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Behind the scenes of brain injury referrals

Despite COVID-19, work is still progressing to allow providers to accept new residents at the first opportunity. Gill Ayris from Richardson Care, which runs three brain injury care homes, discusses the process.

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The admissions team invest a lot of time in developing our contact base of social workers, solicitors, case managers and other professionals who can refer people to our homes. We accept people from across the whole country, so we’ve created a national network over several years. This is enabling us now to reach out to as many people as possible who may need our support.

Richardson Care was established over 30 years ago and the provision for adults with acquired brain injury has increased significantly in the last seven years. It has taken some time to build up our network of contacts but our aim is to grow at a sustainable rate.

A good proportion of our referrals come from word of mouth, which is an endorsement of the rapport and relationships we have built, but primarily the outcomes that we achieve for our service users.

I have been at Richardson Care for nearly six years, working as part of the admissions and referrals team and a year ago, I became admissions and referrals manager.

The team’s office is based at The Richardson Mews, a 25-bed residential care home for people with brain injuries.

This means that we get to see first-hand the progress that our service users are making. It also enables them to build positive relationships with members of the team who are not their direct care-givers.They feel part of a big family.

My background is working for Avon Cosmetics. I was there for over 20 years, and while it’s very different, it’s also the same in some respects. You appreciate the value of client service, and become accomplished in selling a service too.

I was also involved in a lot of events work at Avon, and that is another area of our business here and in the admissions process.

When we receive referrals, it’s hugely important that we assess whether the person in question will fit in with our current population.

If you’ve got someone who potentially would not fit in well, it could be a disaster waiting to happen and be hugely disruptive to everyone else in the home. So we’re very mindful of this being a person’s home, a place they can feel happy and safe.

I am involved in getting together all the information needed for a referral, which can be a complex process requiring contact with several parties.

For example, we need full disclosure of the individual’s current conditions, living skills, cognitive abilities, mental capacity, risk behaviours and medications, as well as their medical and forensic history.

If we feel that they would indeed fit into our community, we arrange an assessment. Usually the member of the admissions team who has been dealing with the case, along with the appropriate home manager, willvisit the individual concerned and their support team.

We travel all over the country to complete assessments and if we then feel that we can support that person, we make an offer by letter. The offer letter details the level of specialist care provision and associated costs.

Once we know someone is joining us, we’ll make efforts to get their room ready just as they’d like.

We recently welcomed a resident who liked butterflies, for example, so I went out and bought butterfly bedding and asked the maintenance team to put butterflies on the wall. We want them to feel at home and we’re proud of our personal touches.

Despite the COVID-19 lockdown, we are still working hard to develop what we do.

We continue to take referrals, offering assessments over the phone or via a video link, and we’re reviewing the situation on a weekly basis.

These are fast-changing times and we have had to adapt. I am still in the office to cover the phone and take any referrals, but the rest of the admissions team are with the residents, doing activities like painting, bingo and quizzes.

We’re very aware of the potential impact on the residents of not being able to have family visits or go out to do different activities. We’re all pulling together to help and the atmosphere within the homes is amazingly positive. We’re still providing structure and routine while being creative and coming up with new activities to keep everyone’s spirits up.

In ordinary circumstances around this time of year, our residents might go on holiday for a week, whether that’s going back home, staying somewhere in the UK or even going abroad, as one resident does to see his family. We include that in the person’s care package, and provide the necessary support staff, as we recognise how important these visits are as part of their rehabilitation.

While we have sadly had to suspend visits currently due to the pandemic, usually families can visit any day they like and we encourage them to do so.

Sometimes families have to travel a long distance to visit, as we take residents from across the UK. But even if they are only here a short time, seeing their loved one is hugely important all round.

Across our units, we have created a home from home. We aren’t rehab intensive so it’s relaxed and homely rather than a clinical environment.

