Who is Alison?

Q&A with Alison McKean on her role as AHP Project Lead in Post Diagnostic Support in Dementia [published first on https://letstalkaboutdementia.wordpress.com]

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1. Who is Alison and what matters to you as an individual to keep you healthy, active and independent?

My name is Alison McKean and I’m currently on a p art-time secondment as the Alzheimer Scotland Allied Health Professional (AHP) Project Lead in Post Diagnostic Support in Dementia.  I’m originally from the Orkney Islands and apparently still have my accent, I often get asked about this after presentations! I also work as an Occupational Therapist in Dumfries & Galloway, in addition to my secondment and have worked in the field of dementia care for 16 years.

Anyone who knows me will know that I’m slightly obsessed with running and that is what keeps me healthy, active and independent.  I’m currently training for the West Highland Way race in June, which at 95 miles is by far the biggest running challenge I have undertaken so far.  In the picture below are my two running companions and we spend many hours in the local forests, which we’re very lucky to have on our doorstep.  This is where I spend a lot of time reflecting on the work I am carrying out.

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Ruby and Scapa at Mabie Forest

2. How would you describe your work as an AHP National Lead and what is the aim of the role?

Firstly, I’ll go back in my career to several years ago when I was working as an Occupational Therapist with a lady who had been living with dementia for a number of years.  I’ll always remember her family saying to me “we wish we had known about this Service years ago.”   This got me thinking about how many other people living with dementia and their families are in the same boat, not just in relation to occupational therapy but also the other AHP Groups.

I knew how much the AHPs  could also offer people in the early stages of their dementia journey but recognised that often people with dementia and their families were not getting access to us.  My work as AHP National Lead is around developing new ways of working, in partnership, to enable people with dementia and their families to have access to the support of the AHPs at the right time, in order to build resilience and enable them to live well with dementia.

The work is exciting and is always evolving, it is amazing how much can be achieved by having the right conversations with the right people who all have a passion for improvements in dementia care.  I am grateful to all the people who have supported this work and what inspires me is thinking back to that visit from several years ago.

3. With regard to the AHP profile in working with people living with dementia, who should AHP’s be engaging with and what should their key message be?

The key message is that the AHPs have the knowledge and skills to enable people to self manage and live well with dementia for as long as possible. Therefore the AHPs need to continue to engage with people with dementia and their families and carers, the Dementia Link Workers, the Primary Care Practice Teams and each other.  If we can all work in partnership, this will achieve the best outcomes for people with dementia.

4.  How do you think AHP’s should raise their profile in dementia care and how important is sharing and spreading good practice?

From carrying out a large piece of national scoping work with the Alzheimer Scotland Dementia Link Workers and the AHPs, it was evident that there was lots of good work already being carried out.  However it was clear that the AHPs felt that they could be doing more when people are in the post diagnostic phase.  The AHPs need to continue to identify their best interventions for people with dementia and build on our current evidence base.

AHPs are renowned for being modest and although I myself have never been keen on giving presentations, to put it mildly(!), an important part of this role is sharing the work I am doing.  I had the opportunity to present my work at the Alzheimer Europe Conference in Slovenia last year.  Whilst I was in my usual pre-presentation nervous state, Jim Pearson, Director of Policy, Alzheimer Scotland, said to me, “you’ve got a great story to tell, so just tell it”.  The session went really well, resulting in new connections and ideas.  I continue to remind myself of the story and the importance of sharing and spreading it.  If I can do it, anyone can!

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Just arrived in Slovenia with colleagues from Scotland

5.  If you could give one piece of advice to a newly qualified AHP, what would it be?

If you have an idea or feel that something could be done better, no matter how small it might seem, do something about it, tell someone and use your determination to see it through.  Get out there and work on your story as an allied health professional, you never know where it might lead.

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Participating in the 42 mile ‘Devil O The Highlands’ Footrace 2015

To find out more about this work you can see all our work on this community of practice: http://www.knowledge.scot.nhs.uk/ahpcommunity/ndp-workstreams/dementia.aspx

It’s always inspiring to hear about how the AHPs have made a difference to people in the early stages of their dementia journey – have you got any stories you could share with me?

The First 1000 Days.

By Donna Gilgallon and Laura McIntyre (Paediatric Dietitians, NHS Ayrshire and Arran)

With Children’s Day being celebrated, we felt it was only fitting to highlight the importance of a child’s first 1000 days. The concept is a relatively new one which is being promoted worldwide. Focusing on the nutritional journey a child takes from conception to their 2nd birthday; their first 1000 days is so important. But why? A growing body of evidence suggests that much of a child’s lifelong potential is determined within these initial 1000 days, and nutrition is a key element. As parents and health professionals, we have the opportunity to help set a strong foundation for lifelong health and well-being for all young people.

