“Rabbit stew anyone?”

The role of a dietetic student in a care home

The North Highland health and social care partnership supports a strong and integrated model of care for adults, including care homes. I was appointed as the nutrition and dietetic advisor for care homes in 2014 and took the lead in championing this work, along with Emma Pasieka (the Board’s dietetic placement co-ordinator), Urray House care home (part of the Parklands care group) and Dr Myra MacKenzie from Robert Gordon’s University. AHP practice education lead, Kerrie MacLean, advised and supported the group’s work using her experience of other AHP’s placements and in linking closely with NHS Education Scotland.

We developed a pioneering, first UK experience, of placing a student dietitian in a care home setting in The Highlands. In the course of the placement, the dietetic student and activities co-ordinator engaged with a group of residents with dementia and 2 of their relatives in remembering favourite meals from childhood, mainly from the wartime. Their memories and discussion then helped care home staff and the cook design a World War II themed lunch menu. It included scotch broth, rabbit stew and clootie dumpling.

Photo kindly provided by Urray House care home (part of The Parklands care group)

The themed lunch was open to all residents and their relatives and we also had interest from the local press. Some of the comments from the day are recorded below from residents, relatives and staff, which sum up the event:

“Clootie dumpling was the best part”

“We always got clootie dumpling at birthdays and if you were lucky, you got a silver threepence”

“I was brought up on rabbits; they were tastier before the war”

“The food here is excellent and the chef has a real interest in food and nutrition: it’s great that she was able to prepare this meal for residents” 

“I think the whole idea was great. My mother was telling me about when she was little when her mother used to go to the butcher and get a rabbit for a shilling. She’d then sell the rabbit skin to a man that came round the houses; there’s no way she’d have remembered that without this themed lunch bringing back those memories”

“Having a focused discussion around food memories is a great way of engaging

with residents who have dementia and their families, giving them a voice in choosing their favourite menus and following up with a themed meal, where staff dress up to serve the food. Everyone can participate have fun and enjoy the memory.”

The work of the student dietetic placement demonstrated a successful innovative, multi-agency approach to placing a student dietitian in a care home setting, facilitating active conversations with people living with dementia. It worked particularly well with the people who can at times appear quiet or withdrawn. We were also delighted that our work was recognised at last year’s Scottish Dementia Awards as a runner up in “the most innovative partnership” category.

Dietitian Students in Care at Home Settings

We have built on the success of our work in the care home setting with our dietetic students and have been continuing to develop a model of practice placements in “care at home” settings. In NHS Highland alone 19,000 people receive care at home and the provision of adequate nutrition and hydration can be a challenge within this setting. Student dietitians rarely have the opportunity to experience the reasons for this, or the opportunity to present solutions.

As a result, in 2015 NHS Education Scotland, the Care Inspectorate, NHS Highland, Robert Gordon University and Highland Home Carers agreed to go one step further than care home placements, and test another new model of training student dietitians; this time in the context of ‘care at home’ settings. You can find out more about this work in my blog post here https://ahpscot.wordpress.com/2016/01/11/care-at-home-pre-registration-training/. I believe that we are offering a great learning opportunity for our dietetic students while also supporting the needs of individuals and their families, in a very proactive, person-centred placement model.

Our experiences of implementing and evaluating a dietetic social care placement model has just been selected to be presented in a poster session at the International Congress of Dietetic Associations in Granada, Spain in 2016.

Reflections

Thank you for taking the time to read my blog post.

Food forms such a strong part of our social and personal memories and reminiscing about events can offer a fascinating insight to family & friendships, social history and opens conversations up with groups of people from all walks of life. So can I leave with this…..

“Think back to your memories of your 10^th birthday party, what food & drinks were offered to all your friends & guests?”

 

Evelyn Newman RD, NHS Highland, Nutrition and Dietetic Advisor: care homes, evelyn.newman@nhs.net

@evelynnewman17

Evelyn’s role as nutrition and dietetics advisor: care homes, is unique in the UK. She works within NHS Highland’s integrated adult social care team, working at a strategic advisory level, supporting the 73 care homes in the North of Highland. The role is very varied offering: many forms of training; tailored nutrition/hydration advice for care home managers; up to date food, fluid and nutrition policy and resource development and information.