Our focus is on well-being and developing skills of daily living. Experience has shown us that by treating people as individuals, with dignity and respect, helps them to engage with their support team.

They become more independent and improve their quality of life.

Of course it is a business, but I think the personal touches come from the fact it is family owned and run, without pressures from external shareholders. Richardson Care has been in business for 30 years, with 75 residents across six homes at present.

When people come out to see us, be they a professional or a family member, I always encourage them to visit our homes and see for themselves what we do and how we do it.

A few years ago my dad was diagnosed with dementia and I would have absolutely loved him to come here (although social services thought he’d be better off in a specialist dementia unit). The fact I would want my own dad to come here says it all, I think.

Sometimes it doesn’t work out for people we take here, and they won’t engage even though we’ve done the best we can, or perhaps their needs have escalated and they’ve become disruptive. But we will always try our very best.

We have good relationships with other care providers, so we know what other options are out there if someone isn’t suited to our homes, for whatever reason. We had one resident recently who had to be sectioned and went to another unit, but then he came back to us and has settled in well.

It’s fantastic to see people doing well with us, but one of the most beautiful things for me is to see people being supported to go back home.

Getting people back into their own home or to supported living, and giving them the quality of life they want through getting their independence, is what this job is all about.

Knowing that you’ve made a difference, that you’ve been part of that team to make a difference to a person’s life, is so important to us all.

Richardson Care has six residential care homes in Northampton, three of which provide care for adults with acquired brain injury. The remaining specialise in supporting adults with learning disabilities.www.richardsoncares.co.uk.

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Legal

Video: everyday vs specialist tech

Assistive technology Expert Andy Fell joins Irwin Mitchell law firm for an in-depth exploration of the very latest independence-boosting devices and platforms.

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Technology plays a day to day role in our lives and mobile phones, tablets, Alexa and Siri are common place.

Imagine the impact on your life if you were no longer able to interact with a touch screen or keyboard or give voice commands….

In this virtual event, Assistive Technology expert Andy Fell gives practical demonstrations of how everyday technology and specialist technology can be used to help give independence to those who need it most and why specialist technology may be needed.

During the event hosted by Lauren Haas, personal injury solicitor at Irwin Mitchell LLP, Andy goes into detail about what apps and gadgets are on the market, how everyday technology can be optimised such as the Amazon Alexa, and answered a number of questions ranging from touch screen sensitivity to smart watch reminders.

Case managers, ancillary medical professionals, as well as interested members in healthcare, social care, parents and clients may find this recording useful, as well as anyone caring for, working or living with people such as dementia sufferers or sufferers of other conditions which restrict their mobility.

Andy Fell is an independent disability and assistive technology (AT) consultant with almost twenty years’ experience working with all disabilities and age groups.

He is a qualified Rehabilitation Officer for the Visually Impaired and, since qualification, has lectured on the use of assistive technology and role of AT in the life of disabled people.

He has worked with a wide range of charitable organisations including British Dyslexia Association, was head of assistive technology for Guide Dogs for the Blind and National Disability Advisor for the Royal Yacht Association.

He has also worked for blue chip companies, the emergency services and various government departments including Department for Work and Pensions.

Andy is a fellow of the Royal Society of Arts, chairman and founding trustee of the Wetwheels Foundation and sat on the British Dyslexia Association – Workplace Assessors Professional Review Panel.

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The relationship between music and running

By Daniel Thomas, joint managing director of Chroma Therapies.

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By Daniel Thomas, joint managing director of Chroma Therapies

With its ability to produce new neural pathways, Neurologic Music Therapy is able to encourage movement, co-ordination, improve speech and language, and improve the ability to read/feel emotions, reactions and more, in people living with catastrophic injuries.

This is because music automatically connects to the brain. And this automaticity is what makes music so powerful.

Music also has to ability to push your training capabilities farther and faster especially in running.

This is why a running playlist is the ideal accompaniment to any runner.