A healthy diet, whilst a baby is growing in the womb, boosts brain development and reduces the risk of several diseases, as well as obesity in later life. Pregnancy is also a time when a Mum can influence the tastes their baby will prefer as a child.

We hope that through good health promotion in the UK, all parents are aware of the benefits of exclusively breastfeeding their baby from birth until 6 months of age. Not only does breastfeeding provide all the essential nutrients that a baby needs for growth and development, if Mum’s are given the right support, it can be one of the most treasured experiences for both Mum and baby.

BabyledAround the age of 6 months most babies will be showing signs of readiness to wean: exhibiting an interest in food; sitting up well with support; grabbing at foods and an ability to chew.  This is another crucial step in a child’s development and one which can have a huge impact on their relationship with food for the rest of their lives. We often receive referrals for children aged 2 and over who have fussy eating tendencies, and as a result mealtimes can be the most stressful part of the day for many families. When speaking with parents facing this challenge, these difficulties can often be related back to feeding in the early years of life.

FingerfoodAs Dietitian’s we love food and would love children and adults alike to feel our passion too. That’s why we cannot express the importance of family mealtimes enough. If a baby has the opportunity to sit down, in a relaxed environment with little or no distractions, alongside the rest of the family, they are more likely to enjoy a wide range of foods. Providing a baby with as many tastes and textures during weaning also helps their acceptance of new flavours throughout their childhood and helps to provide all their essential vitamins and minerals.

Some noteworthy nutrients in a young child’s diet include Iron and vitamin D.

When in the womb, babies lay down enough iron stores to last around 4-6 months.  Following this it is important they have some form of iron in their diet.  The best sources are red meat as our body absorbs this very easily e.g. beef.  Other good sources of iron include:

  • fortified breakfast cereals
  • wholemeal bread
  • Pulse vegetable (beans, lentils and chickpeas)
  • Eggs
  • Dark green leafy vegetable

Another vital nutrient is vitamin D, also known as the sunshine vitamin!  Most of our vitamin D comes from sunlight (very few foods contain this vitamin) and as we don’t get much sunshine in Scotland it is recommended by NICE that supplements should be taken by all:

  • Pregnant women
  • Breastfeeding women
  • Children between 6 months and 4 years of age taking less than 500ml infant formula

Vitamin supplements including vitamin D are available via the healthy start scheme for eligible families (https://www.healthystart.nhs.uk/). It’s our job as AHPs to highlight and promote this to families.

By now we hope you have a better idea of the way we can influence the first 1000 days of a child’s life. By providing a child with the best experiences in these initial days we are giving them the best start to a happy, well nourished and healthy life.

Celebrating Success!

By Isabel Travers, Senior Occupational Therapist

This year, Learning Disability week in Scotland will be held from the 16th-20th May with the theme of Celebrating Success. The premise is to highlight the achievements of people with Learning Disabilities. There are various events planned for the week to raise awareness of Learning Disabilities across Ayrshire and beyond.

On hearing the theme for this year the achievements of one young lady from Ayr came to mind whose successes in life should indeed be celebrated.

Fiona DawsonFiona Dawson is a dynamic young lady with a learning disability and Down Syndrome, she lives with her mum in the family home Ayr but is keen to move to her own home as she states,  ‘I’m 35 now so it’s about time’!

Fiona is a very busy lady working two afternoons a week, paid employment in a local shop and voluntary in an office.  She is a competitive swimmer and training three nights a week between Prestwick Pool and the Citadel leisure centre.  She also spends one afternoon week with a personal trainer.

Fiona has had an amazing year as part of the South Ayrshire Swim Team para squad who were recent finalists for the ‘activity in the community award’ in Ayrshire’s Sportsability Awards.

There are eight members of the team who compete regularly at a high level and have been hugely successful winning 10 gold, three silver and three bronze medals between them at three recent regional championships held in Glasgow.

Last year Fiona travelled to Italy for the Down’s Syndrome European Championships and returned with 11 medals, including three gold!  In a recent competition held in Southampton she won a further two silver and a bronze medal.

Her next swimming challenge will be when travelling to Florence, Italy, in July as part of the GB team to compete in the Down Syndrome World Championships. She has also been selected to swim at the Special Olympics in 2017.

As if that wasn’t enough, she is currently developing her cooking and budgeting skills with Occupational Therapy in preparation for the move to her own home where I’m sure she will be as accomplished as she is in her sporting endeavours.

The secret of Fiona’s success; like every successful sportsperson, support and encouragement, natural aptitude, drive, ambition, resilience, determination and lots of hard work.

The aim of sharing Fiona’s story in this way is to hopefully challenge perceptions of people with a Learning Disability; highlighting just what can be achieved and the valuable contribution people with a learning disability can make to society as a whole.

