Embedding a rights-based approach across an occupational therapy Psychiatry of Old Age service

Hazel Douglas (right-hand side): Team Lead, Occupational Therapist, Psychiatry of Old Age, Perth and Kinross, based at Murray Royal Hospital, Perth, with a practice remit for people living with dementia, and older people with mental health problems (inpatients and at home). 

Twitter: @HazelRDouglas1

Danny Shanks (middle): band 6 occupational therapist, liaison psychiatry service, Perth Royal Infirmary.

Aileen Stewart (left-hand side): band 6 occupational therapist, rural North Perthshire.

As occupational therapists working in a Psychiatry of Old Age service in Perth & Kinross (NHS Tayside), we recognised a joint aspiration to review our personal and team understanding of a right-based approach when working with people living with dementia, their families and carers.

The publication of ‘Connecting People, Connecting Support’, was an example of important policy that influenced our team decision to refresh existing knowledge and expertise related to a rights-based approach.

Specifically, we were motivated to find out how we could translate a rights-based approach to three areas of our practice;

  1. Working with people living with dementia when admitted to an acute hospital setting
  2. Review and update knowledge of evidence-based interventions; and
  3. To challenge stigma associated with a diagnosis of dementia.

The MSc module co-delivered by Alzheimer Scotland and Queen Margaret University, Edinburgh, ‘Developing rights-based practice for Allied Health Professionals (AHP) working with people living with dementia, their families and carers’, was an opportunity for us to explore in depth, our identified service-led learning goals.  To find out more about this module, please refer to last week’s Blog:

https://letstalkaboutdementia.wordpress.com/2019/04/18/educational-opportunities-for-allied-health-professionals-ahps-translating-a-rights-based-approach-to-practice/

Here, we offer our reflections.

Danny Shanks (completed MSc module in 2016):

“As an Occupational Therapist working within a Psychiatry of Old Age Liaison service, a focus on person-centred care is at the heart of what I practice and as an outcome, is what I strive to achieve.  This can at times be challenging within my workplace setting of an acute hospital environment where the fast-paced nature of a general hospital may be at odds with an older person’s wishes, approach to life and their specific rehabilitation needs.

Completing the MSc module allowed me to sharply re-focus on the basic human rights of an older person with mental health needs, reminding me that their rights are exactly the same as every other person admitted to hospital.

I now feel significantly more confident to articulate my professional reasoning and to frame this in terms of a rights-based approach to practice when discussing decision-making around rehabilitation and discharge planning.  The outcome for me as an AHP practitioner was a clear improvement in my person-centred approach to practice, an area I explored as part of my assessed presentation, specifically the ‘right to personhood’.”

Aileen Stewart (completed module in 2017): 

“I decided to complete this module with support for funding from the AHP Careers Fellowship Scheme.  The module was relevant to my area of practice, Old Age Psychiatry, and I was able to dovetail the learning outcomes of the module to my practice setting.

Specifically, in parallel to undertaking the MSc module, our team were involved in the Scottish national pilot of the occupational therapy home-based memory rehabilitation programme (further information, here:

https://letstalkaboutdementia.wordpress.com/2019/01/17/occupational-therapy-home-based-memory-rehabilitation-in-scotland-an-update/)

I felt our involvement in this pilot would be a relevant topic to explore as part of my assessed presentation, the title of which was, ‘The right to access occupational therapy led home based memory rehabilitation for people living with dementia’.   This highlighted a gap in service provision in Perth & Kinross to provide an early diagnosis intervention.

When completing this module, I was also working full time and balancing home life as well. The support from my line manager and the passion I hold for this area of practice ensured success.  I would recommend taking the leap to study, as there is no perfect time and the outcomes, including the sense of achievement, is worth the hard work.”

Hazel Douglas (completed module in 2018):

“Having supported two team members to complete the MSc module, and having seen the impact their learning has made to us as a team as well as the ripple effect to our multi –disciplinary colleagues, I was very pleased to undertake the module myself.

Whilst studying, I was able to consider the impact a rights-based approach can have on empowering people living with dementia, their families and carers to feel in control of their own journey as they navigate the complicated process of managing everyday life.

The stigma and prejudice of a diagnosis is still there in clinical practice, despite important developments through campaigns to increase awareness of dementia in the public setting as well as within health and social care.  We need to be proactive and creative in reducing discrimination at any level for all living with dementia, and to support AHPs to feel able to achieve this.

For my presentation, I chose to explore and reflect, ‘Embedding a Rights Based Approach within local practice, for cognitive assessment of people living with dementia who are still driving’. This is a developing area of our local clinical practice and is also relevant at a national level.

I would encourage any AHP to consider the opportunity to take part in this module in future years as an excellent opportunity for their personal learning, but also as a means of impacting whole service provision and increasing awareness of a rights-based approach.”

Questions:

  1. How do you approach conversations with colleagues when considering a person’s rights?
  2. What are the ways through which you embed a rights-based approach to your practice?
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