1 Occupational Therapists guiding volunteers in palliative care results of a qualitative research. Maryke Moens (3rd year student Artevelde University College Ghent, Belgium)
2 Contents workshop Introduction: palliative homecare and the volunteer What s the problem? (results of the qualitative research) PDL a solution? (practicing + discussion) Conclusion and final statement.
3 Introduction: palliative homecare and the volunteer Palliative homecare includes: Pain- and symptom reduction, emotional, spiritual and social care. Palliative homecare-team: GP, physiotherapist and nurse. (Volunteers are supplementary) (http://www.palliatief.be)
4 Introduction: palliative homecare and the volunteer Profile volunteer: Sex (n=354) 85% 15% Age (n=354) < 30 years years years years years > 70 years Still working or not? (n=354) professionally occupied not professionally occupied 62% 38% (Baerten, 2005)
5 Task of volunteer: o o Available 4-8 hours/week; emotional, social and spiritual guidance of palliative person; o o o o o substitute partner or family members; night watch; administration and organizing activities; mourning care for relatives and accompany the relatives after the decease. (Baerten, 2005)
6 Current basic-education of the volunteer: Communication lessons; mourning care and ethics; theoretical background about pain- and symptom reduction; comfort care; privacy and lift-techniques. (Baerten, 2005)
7 Results Motivation to do voluntary work: 3 main reasons of internal motivation: 1. Opportunity of personal growth; 2. Meaningful occupation to spend time on; 3. Have wide interests in life and end of life. How to cope with psychological burden? 1. A semi-structered interview (sample of 12 volunteers) following results emerged: compensation and psychological help from the organization. 2. Extra result : lack of ergonomic education for the volunteer itself and for the patient during the care. => 7/12 volunteers said the basic education was sufficient but it was too philosophic. The practical side was sometimes overlooked. (Moens, 2011)
8 Teaching PDL a solution? PDL = Passivity's of Daily Living 7 factors: 1. To lie; 2. To sit (position the person); 3. To wash (to be washed); 4. To dress (to be dressed); 5. To change (to be changed); 6. To transfer (to be transferred) and 7. To feed (to be fed). (Loudon & Jelier)
9 Principles of PDL and the haptonomical approach: 1. Prepare the person to the touch. 2. Do not lose physical contact, using a warm touch. 3. Stay continuously in contact with the person by eyecontact and conversation. 4. The approach has to be caring and gentle but not childish. 5. The approach has to be a sensory focused approach with matching emotions. (Loudon & Jelier)
10 Why OT? (MOR-model) Person who is palliative Environment: the volunteers Activities of daily living. e.g. getting dressed.
11 person who is palliative Environment: the volunteers + OT Activities of daily living. e.g. Getting dressed. Activities of daily living. e.g. Getting dressed.
12 Techniques To lie, to sit and to be transferred Techniques that need proper ergonomic explanation are : Rolling the person over. Lifting the person higher or lower into the bed. Shift the person to the side of the bed. Helping the person to get seated from a lying position and reverse. the use of a passive or active lift (for example the Arjo Sara): when possible
13 (film: positioning person higher into bed using the Multi glide )
14 Active lift Passive lift
15 Techniques to wash, change and position (to sit and to lie). Problems that could emerge: Spasms in the hand and arms. Spasms in the feet and legs.
16 Solution: Use of Key points Spasm hand: Envelope-technique Wrist palmary flexion with corresponding hand. Opposition of the thumb with other hand. Extension of fingers Give full hand with corresponding hand. Combine key points with swinging-movements away from the body.
17 Bend Knee with Extension spasm : Use thumb to put big toe in plantar flexion. Place 4 fingers in hollow of the foot. Place a hollow hand in the knee cavity. Bent the knee and place the foot on a flat surface. (do the same thing with the other leg) One hand holds both feet. Swing both legs gently to become an abduction of the legs. Put your arm under the legs and support the knees.
18 Strengthen knees with flexion spasm : Take the heel with one hand Push with the other hand gently above the knee to strengthen the leg. Why these techniques? Bending and strengthening legs, holding hands, are all necessary to put on clothes, to wash the person, etc.
19 Techniques to be dressed in bed Film PDL (to be undressed)
20 Solution: a good technique and adjusted clothing. Necessary for good comfort for the person is extra heating. Make sure your hands are warm. Explain what you are going to do. Chose clothes the person wants to wear / likes!
21 PDL requires a full education! Before you can teach PDL to someone, you d have to take PDL-courses. Problems: PDL isn t known out of the Netherlands and Belgium. Expensive course: +/- 870 Information / contact: Mobicare PDL-consult Mariniersweg VE OUDE-TONGE Telefoon: +31 (0)
22 Time to put it in practice
23 Discussion PDL + use OT Do you find an OT as a coach/mentor useful? Is the role as a coach part of an OT s job description? Do you find it important that OT s could participate within palliative care? Would you use PDL?