Settling in to an Art Therapy Placement:

“The Groundwork for Great Work”

Meet Jenny

My name is Jenny Jamieson and I am a student Art Therapist in my second year of the Msc Art Psychotherapy (International) at Queen Margaret University. I have the great privilege of being on placement two days a week in one of Alzheimer Scotland’s busy day centres in the west of Scotland. The service I provide includes facilitating a small art therapy group and also working with individuals one to one.

Meet Leah

My name is Leah Mackay and I am also a second year Art Therapy Student on placement at one of Alzheimer Scotland’s dementia resource centres. Art therapy fits into the service well, providing a therapeutic intervention both on an individual basis and in small groups.

We have been working with Alzheimer Scotland staff to make sure that all the things we need for our role are in place.

It is our hope that through sharing our five ideas of being an art therapy student will be will be useful for anyone interested in supporting art therapy to happen where they are.

• Tools of the Trade

 

Central to the provision of Art Therapy within any setting is access to a range of art materials. A basic range of materials could include:  clay, paints, chalk and oil pastels, a range of paper, pencils, pens and brushes.  The list could go on and on but it is amazing what can be created from very little!  Once a person gets a feel for the materials they can choose to use them how they wish.  For example, felt tip pens lend themselves well to controlled mark making whereas clay and paint can be squeezed and smeared in a less predictable process.

Art therapy provides a time and space to express thoughts and feelings that can be difficult to put into words. It is not an art class; there are no rules about what to create and how to do it. It allows someone the opportunity to use the materials in a different way, offering the chance to explore and even make a mess! So, while it may not always be possible to have a sink in the same room it really is necessary to have one nearby.

• The Right Room

 

We try as often as we can to have the art sessions in a private room. As very personal topics and emotions can be shared in art therapy so it’s important that there are no interruptions. It is also important that sessions are held at the same time and place each week to provide consistency. However, we are not looking for the perfect art studio. Part of the task of a trainee art therapist is to learn to work creatively with available spaces to ensure that the environment is right for safe and effective art therapy.

• Storage Hunters

 

Art work can be deeply personal and the art therapist is trusted to look after art work until the end of therapy. Careful consideration is given to the provision of a secure space for the safe storage of art work so that it comes to no harm.  A lockable cupboard or drawer or a filing cabinet are examples of suitable storage spaces.

• Solid Support

 

Supervision is of central importance to trainee and experienced art therapists alike. For students, profession specific supervision is provided by a health care professional council registered (HCPC) practitioner within our university but on-site supervision is just as important. Weekly supervision with the people we work with in Alzheimer Scotland enables effective communication around any issues that may arise in order to support and inform our learning as students.

• Information Exchange

 

As students, access to information about Alzheimer Scotland services is essential but it has also been important for us to share information about what we can offer. Before we begin Art Therapy sessions with the people who come to the Alzheimer Scotland services we provide information about what it is and what it involves and may provide ‘taster’ sessions so potential participants can try using different art materials. Art Therapy students will also be working to evaluate the work we are doing and will be asking the question,

“What was important for you” during our art therapy session today?

Thank you for reading our blog and we are interested in your thoughts.

Perhaps you would like to share your experience of using art materials in our comments section. What has been important for you?

For more information about Art Therapy, go to http://www.baat.org/

Adrienne McDermid-Thomas

Alzheimer Scotland AHP Practice Education Facilitator

@adrienneahpmh

My role is to build on a programme of work of developing AHP student practice placements, an AHP internship programme and AHP volunteer opportunities in Alzheimer Scotland supporting the aspiration that all allied health professional students are skilled in dementia care on graduation.  I have had some really positive experiences of joint AHP working in the past and am very much looking forward to this further opportunity to work together with AHP colleagues and Alzheimer Scotland to develop ways of working which are sustainable and best suited to meeting the needs of people living with dementia and their carers and families.

 

Exploring Occupational Therapy in Alzheimer Scotland: a student’s perspective

What is Occupational Therapy?

