After graduating from Glasgow Caledonian University in 2017 with an undergraduate degree in physiotherapy, I decided to take the unusual route of returning to GCU as a PhD student. However, as a newly qualified physiotherapist returning to university for three years of full-time academic study, I was aware of the need for valuable clinical experience as an autonomous professional during a formative time of my professional career. Therefore, over the past year – since qualifying as a physiotherapist – I have been working part time as a physiotherapist at Erskine in a role that has supported my professional development while also affording me the time required for my PhD.
Erskine is a unique organisation, founded in 1916, that provides care for veterans and their spouses across four homes located in Bishopton, Glasgow, and Edinburgh. Most of Erskine’s residents are aged 80-90, with a few over 100; although we do have some ‘young’ under 80’s! As anticipated with an ageing population, the residents at Erskine present with a wide range of care needs, from those with highly complex care needs to those who require minimal support to live an independent life. As a result, the care provided at Erskine is varied and can include general medical care, rehabilitation, and end of life care. As a physiotherapist, I am part of a multidisciplinary team involved in delivering this care alongside care staff, nursing staff, GPs, speech and language therapists, and podiatrists. Due to the variety in care needs of Erskine’s residents, my role within this team is diverse and can involve the management of acute infections, long term neurological conditions, and musculoskeletal injuries, in addition to the multiple co-morbidities and mobility impairments associated with ageing. The variety in this role has proved valuable to my development as a newly qualified physiotherapist as it has provided me the opportunity to apply my knowledge and skills from various clinical specialisms within a complex care setting. Find out more about Erskine through the following video: https://www.youtube.com/watch?v=YnByp1aStXw
Erskine is also home to a large number of residents with dementia, and there are specialist staff and environments at Erskine designed to support their care needs. With an ageing population, the prevalence of people diagnosed with dementia will concurrently increase meaning that an even larger part of physiotherapy practice will involve the management of those with cognitive impairment. As experienced at Erskine, cognitive impairments can have a significant influence on resident’s mobility and balance, leading to increased risk of falls and restrictions in physical function. In addition, as dementia and associated cognitive impairments are complex and multifactorial, our residents may also present with a range of other clinical features such as communication and psychological impairments which pose a challenge in the treatment and rehabilitation of these residents. Therefore, not only has my role in Erskine provided me with clinical experience across a broad range of core specialisms, it has also provided me the opportunity to develop my communication (particularly non-verbal), adaptability, and problem-solving skills that are required to work with those with dementia.
A large part of my role as a physiotherapist at Erskine also involves the promotion of physical activity and prescription of therapeutic exercise. This part of my job most readily translates to my work as a PhD student investigating the effects of exercise in Multiple Sclerosis. Similar to people with Multiple Sclerosis, the benefits of physical activity to older adults are threefold: health promotion, symptom management, and potentially disease modifying (see recent study by Lamb et al.). Therefore, we encourage the residents at Erskine to meet the recommended UK physical activity guidelines by running weekly seated and balance exercise classes, static bike sessions, and providing residents with appropriate wheelchairs and/or walking aids to promote safe independent physical activity around the home. Additionally, for the past 3 years, Erskine has organised an annual sporting senior games where residents from Erskine and other care homes compete in various events to raise awareness and promote physical activity levels of the care home residents and wider community.
Although I am still a full-time student, the diversity and challenges I have experienced working within a care home environment has been invaluable to my development as a newly qualified physiotherapist. Working in clinical practice also importantly reminds me that there are individuals and care staff behind the numbers and data that I collect through my PhD, and that the principles of effective patient centred care should also be extended to research design and implementation. As a research, I can learn a lot from clinical practice!
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