OT Week and The Impact of COVID-19: Judith Hardman - Community Crisis Team and Discharge Planning

The COVID-19 pandemic has affected us all in ways we couldn’t have imagined back when the first lockdown started in March. Over that last 7-8 months, we have all come together as a community to learn how to adapt and to cope with the stresses that the virus has put onto our everyday ‘normal’ lives.

As we adjust into the ‘new normal’ (again), and to mark the start of OT Week, I, along with my expert OT team at Julie Jennings and Associates, have reflected on how the Coronavirus pandemic has affected our work, and what we are doing to make sure we continue providing our vital services safely to those who need it most.

Across OT Week we will be highlighting each of the individual roles we undertake, to give a broader picture of life as an OT during the pandemic.

Judith Hardman

Area of work: Community Crisis Response and Discharge to Assess Teams.

Background experience: I worked in preventing unnecessary hospital admissions by identifying and providing the support people need, to stabilise a crisis situation and enable them to remain at home. Additionally, I facilitated early discharge from hospital as soon as patients are medically optimised and continue rehabilitation in their own homes.

Impact of COVID-19 on working practice or your personal perspective:

Risk assessment is always high on the agenda with both these areas of work as situations can be unpredictable and can quickly become unstable. The onset of COVID-19 has altered the focus of risk assessments by finding ways to limit face to face contacts with patients and their relatives in terms of time spent and numbers of different staff visiting. For me personally, this has meant more forward planning and pre-visit investigation rather than my preference which is to ‘go and see and problem solve when you’re there.’ I have also found the wearing of PPE can become a barrier to communication, particularly with patients who have a cognitive or sensory impairment, and rely on facial expression and lip reading to aid understanding. This has encouraged me to use different strategies such as enhanced body language and physical demonstration during assessments and treatments.

On a more positive note, limiting the numbers of different staff visiting patients has enabled me to take more ownership of a situation rather than passing things onto other staff members to complete. This has given me more satisfaction from having more continuity with individual patients and seeing things through to the end. I think patients also benefit from this as they are able to build a more trusting relationship with fewer people visiting and reduce the need to keep telling their story.

It has also given me the opportunity to consistently practise using skills which are outside the traditional roles of OT

Your OT perspective and what you can do to positively influence challenges imposed by the pandemic:

I have found when working in a multi-professional team that Occupational Therapists are sometimes seen as providers of equipment. COVID-19 has given us a platform to promote all the other skills that we use during assessments and treatments that are not always recognised by other MDT members and often go unseen. Post viral fatigue is a common symptom which is now being recognised, and making small changes to the patients’ environment and routine can make a big difference, along with fatigue management strategies, and with equipment being just a small element of OT intervention.  Hopefully this will raise the profile of Occupational Therapy within teams and offer a better health and independence outcome for patients.

Your commitments to support the recovery of People that have been affected by the COVID-19 pandemic:

The intervention I provide is, in the main, short term with outstanding patient goals being referred on to other services. RCOT has published a detailed guidance of the effects of COVID-19 and recommended treatment strategies. I will use this to identify outstanding needs and goals and to justify the future services I am requesting when referring on.