Keep Able Reablement Podcasts
Keep Able is your go to authority on Wellness and Reablement. Our various podcasts cover discussions on real world issues and examples from people in the at home aged care support sector, specifically for CHSP providers.
Keep Able Reablement Podcasts
How exercise physiology supports reablement P2 - Danielle, Feros Care
Exercise Physiology – important factors that make goals of a physical nature part of reablement and both building clients capacity and engaging them in activity. Using a person-led approach.
Discover more reablement resources at keepable.com.au
Hi everyone and welcome to this episode of the Reablement Podcast, where Keep Able are talking to a range of people who have experience with using reablement and we discuss how it can be incorporated into your services and why it works. I'm Alison Vella from Keep Able. So in this episode we're going to be talking to Danielle, who is an exercise physiologist from Ferros Care here on the Gold Coast. Danielle has 20 years of experience in healthcare and her first 10 years being in private practice, followed by the last 10 years in aged care organizations in the community. She's the Allied Health Mentor and she will tell us a bit more about her current role. Danielle, thanks for being here. Hey Alison, thanks for having me. So we'd love to hear a little bit more about your role.
SPEAKER_01:Okay, fantastic. So the last year or so I've been working as an allied health mentor in a team of about 40 Allied Health professionals. So we have exercise physiologists, physiotherapists, occupational therapists, and nutritionists coming on board as well. And as an allied health mentor, I really help to support the team with managing their caseload of their clients. So any questions that they might have with how they're going with their clients, you know, some goal planning, working out what training the staff need as well to help keep the skills and standards and of the services up to date. Also just supporting the allied health manager. So supporting them in their role. And really as an allied health mentor, it's about inspiring the staff to not only be very professional and offer high quality and standards of care, but also to really enjoy their role and making sure that they're feeling like they're growing as a clinician as well and they're advancing and evolving themselves in their position and staying motivated and really recognizing the purpose in their role.
SPEAKER_00:I have to ask, do you actually incorporate conversations about reablement into team meetings and things like that?
SPEAKER_01:Yeah, absolutely. It is very common, like either in an allied health team meeting or a clinical meeting that involves nurses as well, or even in the community meeting, I think it's really recognizing that reablement is a team approach. It's not just something that you do one-on-one as an as a clinician. Like you do actually include a care manager or the nurse or anyone else who's dealing with the client. So types of discussions that we have is usually would be like, you know, discussing a case or something like that, and working together how we can support this person to not only reable and maintain their physical capacity, but also just on a whole how to prove their improve their overall health and wellness. What are some of your most inspiring client reablement stories? Oh Alison, there's so many. How do I pick one? No.
SPEAKER_00:It's like trying to choose your favorite child, isn't it?
SPEAKER_01:Yeah. Oh, look, recently I've been working with a client who had long-term back problems and like very long-term back problems. So she was in her late 70s, I think, and she'd had multiple back surgeries and had developed a way of living to be able to support herself with this back pain. And and she was often getting a lot of treatment as well from a physiotherapist and just a lot of manual therapy and things. So with a great exercise program that very specifically targeted her weaknesses that she had going on in her body in terms of identifying exactly where she was tight and exactly where she was weak, and therefore how we could improve her flexibility, improve her strength, and just gradually, like a really gradual, gentle approach because of her bad back. Um, we found that sticking to a program and being quite consistent, that after six months she'd actually was starting to have some really significant changes, not only in um having less back pain, but also being able to do more and get back to things that she hadn't been doing for a long time. And right to the point where the physiotherapist said, Wow, you know, I can see that you're actually improving, like the muscle tone in your body's changing, and you're able to do some of these tests more easily than what you ever have in the last few years. So that was really amazing. She just said it was just transforming because she didn't realise that she was capable of doing that because it was such a long-term chronic condition.
