Can phd change the world? Occupational Therapist mug says yes!

Ready to change the world – challenging nutritional care in acute hospitals

On overhearing a 3rd year PhD student saying that “when you start your PhD you think you will change the world but you very quickly learn otherwise, realising your work will be of little significance”, I was horrified and disappointed – what is the point of what I’m about to embark on? Why spend 4 years of my life working towards something which will not have any impact?

Perhaps with the naivity of a new starter, I fought the idea of my PhD being insignificant. Perhaps it is the naivity of a new starter which continues to drive my fight against the disappointment of not being able to change the world, but an inspiring talk from Dame Jessica Corner*, at the Faculty of Health Sciences Post Graduate Conference last week, reassured me I need not be disappointed – that I have started a journey which will create impact on the world to a lesser or greater extent. Dame Jessica advised us that the 1st step to changing the world is to “believe what you are doing is important” and that is certainly something I can acclaim to! My PhD is just a baby step, I am still right at the beginning, but I am confident that Occupational Therapy, Dementia care and reducing malnutrition are all important enough to invest time, money and effort into. There are still plenty of opportunities for my research to fill some gaps and change practice and guidelines for care!

Here are two reasons why I believe what I am doing is important:

  1. We need to listen to those in our care

So far I have found plenty of research on how to improve meal time experiences in long term care settings – environmental changes and strategies to improve social interaction at meal times, for example. There are observations and concerns about insufficient assistance while eating and drinking, and meal times being a task rather than an engaging activity in both long term and acute care. But what about the views of those who, for one reason or another, are malnourished?

What about asking and observing those with dementia in our acute hospitals to really explore and discover the reasons behind not eating and drinking? What about examining the reasons for aversive behaviours at meal times instead of brushing someone off because of their “challenging behaviour” and therefore minimising their independence.

  1. Occupational Therapy skills and the importance of a multidisciplinary approach are not being recognised for their potential impact

After hearing a talk from Dr Tara Sims** at the PGR conference and reading the papers referenced below, I have felt a renewed enthusiasm for being an OT, the impact the skills of an OT can have in care, and especially in challenging poor nutritional care. Occupational Therapists have the skills to assess and evaluate the eating process, as a vital activity of daily living, and can make significant contributions to individualised care plans. Using a holistic approach and activity analysis, we can assess the cognitive, mental, physical, social, sensory and environmental factors around a meal time experience, working with other professions to inform care.

Imagine the impact if OTs, Dietitians, Speech and Language Therapists, Nurses, Doctors and Physiotherapists all combined their extensive skills to comprehensively evaluate malnutrition and dehydration in acute hospital care – I think it’s safe to say we could change the world!

 

* Dean of Faculty of Health Sciences, University of Southampton
**Senior Lecturer in Occupational Therapy, London Southbank University

References

American Journal of Occupational Therapy (2007) Specialized Knowledge and Skills in Feeding, Eating and Swallowing for Occupational Therapy Practice. American Journal of Occupational Therapy 61(6): 686-700

Paul, S. and D’Amico, M. (2013). The role of occupational therapy in the management of feeding and swallowing disorders. New Zealand Journal of Occupational Therapy 62(2): 27-31.

Clinical Academic Research – Dementia PhD

As I approach the first milestone of my PhD – the formulation of a research question – I felt it would be good to start a record of my studies, to share some of the interesting finds and information that I come across during my time as a doctoral fellow.

So who am I?

Naomi Gallant: newly married and recently embarked on a Clinical Academic PhD with the University of Southampton. As a doctoral fellow in the Wessex CLAHRC, my research is focusing on improving quality of fundamental care for people with dementia in acute hospitals, specifically reducing the risk of malnutrition and dehydration. I’m a qualified Occupational Therapist (OT), graduating from University of Southampton in 2011, since when I have held several OT roles ranging across physical and mental health settings. Not wanting to lose these clinical skills, and realising the importance of research influencing care at the point of delivery, I have chosen to follow a clinical academic route with the aim of collaborating research and practice.

So why dementia?

There is a significant need in our society for an increase in dementia awareness. As the Department of Health (2013) highlights, society is not geared up for the increase in the condition, with avoidance being a common reaction – something which needs to be challenged. Conversations with those outside of the clinical or academic world only serve to emphasize the need for dementia awareness in people who have not experienced it within their own spheres. Comments such as “can someone with dementia really use Twitter?” and “the government have spoken a lot about dementia, it must be a real problem?” have fuelled my desire to spread the ‘Dementia word’.

So why me?

Since 2011 I have worked in a variety of settings, both as an OT and a Health Care Assistant (HCA). My time as an HCA in 2 different dementia care homes initiated my passion for ensuring optimum quality of life for people who are unable to express their needs due to severe cognitive impairment. My experience of seeing people, bed bound, in advanced stages of dementia furthered my realisation of a need for better understanding of, compassion for, and care towards these people.

As an OT I have worked in acute dementia wards, community care teams, and general hospital medical and rehabilitation wards. Despite the variation from specific dementia care settings, and despite a lot of wonderful, compassionate nursing staff, I have seen a need for improved dementia care in all of these places. The need seems especially acute on hospital wards where the environment, staff training and resources are primarily ill-equipped to face the challenge of a growing dementia population.

With all these factors combined, the opportunity to undertake this research – which could in small or large part contribute to future policy making – was one which I could not let pass me by. I hope you enjoy the insight this blog aims to bring into my journey.