A truly inspirational story!

Dietitians in Practice: A day in the life of an Eating Disorders Dietitian

Jay KendallAs part of Mental Health Awareness Week (#MHAW16 16th-22nd May 2016) Jay Kendall, Dietitian (Eating Disorder Service, Forth Valley) gives insight into her role and her working day.

I start most days by checking emails to make sure nothing urgent has come through – as I work part time it’s a bit of a juggling act to keep on top of things within my contracted time of two days a week.

I work as a Specialist Dietitian for the Forth Valley Eating Disorders Service and see both adults and adolescents in the community setting.  The adult team consists of a Consultant Psychiatrist, Clinical Nurse Manager, Advanced Nurse Practitioner and two part time Dietitians.  The team for younger patients is called CAMHS (Community and Adolescent Mental Health Service) and is structured much the same way; however it is a larger team which is geographically split and there is more diversity of Nurse Practitioners, Family Therapists and Psychologists as part of this team.

My time is split one day with each although this can vary depending on caseloads.  Today is Tuesday, my adults clinical day so I head over to the unit to do an assessment with our Advanced Nurse Practitioner.  Referrals come into the service from a variety of sources, and these are triaged fortnightly by the team and allocated accordingly.  Each patient must be fully assessed to establish whether they will be taken on by the team or not – i.e. do they have an Eating Disorder.  Most assessments last about an hour and are always undertaken by two member of the team – one to carry out the interview and the other to scribe.  Our numbers vary and patients will be allocated or go onto the waiting list depending on their degree of urgency.  Assessment complete I have patients to see today and developmental work to get on with.

Patients seen and lunch eaten I go back to my office and make a cup of coffee ready to do my admin and crack on with development work for the remainder of the afternoon.

As part of a pilot programme we are running an 18 week nurse-led intensive group for patients with Binge Eating Disorder.  As a service we have seen a rise in the number of referrals we receive for this condition and anticipate that this is an area which will require urgent attention and recognition to ensure correct treatment and management is implemented.  It was felt that group therapy could provide the necessary skills and education for this more recently recognised Eating Disorder, and as such our Nurse Practitioner has developed this group based on Dialectical Behavioural Therapy (informed).  Dietetics has been closely involved within the 18 week course and we have strived to develop appropriate and manageable nutrition education sessions for our patients.  Importantly the aim of the group is to manage the Eating Disorder itself and to reduce the frequency of bingeing episodes through learning skills and mindfulness techniques.   An interesting development as many of these patients find themselves being referred directly into weight management services, therefore initially being treated for weight change as a starting point and as a result struggling to manage their Eating Disorder.  A fact which we now know may actually be detrimental to managing the Eating Disorder itself (i.e. the bingeing episodes), most certainly demonstrating the need to provide evidence-based and timely treatment.

We are currently in the process of developing a pathway in conjunction with our dietetic colleagues within Weight Management and Mental Health to provide the most appropriate care plan for patients within the Forth Valley Area.  Following cessation and evaluation of the group we will have a better idea of how this will evolve within each service and how we can establish the role of Dietetics within this framework.

As Dietitians working within Forth Valley we are working collaboratively to ensure best care for our patients, particularly those who we recognise require additional psychological support and who may be vulnerable to mental health problems associated with their eating habits, whether this is as a result of having a formally diagnosed Eating Disorder or not.  Through good communication and excellent working relationships between teams, and through evaluation and measuring outcomes, we hope to develop and provide experienced AHP practitioner care for these patients. This should ensure the condition is correctly identified, the patient is properly assessed and that subsequently they receive appropriate and timely care within the most appropriate service.

Working within Mental Health, specifically Eating Disorders, can be challenging at times but it is also hugely rewarding.   I enjoy working as part of a close-knit smaller team within Mental Health and it is of course beneficial to also be a part of the wider Dietetic department for support and guidance. I feel this  truly enhances our practice as a profession.

Development work done, I get ready to leave and collect my son from his childminder and look forward to going home for the evening’s activities.

For more information contact: janette.kendall@nhs.net

Or comment below and we’ll get back to you.

Innovating and Sustaining Cancer Rehabilitation in Scotland

Pull up bannerOn the 28th of April 2016 forty allied health professionals (AHPs) from heath and social services across Scotland came together in Edinburgh to learn about, and promote their role in cancer rehabilitation. The event was organised by Debbie Provan, National AHP Lead for Cancer Rehabilitation with support from Macmillan Cancer Support.