SPEAKER_00:What sort of language do you use when you're talking to clients and you're thinking this is a reablement opportunity right here that helps to get them on board? Because I know a lot of people in the industry, we don't use the term reablement with our clients because that just sounds like a made-up word.
SPEAKER_01:I don't even actually really think about it as reablement. For me, it's really about re-empowerment. Like I would use it as a very similar word, like re-empowering people. So, you know, reablement is really about helping somebody to get back to doing something that they haven't been able to do or maintaining something that they want to do. But if you use the word re-empowerment, it can include everything across their life. So it may not just be, oh, you know, physically I'm now capable of doing this, but it can also be mentally as well. Like, you know, sometimes we get challenged by things because of our mental health and well-being or any something that might be going on emotionally in our life. So, you know, through physical fitness and physical strength and um rebuilding your physical capacity, you also rebuild your mental capacity and your emotional capacity and your your overall outlook on life. So you're really empowering somebody. So often, like in every situation that I'm in, not just with clients, I'm often always considering how can I inspire this person or re-empower this person to, you know, bring more to their life or to go to another level or you know, to live their best life. So really, reablement's not just something that I do with my clients, actually do it with the staff members and the team members that I I work with. So, you know, with my whole team, like how can I re-empower my, you know, the team that I'm working with, you know, it's something that we should be doing, you know, in our whole life, really.
SPEAKER_00:Finding out what's going to light the spark today.
SPEAKER_01:Yeah, definitely. And it's something that I, you know, reablement is something I'm always considering with children. You know, I've got two children and it's constantly like you don't want to be doing everything for them your whole life. You've got to really reable them them to say, okay, come on, you can actually do this now. I know it's quicker for me to type your shoelaces, but really like you've got to learn how to do it, give it a go, just keep going. So it's the the same sort of approach at both ends of the scale, whether you're working with a two-year-old or a 92-year-old, you know, just constantly empowering people to take care of themselves. Exactly.
SPEAKER_00:And with children, that can be any age. I still do it with my adult child. So, over your working life and your experience, Danielle, is there any sort of like evidence that you've come across that um you find is really quite helpful and powerful for you?
SPEAKER_01:Yeah, that's a great question, Alison. You know, there are a lot of research projects out there about the benefits of reablement. And for example, if you look at the life curve that has been developed of scientific evidence-based research. But the one thing that I feel is the greatest evidence is just experience, like just your own experience of seeing how supporting somebody with reablement can change their whole life, you know, and then having those conversations with other our health professionals who've got the experience, or even care workers, or you know, it could be family members of just seeing the benefit of powering somebody to improve their health and improve their well-being and get back and active and engaged in life. So sometimes some of the greatest evidence to look into is just your own wealth of wisdom and wealth of knowledge. You don't always have to jump onto the internet and look up what the latest research is. Like we can really value ourselves as a professional, as a clinician, and know that we we can often bring the greatest wisdom.
SPEAKER_00:So, with the mix of professions in your allied health team, just explain for me sort of what the different goals look like against some of those other work titles as well.
