This blog began as a journal of a Winston Churchill Memorial Trust Travel Award visit to the USA to study how Lifestyle Redesign could be used in Occupational Therapy to improve the hospital/home interface for older people. It has continued to record developments and inspiration gained from that experience since returning from Los Angeles early in 2012.

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Monday, 16 January 2012

'If it's valuable to you then it's valuable to me" Pressure Ulcer Prevention Study

The OT clinicians who work with the patients/clients in the Pressure Ulcer Prevention Study (PUPS) meet every Friday morning with the researchers and project support staff to discuss updates on cases, any problems and any admin issues. The interveners are blind to the study methods and hypothesis. I joined them for the meeting.

My understanding of the programme so far is that clients are recruited to the programme for a year, they receive a payment and they are allocated $400 for spending (with the OT's agreement) on equipment that will help them with pressure ulcer prevention. The programme consists of a number of units divided into 4 modules, they were designed to run in order but can be used flexibly as the OT and client agree. I am not yet familiar with the modules so will return to this another time.

Almost all the clients have a spinal cord injury, varying from C4 to L6 levels. Many are young or acquired their injury at a young age, very often through gang related violence or due to violence in the environment around them. There are a smaller number whose injuries were accident or other cause related. There are challenges for the OTs delivering interventions as some clients' homes or neighbourhoods are not safe for them to visit.

The OT interveners who were present talked about selected patients from their caseloads, reporting on their progress, any difficulties making contact (maybe because of coming in and out of jail, family problems or other unexplained reasons). They used the meeting to get ideas and support with any difficult issues.

The issues discussed were very varied, from how to make contact with a non-engaged client, to what equipment would be most suitable, to how to open the topic of sexual activity and intimacy in the context of pressure ulcer prevention and avoidance or adaptation of activities that put pressure areas at risk. One of the OTs summed it up in her words to one of her clients:
"if it's valuable to you then it's valuable to me"

Later on in the day I attended the once per semester Faculty meeting, about 40 of the Faculty were present and Dr Clark chaired the meeting. I introduced myself and explained the purpose of my visit to USC. Various sections reported on progress and it became clear that OT is very much a growing entity, and much of this is due to the success of the various Lifestyle Redesign programmes that are being run from the Faculty. Follow this link for more detail of the way the Faculty is organised and the work being done.

I also attended an early afternoon lecture from a visiting academic about Sensory Integration and Autism, another area of work that is developing here at USC.

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