Each songs tempo stimulates the brain, evoking a running response of either a faster pace or a steady rhythm depending on what you want to achieve.

For a faster pace, a good running playlist should contain songs with 150-180bpm.

Unfortunately, with not many songs out there using that speed (unless you enjoy rock, metal or speed garage for running) than the other option is to choose songs with 75-90bpm, as this tempo is perfect for a steady rhythm and maximising efficiency.

Do you recall an earlier blog where we discussed cadence and stride length using NMT for preventing falls in the elderly?

We suggested music with a high bpm count promotes movement, good cadence and walking speed, so songs like Nancy Sinatra’s ‘These Boots are Made for Walkin’, which has 85 bpm, is ideal.

BPM strongly correlates to step cadence.

Rhythmic Auditory Stimulation (RAS) is an important aspect of NMT.

Predictable rhythmic structure allows the sensori-motor system to move in sync with the beat.

This is, in essence, why music is important to runners, as it has the ability to communicate with the brain in order to help maintain a steady pace or increase speed depending on the bpm.

When it comes to mental wellbeing, we will always discuss music’s ability to improve mental wellbeing, and its effect can also be attributed to runners.

Music’s ability to improve stride, cadence and style, to produce better and better runs, and enable runners to achieve personal goals also have a positive effect upon mental wellbeing.

A sense of accomplishment. And with the right playlist, runners can end each run on a high.

We also like to discuss how NMT is more effective when it is personalised to that individual.

The same can be said in the case of a runner. A playlist that includes, not only songs with the ideal tempo for them, but also have some personal meaning, have the greatest positive effect upon runners.

The more enjoyable the run, the less fatigue is experienced. This may be due to the fact that music is able to interfere with the parts of the brain that communicate fatigue, essentially causing a distraction, so less fatigue is experienced.

For runners, the relationship between music and running can be seen to be just as effective and important as the relationship between music and recovering from a brain injury.

Its ability to improve running capability, speed, motivation, and promote mental wellbeing is what makes the difference between a run just being a run and reaching ‘Flow State’ – the mental state where the runner is in the moment of running – no distractions, and the run becomes…euphoric.

Read more: Running in the name of mental health

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News

Concussion could lead to depression, ADHD, dementia and Parkinson’s – study

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A new study has revealed a link between concussion and the risk of being diagnosed with attention-deficit hyperactivity disorder, mood and anxiety disorders, dementia and Parkinson’s disease later in life.

Despite ‘clinical recovery’ from concussion typically lasting one week, a team of researchers from the University of Manitoba suspected there may be longer term effects. They used 25 years of population-based health data between 1990 and 2015, involving almost 50,000 cases of concussion from people living in Manitoba, Canada.

They found that concussion was associated with an increased risk of being diagnosed with attention-deficit hyperactivity disorder (ADHD), mood and anxiety disorders (MADs), dementia and Parkinson’s disease.

After analysing the population data, they found that concussion was linked to an increased risk of diagnosis of ADHD, dementia and Parkinson’s.

Women who had a concussion were at greater risk of developing ADHD and MADs, but there were no differences between men and women for the risk of developing dementia or Parkinson’s.

Multiple concussions didn’t affect the risk of later being diagnosed with ADHD, but a second concussion increased the risk of dementia, while exposure to more than three concussions increased the risk of being diagnosed with MADs.

While previous studies have found links between concussion and ADHD, dementia, Parkinson’s and MADs, most have relied on patients self-reporting their symptoms, the researchers write.

However, this study can only show an association, not cause and effect.

The mechanism behind this increased risk is unknown, but the researchers state it’s possible that the pathways of some biomarkers that are dysregulated in ADHD, Mads, dementia and Parkinson’s, namely, cortisol, are also affected after a concussion.

The paper, published in the BMJ journal, states that future research is needed to explore the relationships between concussion and ADHD, MADs, dementia and Parkinson’s in other populations.

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