Thursday 12 November 2015. CSH Surrey co-owner Vicky Kershaw was named Winner of the Patient Champion Award at the 3rd annual Kent, Surrey & Sussex (KSS) Leadership Collaborative Summit and Awards at Sandown Park on 12th November. Another CSH Surrey co-owner, Erika Frohlick, our stroke specialist nurse, was a Runner Up.
Vicky, a Domiciliary Physiotherapist, provides physiotherapy care in patients’ homes and in care homes, working with patients to assess their condition, therapy needs and to set goals. She has developed an innovative approach to working with patients with Dementia after drawing on her many years of community physiotherapy experience. Her approach involves truly involving the patients and their relatives, so that together they can identify interests and activities that will engage patients in their therapy.
Key to her success has been respecting her patients as people who have long and rich histories, enabling her to find out what motivates them and makes them tick. By taking the time to listen to patients, relatives and carers, Vicky is able to understand their daily routines, past and current interests as well as mobility levels before their condition deteriorated. Her strength is in building a rapport with patients and putting herself into their worlds. By engaging with patients at their levels she is able to tease out previous interests so she can make these the focus of her therapy activity.
She’s been able to demonstrate time and again that such an approach inspires and motivates patients to participate in and achieve goals. For example, organising therapy overlooking the nursing home gardens for a lady who was a keen gardener, before eventually taking the therapy outside and using the gardens as a motivation to regain mobility. In another example, after listening to a patient’s husband describe how his wife was ‘livelier’ after a weekly visit from a care volunteer, Vicky timed her therapy with these visits. Gradually the lady could stand with help, and recently stood unaided before leaning forward to hug and kiss her husband. She can now stand with minimal support and Vicky is now helping her be able to get into a car so the couple can go out for drives again. The husband has reported that he’s ‘got his wife back again!’ as a result of Vicky’s care.
Vicky also teaches others the skills needed to communicate and interact with people with Dementia so they can deliver more effective care. In one care home she helped staff develop their communication skills with a particular patient. She asked staff to introduce themselves each time they saw the lady, talking steadily and slowly. She explained how the patient needs time to process information and encouraged the use of clear verbal communication, such as: ‘Do you want to stand?’ and ‘Let me help you walk’. By slowing the pace of communication and being clearer in their communication, the staff were able to engage the patient to work with them to regain her mobility, where previously they had been choosing to use a wheelchair for ease and speed.
Vicky continually tries to find ways of increasing patients’ independence. Most recently she has successfully sourced red-coloured Zimmer frames as this colour is known benefit those with Dementia. She persevered in her aim despite many stumbling blocks, and is now part of a research project that is exploring the impact of using these frames.
Vicky says: “I was initially shocked and surprised, but then really thrilled and honoured that someone had taken the time to write the entry and recognise the work I do. I work with a small but very supportive team within an organisation that has a ‘can do’ attitude and encourages us to take new ideas forward and try different things.”
Erika Frohlick, Stroke Specialist Nurse and Early Supported Discharge Coordinator, works as part of our Community Neuro Rehabilitation Service. Erika was compelled to act when repeatedly asked the same questions by stroke patients and their families/carers going through early supported discharges (when patients are discharged to be supported in the community rather than remaining for weeks in acute hospitals). She also listened to their feedback and experiences at 6-month reviews.
She recognised that stroke survivors, families and carers felt unsupported and isolated after discharge from the acute hospital. Often they:
- Didn’t understand their diagnosis
- Were scared of a recurrence
- Were unsure how to cope with the physical and mental health changes
- Didn’t know if their experiences were ‘normal’
- Felt ‘lost’ outside the ward environment
- Were unsure where to go for information and assistance.
Based on these insights, Erika developed a bespoke workshop with a Dietitian colleague to answer frequently asked questions and thus better support patients and their families. The workshops began in 2013 as 20-minute education sessions.
Erika sought participant involvement from the start, with early feedback revealing too much information for attendees during the session. She therefore extended the workshop time and number of topics, working with clinical colleagues to better meet the patients’ needs. Stroke survivors now benefit from two, 2 hour workshops that cover:
- Psychological and cognitive problems, secondary prevention
- Diet and nutrition, occupational therapy guidance.
During the workshops Erika encourages questions and conversation, and facilitates networking during the break. The workshops also include a focus on signposting to local groups and social opportunities and she invites stroke survivors who are further along their journey to the workshops so recent stroke patients can hear from another survivor, not just from care professionals. Through this, attendees benefit from other perspectives and experiences.
Satisfaction is high, with relatives reporting:
- Better understanding changes in behaviour
- Feeling supported themselves
- Feeling better able to provide the right care while encouraging their relative to achieve as much as possible.
Family members and carers express that the information on mood and the psychological effects of stroke is incredibly beneficial. For example, improving their awareness and knowledge of how to recognise and cope with emotional outbursts (inappropriate laughter or tears) and the support this part of the session offers in terms of minimizing the impact on themselves and the stroke patient. Attendees also feed back that they gain reassurance and comfort from talking to others. For example, hearing how people have been affected by their stroke, sharing examples of care and how they have coped with new situations at home and out in the community.
As a direct result of the workshops, stroke survivors and their families/carers have set up their own local self-help group to promote independence and peer support. This continues independently at a local supermarket café, chosen for its mobility access and good parking, thus creating a wider legacy for her work. Erika’s workshops have also been recognised by South East Coast NHS Clinical Senate as an example of best practice stroke care.
Erika says: “I was very proud that my workshops were recognised by the NHS South Coast Clinical Senate as a best practice example of stroke care, and it makes me even more proud that my work has been further recognised by being named Runner Up for this NHS Patient Champion award.”