SPEAKER_01:Yeah, um great question. So it the goals do vary across different allied health professions. And an example could be something simple, like a physiotherapist could be working with somebody who has quite acute injuries. So some of their goals might be about um maintaining or regaining mobility in a joint or something like that. So, you know, range of movement in a joint or something after an injury, so working through post-surgery or post-injury or post-fall or something like that. So a goal for a physiotherapist may be very injury related, or it could be after a chronic case of a lung condition or something like that. So they may have smaller goals that are more clinical focused, whereas an exercise physiologist may have more of a well-being overseeing goal in somebody's life. Like, okay, you've come back from this injury and you've got your full full mobility back and everything now. But you know, we what really want to get your fitness back so you can get down to the beach and get walking again, and and you can walk with your partner again and keep up, or you can go back to swimming at the pool, you can you can drive yourself to the pool, or you can get in and out of the transport and get in and out of the water okay. And so it's more of a sort of a bigger approach in terms of their overall functional capacity through their whole life. And then going to an occupational therapist that's going to be very associated to around the house and can be very specific to things like, hey, you know, we've realized that you're not able to make yourself a cup of tea and take it back over to the coffee table anymore. How can we support you with that? And their approach would probably more of an assistive technology approach. So they'll work with a physiotherapist and exercise physiologist who will be working on physical capacity, and then they'll be offering the assistive technology that it can also re-enable somebody. So it's like, hey, you know, you can't pour the kettle, no worries. We've got this type of kettle that you'll be able to do that, or you're spilling your tea on the way to the coffee table, no worries. Let's get you a tray on your walker and you can you can get that over. That's two very simple examples, but there's just so much assistive technology around that really supports with reablement as well. And I think as a clinician, we sometimes, especially because I've been working in the industry for 20 years, sometimes that's not the first thing that I think of. You know, maybe the younger people who've just come out in the industry, very technology focused, but I really see that that's going to be advancing in the next few years as well, just the amount of technology and how that can be very important in reablement.
SPEAKER_00:So in the aged care sector, quite often the clients not only have your support and your service in place, but perhaps other services that come into their home as well. Do you ever have to sort of communicate or pass on information to other support workers that are working with the same person to make sure that they are also trying to maintain the person's independence?
SPEAKER_01:Yeah, absolutely. That's really important to have that team approach. And that's what I actually really love about working in an aged care organization is that you do get that ability to communicate with each other directly. So just through your, you know, the the systems and the platforms that you use, like I can do a case note and then it's there for somebody else to access and and look at, you know. So and then if it's important that the care workers that are working with the client that they need to know, I red flag it for the case manager to then pick up and communicate with the care workers, or can very easily drop a line to a regional manager who can communicate with all the care workers who are working with that client. So it is a very team approach, and that's actually one of the main reasons why I went from working in private practice to working in aged care because working for myself, I loved it and I, you know, felt like I could make a huge difference, but it wasn't quite as easy to directly communicate with all the health professionals that are working with my clients. Whereas when I'm in this team now, it's just it's so easy to instant, like I can instantly just flick a Teams message to someone and say, Hey, look, Bob's had a fall this week. You'll see it on his case, but what I've been working on associated with his fall was just improving his flexibility because it was when he was getting out of bed, his foot got caught on the sheet or whatever, like that. So when you're now, if you're helping him, can you just keep an eye on his left leg? It's not lifting as high, or whatever the the message is. Like it's it's very easy and and often I'm communicating with the physiotherapists like that as well, like on a restorative care program. Sometimes they are seeing a physiotherapist and an exercise physiologist together. We often just messaging each other saying, Hey, this is what I worked on, or just looking in your case notes.
SPEAKER_00:It's important to complement each other, isn't it? But that, yeah, collaboration, very important where you get the opportunity.
SPEAKER_01:Yeah. And the client can sense that as well. Like when they've got a team of people working together collaboratively, they feel really supported, you know, and then they feel empowered as well because they're like, oh wow, I've got all of these people that are here supporting me and backing me, you know, I better do my part as well. And that's the other part that I feel is really important with reablement, as well as it being re reempowerment, it's also responsibility. You know, there is actually a responsibility for the client to do their part as well. So that is often a conversation that I have. I say, hey, I'm I'm here, I'm giving my all to you. You need to give your all back and play your part. We can't do it all for you.
SPEAKER_00:And that's re-ablement, isn't it? Sort of not doing things for people, but encouraging them to do things for themselves as well. Exactly.