One of the challenges facing occupational therapists in daily practice is that, in general, people don’t know what it is that we do. When people learn that I am studying occupational therapy, they frequently adopt a confused expression and ask more questions about what an occupational therapist does. To help people understand my role, I often compare occupational therapy to physiotherapy since people tend to have an understanding of this role.

So, generally speaking, physiotherapists work with a person to improve their physical ability, perhaps following an injury or surgery for example. Occupational therapists work with people to further develop their skills in real life situations that they will find useful in everyday tasks. For example, a physiotherapist may work on a person’s range of movement using physical exercises and the occupational therapist will work with the person to use or maintain this range of movement to move around their kitchen and make themselves a meal or a hot drink. An occupational therapist can work in almost any setting with people of any age to overcome whatever barriers may be preventing them from doing the things that are meaningful to them. These barriers may be physical, psychological or both. An occupational therapist may introduce the person to new ways of doing things or provide them with assistive equipment to help them.

For more information on Occupational Therapy check out:

https://www.cot.co.uk/about-ot/about-ot

What did you do on your placement with Alzheimer Scotland?

This placement was different to my previous experiences where my role was prescribed, or already established, within a certain field. Within Alzheimer Scotland, I was given the opportunity to experience a range community settings including the homes of people living with dementia, local cafes, places of worship, educational institutions and hospitals. I was free to choose how I worked, along with team members, identifying people I thought would benefit from occupational therapy input. In doing so, I created some basic occupational therapy assessment paperwork and created a few sensory resources. I also helped to facilitate an art group, visited local buildings and gave advice on how to make them dementia-friendly.

For my main project, in order to meet my course targets, I worked with children at a local Primary School to develop activity sheets aimed at helping other children understand dementia. Every setting was different but I don’t think I would have had these opportunities or experiences on other placements and I very much enjoyed the work I did.

Throughout this placement I used social media (Twitter and Pinterest) to promote occupational therapy, to gather resources and see what other professionals or people are saying about dementia. This was totally new to me but I think it is a great way to communicate with other professionals and to promote good practice. I won’t speak more about the use of social media as there is another posting on this blog by one of the Alzheimer Scotland occupational therapy interns, Christopher Cousins, regarding the use of social media in healthcare.

What do you see as the benefits of role-emerging placements for AHP students?

I think most occupational therapy students would agree with me when I say that the clinical placements we undertake as students affect the knowledge and skills that we graduate with, and influence our career path within occupational therapy.

Occupational therapists can work in such a wide variety of settings that it is next to impossible for us to study each setting or subject in great detail. By undertaking my placement with Alzheimer Scotland I have had the opportunity to work in the community with many lovely people, carers and families from various cultural backgrounds; I feel that I have increased my own knowledge and understanding of dementia and my personal experience of working with people living well with dementia, their families and carers. Having explored a range of services provided in the community, I feel better equipped to help people access appropriate services – for the person living with dementia and their families and carers.

I have learnt on this placement that not only can Alzheimer Scotland offer a person additional supports but that I should consider other third sector services, what they offer and if I can I refer to them or guide the people, carers I work with towards them in addition to social services.

As a result of the freedom and independence I was given in Alzheimer Scotland, I have definitely gained confidence in myself as an occupational therapist. I was able to go into a setting that doesn’t currently have occupational therapy, and work towards establishing a new service. This makes me wonder where else I could use my occupational therapy profession?

What’s Next?

To other occupational therapists, students and others out there:

• have you experienced a role-emerging job or placement?
• where would you like to see occupational therapy in the future?
• what other possibilities do you see for our profession?

Thanks for reading my post. I hope it has given you some insight into the benefits of AHP students undertaking role-emerging placements in Alzheimer Scotland and encourages you to think about the possibilities of AHP practice within third sector services and beyond.

Nicola Walker, Alzheimer Scotland AHP (Allied Health Professionals) Student

@VwNicola

I am currently a 4th year occupational therapy student at Queen Margaret University. I recently finished an 8-week, role-emerging AHP placement with Alzheimer Scotland.