25 References Baerten, H., Clicteur, B., Helaers,A.-S.,& van Iersel,T.(2005, april). De onzichtbare kracht vrijwilligers in de palliatieve thuiszorg Kinébanian, A. (2009). Grondslagen van de Ergotherapie. In A. Kinébanian, & M. Le Granse (Ed.), Grondslagen van de Ergotherapie (2e editie ed., pp ). Maarsen: Elsevier Gezondheidszorg. Loudon, S., & Jelier, B. (n.d.). Retrieved 10 29, 2011, from Moens, M., De Muynck, S., De Backer, C., Defloo, S.,& Dewandel, J.(2011) Wie is hij? De persoon achter de vrijwilliger in de palliatieve thuiszorg : drijfveren, stimulans, emotionele belasting en voldoening Ryckbosch, J., Pâquet, G., Tassent, R., & Thomas, N. (2011). Tussen komen en gaan ligt een heel verhaal. Schelfhout, P., Noyez, E., Stevens, A., Schaep, C., Schouteden, J., & Rasschaert, S. (2011). Vrijwilligerswerk in het palliatieve netwerk. Van Autrijve, K., Vandaele, B., Van Driessche, L., Van Gansbeke, E., & Wolfs, F. (2011). Vrijwilligers in een palliatief dagcentrum: de manier waarop zij emoties ervaren. Website: (n.d.). Retrieved 10 29, 2011, from
Self-help and daily living Looking after your joints when you have arthritis Looking after your joints when you have arthritis This booklet provides information and answers to your questions about looking
Getting a result! Information and ideas to help young people who are multi-sensory-impaired and their families understand and participate more fully in the transition planning process Advice for Connexions
Recovering After a Stroke: A Patient and Family Guide Consumer Guide Number 16 AHCPR Publication No. 95-0664: May 1995 US Agency for HealthCare Research and Quality Purpose of This Booklet This booklet
Physiotherapy Department Rehabilitation after shoulder dislocation Information for patients This information leaflet gives you advice on rehabilitation after your shoulder dislocation. It is not a substitute
Preface Care at Home: A Handbook for Parents is a guide that is intended to help parents/guardians meet some of the challenges of caring for a physically disabled child at home. It includes information
Protecting Your Fragile Spine Contents Osteoporosis basics...2 Are you at risk...3 Broken bones in the spine...3 Signs and symptoms of broken bones in the spine... 4 Protect your spine by moving safely...5
Personal health budgets in England - making them work in mental health mind.org.uk Contents About Mind 3 Executive summary 4 Summary of recommendations 5 Background to our research 6 Methodology 7 People
CRACKS IN THE PATHWAY CRACKS IN THE PATHWAY People s experiences of dementia care as they move between care homes and hospitals OCTOBER 2014 CRACKS IN THE PATHWAY The photographic illustrations used in
Lifestyle Coach Facilitation Guide: Post-Core Stress and Time Management Content Overview This session explores the causes of stress and how participants deal with stress. Participants learn ways of reducing
One chance to get it right Improving people s experience of care in the last few days and hours of life. Published June 2014 by the Leadership Alliance for the Care of Dying People Publications Gateway
A Guide to Using Qualitative Research Methodology 2002 Michael Quinn Patton and Michael Cochran Reproduced with kind permission of Michael Quinn Patton Executive Summary This guide to using qualitative
Affirming Life what is a palliative approach? a guide for family and friends with loved ones in aged care 1 Acknowledgements Many people and organisations have collaboratively contributed to the development
Special review Supporting life after stroke A review of services for people who have had a stroke and their carers January 2011 About the Care Quality Commission The Care Quality Commission (CQC) is the
TA2, 2nd Edition, January 2002 TECHNICAL ASSISTANCE GUIDE A publication of the National Information Center for Children and Youth with Disabilities Helping Students Develop Their IEPs N IC H CY This guide
Before, During and After Hip and Knee Replacement Surgery A PATIENT S GUIDE OAS S OAS S Acknowledgments This revised booklet is based on information produced over the years by a variety of organizations.
National Cancer Institute Taking Part in Cancer Treatment Research Studies U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Taking Part in Cancer Treatment Research Studies If
One in 3 Canadians aged 65 or over fall at least once a year. Many of these falls result in serious injury, and loss of mobility and independence. Most falls can be prevented. TAKE ACTION... to prevent
Income Support medical component claim form (adult and young person) This form is for adults and young people aged 12 or over. There is a different form for children under 12 years old. Please use a black
My Child Has Selective Mutism, What Do I Do Now? Written by Christine Stanley and Teresa Cardulla Evaluate your child. Once you suspect selective mutism (SM), you should confirm that diagnosis. In doing
What should I ask my doctor? Thinking about lung cancer brings up many questions. Sometimes it is difficult to keep all of your questions straight. Many patients have topics in mind they want to discuss
A coming out guide for trans young people Introduction 2 Green Light Project 4 What is Coming Out? 6 Support & Advice 8 Things to Think About 9 Coming Out Step by Step 10 Questions & Responses 12 Coming
CANCER FOLLOW UP CARE THE VIEWS OF PATIENTS AND CARERS EXPRESSED IN A RANGE OF FOCUS GROUPS HELEN SHELDON, ARWENNA DAVIS, SUZANNE PARSONS PICKER INSTITUTE EUROPE MAY 2008 Picker Institute Europe The Picker
WHO CARES? The Future of Adult Care and Support in Northern Ireland A discussion document Page Number Ministerial Foreword 3 Introduction 6 Structure 7 What is Care and Support? 8 Why do we need to change?
qé~åüéêë=~åç=pìééçêí=pí~ññ tçêâáåö= qçöéíüéê= pí~åç~êçë=~åç=dìáçéäáåéë Acknowledgments The Department of Education appreciates the efforts of all who have contributed to the development of this document.
A WorkLife4You Guide Communication Skills for Healthy Relationships Communication is vital in creating and maintaining a relationship, whether it be an intimate relationship such as with a partner, child,
TEACHING ADULTS TO MAKE SENSE OF NUMBER TO SOLVE PROBLEMS USING THE LEARNING PROGRESSIONS Mā te mōhio ka ora: mā te ora ka mōhio Through learning there is life: through life there is learning! The Tertiary
Now I feel tall What a patient-led NHS feels like December 2005 Now I feel tall What a patient-led NHS feels like December 2005 DH INFORMATION READER BOX Policy HR/Workforce Management Planning Clinical
Partner in Mental Health Leadership: Parenting for Life Presents: Kids Can Cope: Parenting Resilient Children at Home and at School Have you ever wondered why some people are particularly good at dealing