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Inpatient rehab

‘Music therapy should be a frontline resource’

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Professor Kathleen Howland has practiced music therapy for over 35 years

Music therapy should be commonplace in frontline care, particularly during the times of isolation brought about by the pandemic, a leading clinician and teacher has said.

Professor Kathleen Howland says the power of music can have an immeasurable impact on patients, from those in recovery through to those at the end of their lives.

“I absolutely contend that music should be a frontline resource. For someone dying in isolation, music is the sound of love. It can help with grief in a way that nothing else can touch,” says Kathleen, who has practiced in music therapy for over 35 years.

As one of only five dual-qualified music therapists and speech language pathologists (CCC-SLP) in the United States, Professor Howland has worked widely with patients at all stages of recovery during her career, particularly those with neurological conditions.

And while the benefits of music in rehabilitation are widely known, Professor Howland – also a music therapy tutor at Berklee College of Music and founder of Music Therapy Tales – is keen to point to its impact for patients in hospital settings.

“When people are socially isolated from their loved ones, music can be very powerful,” she says.

“In a hospital, it can be a very saturated environment with the noise of medical machines and alarms, but what can be very aesthetically pleasing is to take someone’s musical preferences and balance them with silence.

“I’ve been working with a hospital in Connecticut and their cardiac care patients, and music can provide a sense of order and hope.

“There is also the work of Brian Schreck in his creation of Music of Heartbeats, which is spreading like wildfire in the United States in its popularity. It takes the heartbeat of a loved one who is going to pass away and uses that as the bass to some music they loved.

“This is recorded by therapists with the nursing staff, and can then be sent to their family as something they can keep and treasure forever. As well as having their heartbeat, their music will be with it.

“The power of music is such a powerful thing – it is the sound of love.”

Professor Howland has worked extensively with neuro patients during her career and is hugely passionate about the impact it can have on their rehabilitation.

“Music is a brain-based intervention for brain-based disorders – period,” she says.

“In the United States, the changes in insurance have limited access to the proper therapy they need, which is absolutely shameful. It can be a choice of whether you want to walk or talk, because you can’t afford both, and often it’s the walking that happens as that’s easier to achieve.

“But in my work as a speech therapist, the power of music can help so much. There was one man who had a stroke, he came to me three times a week for a year and a quarter – I worked him good!

“If people have the opportunity to rebuild their neural circuitry and rebuild their speech capability, then we can vary that with gait work so they don’t get fatigued. But I’m always looking to use really functional motivation to force their neurological hand and push through that damage.

“There was once I was accompanying the man on a trip, I was his companion, and my daughter had to travel with us. We were at the airport having dinner and my daughter wanted dessert. I said she couldn’t have it, but he wanted her to. I said to him ‘If you want her to have it, then you order it for her’.

“So through using melodic intonation therapy (MIT) techniques we’d been working on, I sang ‘Key Lime Pie’ and he repeated it, he ordered the dessert for my daughter.

“The brain doesn’t have to work very hard if it knows what to do – something so familiar as Happy Birthday can come easily even in acute cases – so I’m always looking for things that challenge and push and melodic intervention can help to provide those opportunities.”

Inpatient rehab

Review launched into end-of-life stroke care

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End-of-life care after stroke and how current practice can be improved is being investigated in a new landmark study. 

Hospital stroke units across the UK will be assessed to establish their current end-of-life care approach, and the views of health professionals, alongside patients and families will be sought in formulating the recommendations for best practice. 

It explore current challenges around receiving and providing end-of-life care after stroke and will investigate what medical professionals, patients and carers consider both helps and hinders current levels of care. 

The 18-month study is being supported by a grant of £142,626 and involves universities and NHS Trusts across the country. 

It is being led by the UK’s largest nurse-led stroke research team at the University of Central Lancashire, whose School of Nursing is home to the only two nursing professors of stroke care in the UK. 

“Despite medical advances, 21 per cent of stroke patients die within 30 days of having their stroke. High quality end-of-life care and support after stroke is therefore crucial,” says Dr Clare Thetford, senior research fellow from ULCan’s School of Nursing. 

“However, stroke is different to other conditions, and can make end-of-life care complex.

“There is a lack of education and guidance for healthcare professionals responsible for providing this care. This may cause inadequate, inappropriate or delayed care and support. 

“We will explore what specific challenges stroke may create, and how the many recent changes to general end-of-life care might work with stroke patients.”

The National Institute for Health Research Programme Development Grant will see UCLan and Lancashire Teaching Hospitals NHS Foundation Trust (LTHTR), based in Preston, collaborate with partners including Oxford University Hospitals NHS Foundation Trust, Canterbury Christ Church University, University of Nottingham, Poole Hospital NHS Foundation Trust, University of Exeter, alongside a dedicated patient and public involvement group.

Professor Liz Lightbody, who is leading a National Stroke Workforce group for end of life care, on behalf of Health Education England, says: “There is a view that providing end of life care is the role of specialist palliative care teams, but this is not the case. 

“Good quality end-of-life care is everyone’s business, all staff involved in caring for patients following a stroke should have the knowledge and skills to provide compassionate and sensitive end of life care.

“LTHTR is committed to providing mechanisms to translate research evidence into practice and thereby influencing improvements in the quality of care. It is providing a pivotal role in the transformational development of stroke services across South Cumbria and Lancashire and will ensure the results from this research are implemented into practice.

“Together we are at the forefront of new innovations in healthcare, so I am delighted that we are involved with this research and that local patients can benefit from access to emerging new treatment for strokes.”

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Inpatient rehab

Nurses to establish specialist centre in Nigeria

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Two nurses from a care and rehab community are using their 20 years of experience with the provider to open a specialist care centre in their native Nigeria. 

