Integrated Care Matters Series 5 October, 14 th 4 – 5.30 pm BST HOSPICE INFLUENCED CARE IN COMMUNITY SETTINGS Hosted by IFICs Intermediate Care Special Interest Group
Images: Orange Smile; Places in the world
UK Crown Dependency Popn: 85,000 Size: 33 x 13 miles
Our strategies
Panellists Lisa Rae, Social Worker Dr Max Watson Sinai Health Systems Alison Christian Hospice UK, London & Toronto Physiotherapist Professor Gunn Grande Belfast Isle of Man University of Manchester
Housekeeping ➢ Panellists : Please mute your microphone on the tab when not speaking ➢ Delegates: Please add your questions to the Q&A Box Use the Chat Box for comments or weblinks and send to all ➢ Twitter – @ IFICInfo #IFICScotland #ICMatters #BuildBackBetter
The Role le of Carers to Support People in in Community Settings Gunn Grande University of Manchester United Kingdom
The im impact of of for orced in innovation durin ring COVID-19 on on Fatigue an and Breathlessness (F (FAB) foll ollow-on se sessi sions Alison Christian Physiotherapist Hospice Isle of Man
Fatigue and Breathlessness (FAB) Interventions FAB FAB Follow-on Zoom FAB Follow-on • 8 week structured • Weekly rolling programme • Drop in • Weekly • COPD, cancer • 1-hour long • 1-hour long • Physical activity, • Self-led exercise session • Staff-led education, relaxation in gym • Structured session • Staff-led • Unstructured session • Supervision • Invited to attend FAB • Supervision from staff • 1:1 Telephone support Follow-on on • Caseload of 19 completion
Patient characteristics 9 Respiratory conditions (e.g. COPD) 4 Neurodegenerative conditions 1 Cancer (e.g. MND, MS) Other: Old age, rheumatoid arthritis, scleroderma and 3 polymyositis 77% 23% 3 10 8% 8% (1) 15% 15% (2) 69 69% (9) 8% 8% (1) 50-59 60-69 70-79 80-89 Age
Zoom sessions compared to Hospice-based sessions 86% Thought that the Zoom sessions were ‘good’ (12 ou (12 out of of 14 14) 64% Felt that Zoom sessions were ‘no different’ or ‘better’ than sessions held at Hospice (9 ou (9 out of of 14 14)
During the COVID- 19 outbreak… “Yes it has been great to see the staff and the other patients who have participated and we have all had a 71% quick chat at the start and end of the sessions. It has been great to still have the sessions albeit delivered in a different way” Felt that Zoom “As I was shielding at home the Zoom sessions “It was nice catching up sessions were were one, regular, contact with the group” ‘helpful’ for with people outside” social contact (10 (10 ou out of of 14 14) “Just nice to see different faces and hear different voices”
During the COVID- 19 outbreak… 64% Felt that Zoom sessions were ‘helpful’ for psychological support (9 (9 ou out of of 14 14) “Having this contact each “It helps me to see and know week had been helpful” that the world goes on” “I did look forward to the sessions”
During the COVID- 19 outbreak… “… is always so cheerful and helpful and 77% ready to give advice if needed” “Definitely, as I can talk on a one to one basis” Felt that the individual “I have been given help. My husband is not well and it helps to know someone cares” telephone support calls “It is lovely that the contact has continued in this way were ‘helpful’ and presents an opportunity to discuss matters that (10 ou (10 out of of 13 13) wouldn’t be appropriate to discuss amongst a wider group” “Comforting to have a contact if needed”
Advantages of Zoom “Not “Keeping in touch, and a “Company missing out constant reminder of dealing during isolation” on exercise” with breathlessness” “Working at own speed “No travelling to the Hospice. I find it and not having to ask my exhausting getting ready to go out” husband to take me” “Easy to access using zoom and the directed exercise sessions have been very good. We probably do more exercise via zoom than we would at Hospice, where we would spend time chatting amongst ourselves too”
Disadvantages of Zoom “I find it difficult to “Not being able “You can’t beat handle the zoom to use exercise seeing people in principle” equipment” person” “Not really having contact with “… Not having the garden people. I miss the chats with the walks in the good weather” people who attend” “None really other than the fact broadband or computers seem to lock up rather frequently leaving us with a frozen picture whilst the image is frozen”
New activities “I’ve enjoyed the 77% music, especially Queen in TT week. Said they wanted More please” to continue doing “Makes it more exercise to music cheerful – and 92% challenging, trying to in sessions follow” (10 out of 13) Said they wanted sessions to continue “Very relaxing” finishing with a short relaxation “Really beneficial” (12 out of 13)
Reminders about breathing tips 92% “Find I use them more “Most helpful” when reminded” Found the reminders about breathing tips “Very very useful” help lpful Breathing square Fan Blow as you go
The challenges Initial Getting patients on board Technology issues – staff and patients Communication Resources Equipment Discovered Patient safety and risk assessment/communication The “silent audience” Adapting content for differing levels of ability Varying the content Increased stress level!
Attendances Start of lockdown / • 26 • 21 • 12 Jan Feb March getting organised for • Hospice • Hospice • Hospice Zoom • 32 • 39 • 40 April May June • Zoom • Zoom • Zoom 1 session 5 • 25 • 31 • 44 cancelled due July Aug Sept • Zoom • Zoom • Zoom Wednesdays to staff shortage
Going forward: What would suit you best? “The Zoom and Hospice sessions 7 could be on 6 different days” 4 4 2 1 Return to Sessions at Mix of led Continue Option to Other self-led Hospice but and free with Zoom attend at workout at led by staff time to use at home Hospice or “Zoom weekly Hospice equipment at home via and visit hospice Zoom monthly?”
The Future Try FAB Follow-on: Sessions at Adapt Hospice and on Adapt Zoom to run concurrently Evaluate
Thank you Alison Christian Physiotherapist, Hospice Isle of Man Alison.Christian@hospice.org.im Stay in touch, sign up to our newsletter at www.hospice.org.im
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Community Hospice Lisa Rae Director, Volunteer, Intake and MOW Services October 2020
Future Webinars Date IFIC SIG Hosts Topics (subject to change) 18 th Nov Self Management and Co-production Social Prescribing- up close and personal or physically distanced? 17 th Feb Ageing & Frailty Age Friendly, Healthy, Connected Communities 10 th Intermediate Care Community hubs and neighbourhood teams as key March integrators 14th April Compassionate Communities Social leadership, collective action and kindness 14 th May Palliative and End of Life Care Enhanced supportive, palliative and end of life care 16 th June Self Management and Co-production + Health Literacy and Realistic Medicine Polypharmacy
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