SPEAKER_01:Yeah. You know, whatever role you have in aged care, they're all equally as important. So whether you're working on the grounds with the client helping them to shower, dress, or shop, or whether you're a clinician who's helping to do an exercise program, or an occupational therapist who's helping to support, set up their home, or somebody who's working in assistive technologies making sure they've got the right technology, or whether you're the person in the office answering the phone and making sure that their services are happening on time, or even the rostering lady, or the cleaner, or if you're in the office, like all of those roles are equally as important. There's not one that's more important than the other, you know, and I think that's really important to remember that and just so we can all appreciate each other as well working in aged care. Because I often see the care workers just work so hard. They're some of the best workers, and they really love their clients, and they, you know, they give their all to their clients. And I think that's that's amazing, you know, like working in an office sometimes in aged care, you may not always realize exactly what that's like. So it's just recognizing that it's about working collaboratively as a team and recognizing that each person is equally important and just treating each other with that equalness and respect as well. It's just helping people to really appreciate their value in what they're bringing to the industry.
SPEAKER_00:As you said, yeah, if everybody works together, it's for the improvement and the betterment of the client. It's to make them more independent, make their life just that bit better. Absolutely.
SPEAKER_01:And I always like to shoot bigger as well. Like I really consider about improving the whole industry together as a team, working together collaboratively, you can develop new pathways of care, you can develop new models of communication, you can really bring something that may help to transform the industry that other organizations may not be doing, and have that focus that even though you might only have one role, you can still impact the whole industry very easily by developing something and offering it to the Department of Health and Aging. Like that that's how things change. It's from the ground up, really. It's not always just the people in the offices who are writing the policies, like we're the ones who can actually feed back and go, do you know what? Like that's not working, and this can work. And if we have more voices like that in the industry, like we can really change it. And I often thinking that developing a model of care or a service or an industry that I'm going to be in one day. So it's not just about that, but we're all going to be there eventually. What do we want it to be like? Exactly.
SPEAKER_00:Great points. Can you describe sort of just a very typical sort of program might look like for a client with you? Sort of what exercises and things do you get your clients to do?
SPEAKER_01:Yeah, absolutely. So with a typical program, I like to give it like a focus of eight to twelve weeks. So you can't just stick at the same program for the eight to twelve weeks. It starts off often very gently just to determine exactly what the client is capable of. So usually I just start with something simple like stretching, because stretching can actually offer a lot of relief as well. So it might just be starting off with going, hey, let's look at your flexibility and see how that is, because your flexibility actually influences your whole mobility and even your balance. You know, I don't think people realize that their balance is so affected by their flexibility by by the change that it makes in your posture. So, like if I was to look at a program, it would start off with a series of stretching, often seated, you know, if they can do that, and then maybe lying on the bed, some lying down stretches and some standing stretching. And then we'd go into like looking at balance as well and doing some balancing exercises, again, starting off super simple, and then some really simple strengthening exercises. So um starting off on the chair, seated, you know, strengthening. And I always start off at that base level because it's great to not over push it because if somebody can't do it, then they get disheartened. Um, and also if they can do it really easily, that's very empowering and inspiring. So I just start off with those bases of those, you know, four three or four areas, you know, flexibility, strength, and balance, um, and a little bit of mobility and walking and and that type of thing, and then just build on it. So then you make the exercises gradually a little bit more difficult, a little bit more difficult. And how quickly that progression happens actually really depends on how much the client does the exercises in between the visits, you know. So sometimes you could be working at base level the whole time, which is is fine as well. And some people advance really quickly, and it's not really making it go anywhere in particular, but just responding to exactly how the client is responding to the exercises. So there's no sort of set formula, you've got to really tune in to the client that you're working with.
SPEAKER_00:Fantastic. Thanks so much for being here, Danielle. We really hope this discussion has been valuable for our listeners. And we encourage you to visit our website at keepable.com.au to use our resources on wellness and reablement.
SPEAKER_01:Thanks, Alison. Thanks for having me, and also thanks for you know developing and producing these podcasts because they're really important for the industry, for everybody working across the industry and clients, the professionals, the clinicians, the you know, everyone. So we really appreciate it. Thank you.
SPEAKER_00:Oh, fantastic, thanks so much.
