations to us working remotely? Yes – we need people to have access to technology and be willing to give it a try. On the first point almost everyone has a smart phone in their back pocket, on the second we are relying on people being willing to experience some technical discomfort in order to do their essential work.
- Finally we have to consider the survival of organisations and charities offering traditional face-to-face services. We have to recognise that unless we find ways to support each other to explore new ways of working those organisations simply will not be able to survive the necessary ‘lockdown’. Effective and productive organisations staffed by experienced, motivated and driven people will go to the wall. As a community we all need to share our experiences, what we learn, and the technologies we are using – it is the only way we will all come through this together.
Seeking out and experimenting with new ways of working, particularly when you are also attempting to home school your children or facing anxieties around your financial future, is not easy. But our survival and our ability to offer support to people who need it depends on it. There are organisations and individuals out there with a wealth of experience in this field who can help. Let’s find a way.