Isaac and Nikki Ajibade, two of the longest-serving members of staff at Askham Village Community, are establishing an 18-bed centre in Nigeria which will provide nursing and dementia care, with future plans to expand into neuro support. 

The couple are using Askham’s community approach in creating their own centre, and will use their two decades of experience with the provider to help them establish and develop their new project. 

“We will be using Askham as a source of inspiration for our approach – with a key focus being on the real sense of togetherness we feel here,” says Isaac, who met his wife at the school of nursing in Nigeria in 1976.

“Askham’s owners care for the place, for the staff, for the residents, and it’s this we want to emulate ourselves in Nigeria. 

“To care for people, you need to be compassionate. People need help and I’m always very happy when I’m helping people.”

The couple will retire from Askham, near Doddington, at the end of the month to begin work on developing their centre in Nigeria, which is already built. 

Isaac is currently Askham’s longest-serving lead nurse, who specialises in long-term degenerative conditions of young people, and Nikki is a specialist nurse in dementia care.

Both have played significant roles in the development of Askham Village Community. Isaac joined Askham in 2012, with his current role seeing him manage Askham Place, one of the five independent care units that make up Askham. 

When he first joined, there were only three units, but in his time there the care community has continued to expand its offering, broadening its expertise to cater for ever more resident and patient needs.

The couple also say they regard their colleagues and residents at Askham as members of their extended family, and last Christmas, their children and grandchildren – who live and work in the US, Ghana and Nigeria – all visited Askham during a holiday to the UK.

“In life, we are in stages. The main thing is to move when you are strong, and when you can go out and about and do the things you want to,” says Isaac. 

“We feel we have achieved three quarters of what we want in life! My children are grown and I’m happy they’re all in good places, so the next thing is to go and enjoy the latter part of our lives where we can do good and rewarding work that brings us joy.”

Aliyyah-Begum Nasser, director at Askham, says: “Isaac and Nikki are Askham institutions. They have been with us for many years and to be honest I can’t imagine Askham without them. Their legacy will be here for years to come. 

“Ever since they first started with us, they have always been part of the life and soul of Askham. I have so many fond memories, particularly when we would celebrate the diversity at Askham through international days and Isaac would always come in his native Nigerian attire, much to the delight of the residents. 

“As lead nurse of Askham Place for almost a decade, he has witnessed the many high and lows of working in social care, but has always remained focussed on providing the very best care for his residents.

“Nikki is just as dedicated to her dementia residents in Askham House and her personality shines through in all she does. Just like a proud motherly figure, she runs a tight ship but always makes sure everyone is smiling. 

“Most recently, during the height of the COVID-19 pandemic, she has been what can only be described as a true soldier; motivating her team and ensuring residents were comfortable amidst incredibly trying circumstances.

“On behalf of everyone associated with Askham, we can’t thank both of them enough for all the vulnerable people they have provided excellent care for, and the countless staff they have empowered and led and supported over their years here.

“They’re so dedicated to our residents, and we know they will apply that same dedication to their endeavours in Nigeria. We’re all excited to see it come to fruition and will be doing all we can to support it from afar and we wish them all the very best.”

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Inpatient rehab

Specialist hospital expands capacity

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A hospital which supports people with brain injuries and degenerative neuropsychiatric conditions has invested to increase its capacity, bringing a further 12 much-needed beds. 

St Peter’s Hospital in Newport now offers 51 beds across single-gender units, which provide person-centred assessment, specialist treatment and nursing care for men and women. 

The additional beds come after a significant investment from specialist care provider Ludlow Street Healthcare, which owns and runs St Peter’s Hospital.

In addition to the 12 new en-suite rooms, a new family room and modern communal area have also been created, increasing provision for patients and their families. 

St Peter’s is known for the multi-disciplinary team is has on site, including psychologists, psychiatrists and an extensive group of therapists including dietetics, physiotherapy and speech and language specialists. 

It is committed to pursuing a therapy-based model of care, which can reduce patients’ need for a primarily drug-based pharmacological approach.

“Caring for and treating people with degenerative neuropsychiatric conditions and ABI is a very specialist area which requires expert knowledge and a lot of time,” says Dr Grzegorz Grzegorzak, consultant psychiatrist at St Peter’s Hospital. 

“There is an urgent need in Wales and the UK as a whole for more specialist facilities like ours. Extending our facilities allows us to give immediate help to more people, delivering more positive outcomes.”

Work began on developing the hospital’s facilities in late 2019, and despite the challenges posed by the COVID-19 pandemic, the extension has been completed on schedule.

The expansion of St Peter’s continues to incorporate the bespoke design elements which make it dementia and ABI friendly. 

The hospital has worked closely with The University of Stirling’s Dementia Services Development Centre, to create an environment that is not only innovative and therapeutic but also encourages patient proactivity.

Helen Rocker, hospital director at St Peter’s Hospital, says: “This is an exciting development for St Peter’s and we are looking forward to welcoming new patients to the hospital.

“With all of our staff and patients who are able to receive the vaccine having been vaccinated, this couldn’t be a better time to be opening the new facility.

“The last year has been very challenging and the staff have been exemplary throughout in their unswerving commitment to ensuring the highest standards of virus control. So it’s gratifying to be finally able to look forward and focus on new opportunities to develop our patient services.”

And with the increased provision for patients comes new job opportunities, says Helen. 

“In order to support our additional patients, we will need to increase our staff numbers and we are actively recruiting for RMH and RGN Nurses as well as support workers,” she adds. 

“We have just raised our nursing salaries by nearly 6.5 per cent and are confident that we currently offer some of the most rewarding career opportunities for nurses in South Wales.”

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