A varied programme showcasing projects led by various AHPs was presented to a diverse audience. Delegates were a combination of occupational therapists, physiotherapists, dietitians, radiographers, and nurses and they came from healthboards, council services, the Scottish Government, Macmillan Cancer Support and regional cancer networks.  The majority of delegates described themselves as specialist cancer practitioners, whilst others described themselves as generalists with an interest in cancer, or a service lead/manager. Their main reason for attendance was to network with others working in cancer rehabilitation closely followed by

  • to learn more about cancer policy/strategy,
  • to develop a greater knowledge of cancer rehabilitation, and
  • to learn about sources of support which could aid service development.

Everyone who returned their evaluation (75%) reported that the event met their expectations, and 100% of delegates rated the event as excellent (90%) or good (10%). The most inspiring aspect of the feedback obtained was that more than 93% of respondents reported that they were going to change an aspect of their practice, or take information back to their team as a result of the event.

Will you change anything about your practice, or take anything back to your team following today’s event?

“Be more radical and look into introducing changes. Encourage colleagues to put their thoughts into action and influence change”

“Try to demonstrate impact of our project on other services”

“More positive outlook towards service development. Greater contacts with peers in specialist services”

“Be more creative and link to national strategies more”

“Review in-patient services and get on social networking”

“PDSA – Make it more formal”

CoPIn addition, more than 70% reported that they were either a current member of the “Cancer Rehabilitation: AHP Services and Best Practice” community of practice or they intended to join. This is incredibly encouraging as it enhances our ability to develop services together as an AHP group, and promotes best practice across Scotland.

Whilst a number of projects and services were showcased during the event, delegates were also asked to consider what they needed to improve local practices, and what they could offer others to help move cancer rehabilitation forward collectively. As you can see from the above delegates were very enthusiastic and rose to the challenge. Numerous offers of support were received including:

“I can support people who want to integrate other morbidities into rehab”

“Developing assistant practitioner roles; happy for emails and to meet to discuss role”

“Advice re. training and supporting band 4 OTs”

“Practical resources re OT in palliative care – breathlessness management, fatigue, experience in TCAT Project.”

Moving forward Debbie will link the offers to the requirements, and if helpful she will initiate discussions via the community of practice so that more people can benefit from this.

During the closing presentation the audience was reminded of a few key points discussed during the day, namely:

  • It takes time to improve and to make change happen but if we start small and learn as we go it can happen.
  • Use your connections to pull together bids and applications and be prepared with evidence and rationale.
  • Sometimes big changes come from an informal conversation.
  • Think out-with your own service when considering impact. Not only when gathering data and presenting results but when designing interventions as sometimes by changing another service you can have the biggest impact on your own and vice versa.
  • Improvement advisors are currently being sought to help deliver the forthcoming Active and Independent Living Improvement Programme. These advisors may help you develop your services and show your impact.

TweetreachTo help get these key messages and other points from the day out to colleagues not in attendance and raise the profile of AHPs and their role in rehab with the general public, twitter was used. In November 2014 Debbie put a call to action out via this blog and she introduced the hashtag #AHPCancerRehab. This hashtag was used once again and over the 24hours following the event the twitter hashtag helped the group reach more than 15,000 accounts and made more than 58,500 impressions. To review the tweets sent out on the day take a look at the storify.

You can also view the presentations from the day via the “Past Events and Conference Presentations” section of the “CPD Opportunities” tab on the community of practice. And if you too have something you can offer colleagues to help take rehab forward, or you have examples of good practice which you wish to share, please join the community and upload your resources. You can also e-mail Debbie.provan@aapct.scot.nhs.uk or contact her via twitter @DebbieProvanRD using the #AHPCancerRehab hashtag or you can comment below. You could even write your own blog!

DSC_0220_1.JPGIn summary, the main aim of the event was to build our networks and increase sharing and showcasing; so please do make the most of the opportunities noted above and please share this blog, the community of practice, and the storify with as many colleagues as possible. Together we will improve and sustain cancer rehabilitation in Scotland.

AHPScot Highlights

Screen Shot 2016-05-02 at 07.36.24It’s been a busy few weeks on @AHPScot.

Below are a selection of some of the tweets which have celebrated great AHPScot practice, innovation and success.

Look out for a new blog next week.

Physical Activity

 

AHPCancerRehab

 

 

 

eHealth NMAHP

 

Advancing Healthcare Awards 2016

 

 

AHPScot Blogs

 

Advancing and Awarding Scotland’s AHPs

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The Advancing Healthcare Awards for 2016 took place in London on the 15th April

This is the 10th year of these awards which recognise and reward projects and professionals that have lead these with the aim of making  a difference to patients and clients they work with.

Scottish winners were plentiful. AHPScot is delighted to list some of the AHP and Healthcare Scientist awards below. If we have missed any please tweet and let us all know who. You can see the full list of winners here .

Next year it could be you……….