Rehabilitation Case Studies: BGS Autumn Meeting 2023

British Geriatrics Society
Date Published:
10 November 2023
Last updated: 
10 November 2023

These case studies were presented as part of the BGS Autumn Meeting 2023.

Rupinder Chal, NHS Birmingham and Solihull

This presentation is about how we brought health and social care teams together to wrap around support for the population of Birmingham. It will cover the ethos of homefirst and how we optimise independence for those who are referred as part of the early supported discharge and admissions avoidance pathways.

Elaine Marsh and Elaine Johnstone, East Dunbartonshire HSCP

The CAPA Team are changing the culture of the delivery of rehabilitation in Nursing homes. The Programme was commenced within the Care About Physical Activity Improvement Programme within the Care Inspectorate in Scotland; looking to use an improvement approach to help care providers build physical activity and more movement into the daily lives of residents in Care Homes and beyond. The CAPA service in East Dunbartonshire have 3 main strands of work : 1.AHP Support to Care homes; providing Physiotherapy and Occupational Therapy, with Senior Healthcare Worker support to our 14 Nursing homes, to maximise opportunity for rehabilitation and reablement to residents.

2.Care About Physical Activity intervention, building on the work of the Care Inspectorate by embedding physical activity into each and every resident ensuring inclusion and access for all.

3. Prevention and Management of Falls and Fragility Fractures in Care homes. Offering support, care and treatment to residents and staff in line with the Scottish Care Inspectorate Tool on same. This can be in the form of training and assurance visits to Care Homes, as well as assessment, care and treatment of fallers.

Mr Ben Wilkins, CEO, Good Boost

Ben Wilkins is CEO of Good Boost, a social enterprise delivering digital musculoskeletal supported-self management services in partnership with leisure centres, swimming pools, community venues and charities. Ben is a registered Osteopath with a Master's in Osteopathy (M.Ost) from Oxford Brookes University and an MSc in Musculoskeletal Science from the University of Oxford, with publications in aqua rehabilitation, digital rehab technology and peer-led MSK community services. He's an MSK Clinical Champion for Versus Arthritis, Chair of the MSK Expert Group for the World Health Innovation Summit (WHIS) and a member of the WHO’s World Rehabilitation Alliance. Ben is a trustee of Healthwatch Merton with a focus on social prescribing, and completing a fellowship investigating the role of gamification on motivation and behaviour change for older adult MSK rehabilitation.

Emma Tarpey, Liverpool University Hospitals NHS Trust

Positive outcomes for older people from a united MDT approach to active participation and engagement in functional activities to maintain a sense of self and independence. Exploring the benefits of completing purposeful and meaningful group activities to retain wellbeing and positive mental health while in a restricted environment.

Katie Linas, Sarah Simmons and Emma Tarpey, Liverpool University Hospitals NHS Trust

What is a bed disco and why is it an inclusive and effective way of preventing deconditioning or promoting reconditioning in a sub acute hospital setting? Find out how we deliver this innovation to frail older inpatients, many living with dementia and how it benefits both patients and staff.

Dharitri Hombardi, Mid and South Essex NHS Foundation Trust

Donna Sterling  and Rachael DiCaprio, NELFT

To showcase NELFTs new D2A Nursing pathway set up 2.5 years ago and compare this to the existing national D2A nursing pathway. This presentation will help explain the differences between both pathways, compare outcomes since its inception and provide insight into why we are seeing such positive results.

Gagan Singh Bhogal and Rebecca Copeland, NELFT             

We will be talking about what the Intensive Rehabilitation service is, what it was set up to achieve and how we have succeeded in this, as well as how the service has supported the wider system within our working boroughs.

Hear from Physiotherapist Carrie-Ann Wood and arts and health professional Hannah Dye, on their innovative dance programme that provides an alternative to exercise classes for older adults prescribed strength & balance physiotherapy at Guy’s Hospital, London. Co-designed with patients, physiotherapists and dance artists, Breathe Dance for Strength & Balance is offering patients choice over their healthcare pathway and seeing multiple benefits.

The Cancer Older Peoples Service, based at the Beatson - West of Scotland Cancer Centre joined forces with Maggie's to form the Living Well With Cancer In Older Age Class.

We all know the importance of getting older adults moving and of tackling loneliness. Older adults were less likely to engage with third sector support services and we were keen to address this. Only 40% of the over 65's visiting Maggie's Glasgow access wider services. After lockdown we noticed that many older adults attending our oncogeriatric clinic, as well as attending the Beatson had become deconditioned and socially isolated. We know that sarcopenia in older adults with cancer is common and results in poorer cancer outcomes. We were also faced with increasing challenges accessing AHP services e.g. the community rehabilitation team due to workforce challenges. We developed this class to address these issues.

The class was led by a Maggies exercise expert, the centre manager and a frailty nurse specialist from the Cancer Older Peoples Service. Clients at any point in their cancer journey, regardless of what treatment they were getting (even if best supportive care) could access the Class. Thus, it could be used to support prehabilitation or rehabilitation. Most of the referrals came from the Cancer Older Peoples Service - thus could compliment comprehensive geriatric assessment delivered in the oncogeriatric clinic or inpatient setting. However, clients could also self refer and other health professionals could refer patients in.

The course consisted of 4 x 2 hour classes;

  • Week 1: introduction, discussion of functional movement, exercise session and initial fitness test.
  • Week 2: functional movement session and discussion in eating for health.
  • Week 3: functional movement session and discussion to managing stress, followed by relaxation session.
  • Week 4: functional movement session, exercise test and discussion on further community support.

The first 2 classes only had 5 people each - due to social distancing still being in place at the time. Age range was from 68 to 72. All had significant improvements in fitness markers: sit to stand and step up and self reported improvements in fitness, nutrition and stress. All reported they felt they could live better with cancer, enjoyed the course and went on to participate in other Maggie's activities. 1 client was deemed fit enough for surgery after attendance at the oncogeriatric clinic, coupled with the class. Another client managed to get back to baking.

There are still barriers needing to be overcome: access to transport allowing people to attend; clients at times not taking up the opportunity to attend, this does seem to be improved if it is badged an exercise class; lack of other health professionals out with the cancer older peoples team referring into the class. However, despite this, classes have been running for over a year now - and clients still continue to show improvements and increasing engagement with Maggie's. So much so there are plans to roll out this project to all the Maggie's centres in Scotland.

Home Visit Rehab Service for older people across Bristol, North Somerset, South Gloucestershire and Taunton

Older adults are often deemed 'not for rehab' or expected to wait a long time for therapy. But sometimes it's too late once they have reached the top of the list, or it is not explained to them that there are other options such as private rehab. Not all oder adults engage in the digital world so we should do more to empower them to understand their options for healthcare.

Feedback on this resource?

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.