The Reablement Team – Programme of Exercises:
In my last post, I discussed my frustrations at the lack of information shared throughout services within the NHS, in particular GP referrals into the support and therapy services available for people with Parkinson’s.
However, I am pleased to say, after a number of weeks and a GP referral to the ‘Reablement Team’ within ‘Community Health Services’, my dad has finally stepped onto the right pathway of care for his Parkinson’s.
This is proving to be an excellent programme for my dad and we are already seeing positive results.
The first initial assessment was carried out in his own home by a Physiotherapist and a specialist Parkinson’s practitioner. I was able to observe the assessment which was very thorough and clearly defined throughout. The assessment consisted of a number of information gathering tasks.
Physiotherapist – Introduced herself to my dad, giving her name and the reason she was in attendance. She created a relaxed atmosphere taking time to explain what the assessment was about. She explained about the information she required on his medical history, medication, current wellbeing, general health and ability around the home. Once the discussion was completed, the physiotherapist asked my dad to perform a number exercises, in order for her to assess the strength in his legs and arms, balance and stance.
Parkinson’s Practitioner – Introduced herself to my dad, giving her name and the reason she was accompanying the Physiotherapist. During the physiotherapists assessment, the Practioner was constantly assessing each movement my dad made, identifying areas of concern that were showing through his movements, balance and eye movements due to his Parkinson’s. I found this very interesting, as I was not aware of these areas of concern, due to my lack of knowledge on Parkinson’s, but the information was incredibly useful to me and my dad.
This is one of the reasons you need the experts to support you when caring for someone with Parkinson’s disease, as they have the skills and knowledge to deal with these concerns.
Assessment included the following:
- Dad walking up and down the stairs
- Getting on and off his bed
- Using the bathroom (was the toilet too low, did he require a higher seat)
- Using the bath/shower (if he had a chair or bath board)
- Access into and out of his home
- Assessing his kitchen, cooking, preparing food (did he require a trolley)
Incidentally it was while they assessed his bathroom, that they identified that the battery operated rise and fall bath chair, which had been fitted months earlier, was much too big for the type of bath he had. They explained how a bath board would be safer and easier to use, and that they would arrange for this to be replaced.
I cannot praise the two specialists enough, they took this time to assess my dad, they were excellent with him, and treated him and myself with so much respect during the assessment.
The Outcome – The Physiotherapist arranged to visit my dad the following week to go through a programme of exercises with him. This would involve muscle building exercises and retraining his brain to engage with different movements, while trying to break some initial habits, such as standing on his heels instead of his full foot, this creating the possible balance issues he had been experiencing. Although some of the balance issues could also be due to his condition and medication, the exercises would help.
Occupational Therapy Team – Once the initial physiotherapy sessions had been established, it was decided to call in the Occupational Therapy Team, due to my dad having some problems with the programme of exercise. This was nothing to do with the exercises, it was due to the slight memory lapses my dad was suffering from (another symptom of his Parkinson’s, and one that is being assessed through another service – The Memory Clinic) and the Physiotherapist wanted to make sure the exercise programme continued.
The Occupational Therapists arranged to visit my dad each day to go through the programme with him, and establish some continuity for him, this would enable him to get into a routine, as well as having someone supporting him through the exercises. This really helped him, and I think he even started to look forward to it.
Dad has now been on the programme for 3 weeks, and has taken to the exercises very well. He understands the importance of the exercises, and how they are helping him to regain some of his muscle strength, as well as helping his balance and walking.
- If this programme is so important to the wellbeing of patients with Parkinson’s, why is it, that I had to research and discuss this with a number of people before my dad gained the right support and was placed on the right pathway of care?
- Should all Parkinson’s patients go through this programme?
- Should this programme be established as soon as a diagnosis of Parkinson’s is made?
I guess I have been lucky, due to working in the NHS and having an understanding of the services available, I was able to speak to the right people, in the right places and push forward to gain the right referral from the right service (GP) for my dad.
Although this took time, 5 months to be exact! I didn’t give up. . .
However, I do still wonder if there are other people just like my dad, with newly diagnosed Parkinsons, who have nobody to push for them and are not getting the right support from these excellent services just for the want of the right referral. . . .