Understanding Occupational Therapy

Welcome to the second episode of The Golf in Society Podcast were we are Reimagining Golf Clubs as Healthy Ageing Hubs.

In this episode I sit down at Hillsborough GC for a conversation with occupational therapist Liz Fletcher.

Liz works for a fellow social enterprise Sport for Confidence who we are excited to be working in partnership with on our latest project in the Sheffield area "Reimagining Golf Clubs as Healthy Ageing Hubs".

Listen in as we ask, what is an occupational therapist? Learn how occupational therapists are helping to shape our future support services, and gain an incredible insight it their world.

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Transcript

0:01

Hi everyone, I have got the pleasure of being in the company of Liz Fletcher this morning. Liz is an occupational therapist. And I have to say, when I started Golf in Society, I hadn’t got a clue as to what occupational therapy was all about really, but Liz and other occupational therapists that I have met in the last couple of years really have enlightened me in terms of the difference that occupational therapy can make to people’s lives. Now, Liz works for a great fellow social enterprise called Sport for Confidence, who specializes in delivering occupational therapy and community settings and transforming lives really. So it’s my pleasure to welcome Liz this morning. Hello, hello. And we are actually doing this podcast at Hillsborough Golf Club, which is quite an exciting venue for us, because we are launching a new project, which is basically to reimagine golf clubs as healthy aging hubs where people can come and enjoy professional sport activities, the opportunity to socialize in beautiful green spaces, natural surroundings, and inspiring clubhouses really where they get a chance to relax and enjoy the life that they are looking to have with the challenges they face, and hopefully to get their lives back on track after a diagnosis or stay in hospital. So it’s quite interesting that we are here at Hillsborough this morning, which is going to be one of our venues for this exciting new project. Sport for Confidence, they are one of our delivery partners. And they will very much look after the occupational therapy and physiotherapy part of the project. And we have also got the Advanced Wellbeing Research Center and the Sport Industry Research Center from Sheffield Hallam University, who are our research partners on this project. So without further ado, I am going to hand over to Liz. And Liz is going to do a little bit of myth busting for us. So Liz, as I say, when I first started, I hadn’t got a clue what occupational therapy was all about. So for our listeners, can you just put it in layman’s terms, what occupational therapy is all about? Wow, this is a real challenge. Thank you for starting with this one, Anthony. Occupational therapists come out of university really not knowing how best to describe their role, partly because, on the one hand, it’s quite broad. And so we are not traditional health workers in the sense that we focus on a diagnosis as such. And so we are not led by somebody’s diagnosis. Obviously, that’s important. But what drives us as occupational therapist is thinking about what people want to do and how they want to best lead their lives. And we want to think about what somebody wants to do and how they can best get there. And we might think about adaptations of the environment or adaptations of the activity itself. And so in this situation, being at a golf club, we might work really closely with the golf coach in thinking about how best we can adapt golf to make it enjoyable, meaningful, practical, possible for the person. And like so many other healthcare professionals, occupational therapists work in a person centered way. But I know I am slightly biased, but I have to say that occupational therapists are absolutely brilliant at being able to always put the person first, because what is important to that person is our absolute focus. And so when we start our kind of initial assessment, one of our priorities really is really exploring what is important to that person. They might have just got a diagnosis of dementia or a mental health condition or something like that. And actually, how is that diagnosis affecting somebody? How does it affect their view of themselves? How does it affect their ideas of the future? A diagnosis of a health condition can impact us all very differently. Our hopes and dreams of becoming a golf champion or becoming a mum or a carer or whatever we wanted from our future might have completely shifted with a health condition or a diagnosis. And so we as occupational therapist want to think about, with somebody, what their future holds, what their hope, some dreams are, and how we can work with that person to make that a reality as best as possible. So I don’t think that’s in a nutshell. Well, I think, overall it gives a real flavor to the audience as to what it is all about. When I first discovered occupational therapy, it was quite interesting, because, as you say, you take a person from their starting point after a diagnosis or a challenge in their life. But most importantly, you sit down with them and you spend quality time understanding what their future look like, what they want to achieve in their lives, their hopes, their aspirations. And what I loved about it is that — from what I witnessed — you then took all of that great quality information you got from the people that you are supporting, and then you go away and you design packages for support tailored around their needs. Not only just design them, but then think about the delivery of them. So you have actually got the people involved in creating their own support program that gives them the stepping stones to get closer to those dreams and hopes and aspirations they have for the future. I am so glad that you observed that as part of the OT process. But that is exactly how we want to work. We may not always be able to work like that in traditional health services. But in a golf center or golf club, it does give us the freedom to work in that way. And it’s so important. We as OTs think about the person first, but also thinking about that — you might have heard the word co-production — how we work with people as partners. We think about the importance of the power dynamics. And actually, in a traditional way, it can be quite a strange thing going to see a healthcare professional and thinking of the healthcare professional as the person with the power, and making the decisions, they know what’s best for you. And really, I personally see that as a bit of an old fashioned way of working. But it’s hard to move away from old fashioned way of work. And even if we know that’s not right, but actually how do we work with a person and ensure that they are in the power seat driving what they see as important in terms of change for themselves and change for others. And actually, if you are working with individuals, they come with a family and carers and friends. And so it’s actually quite complicated to do well and to do right. And I am not saying that we as OTs are perfect and get that right the whole time, but that’s something we strive to do. And yeah, it’s getting them to think what they want from an intervention and how they see it working. And so working with people as partners, I would say, is a key skill for occupational therapists. Totally agree. And that’s a fantastic start to the conversation. So this morning, as I say, we have the pleasure of being in the company of Liz Fletcher at Hillsborough Golf Club, which is going to be one of our venues for this exciting research project that we are just about to launch in Sheffield. We have been talking a little bit about what occupational therapy is and the difference that it makes to people’s lives. And in my own terms, from what I have witnessed and how I see it. I have given you my view of what occupational therapy is all about. But I think for people that don’t know about occupational therapy that are living in local communities, facing a few challenges,

the best way I can describe it really is: 9:02

“The occupational therapists that I have worked with so far are the people that put their arm around you, they hold your hand, they take the time to listen, and all of those things in a busy life — living with a diagnosis, looking after the loved ones and everything else that everyday life throws at us — they are the people that just give you the breathing space to actually sit down and say what it is you want in life and then put a program of support in place to make sure that that happens.” And what I like about it is that they don’t try and do everything themselves. They basically then bring in their amazing network of fellow health professionals, advisors, support networks to build that package of support around the families so that it does become real good quality support that they give to the families. And the one thing I love about occupational therapy is they want to be with the family, the individual, for the duration of them improving the lives. They are not just quick in quick out. They want to build up that long lasting relationship that goes deep and is meaningful. That gives the family and the individual every single opportunity to achieve their dreams. So with that in mind, that’s what excites me so much about having occupational therapy designed into this new research program. And I have talked a little bit about how I see occupational therapy and why I am so excited about having Sport for Confidence and Liz in the team on board. But from your perspective, Liz, what’s the thing that excites you most about this pioneering research project? I love the way you describe occupational therapy and your experiences, first of all. And I think that what you have said is absolutely true. However, in short term or highly pressured health services, often we can’t do what you have just said. And actually, working in a community space in this way provides us with an opportunity to absolutely put in place what you have just said — making sure that we can build up them meaningful relationships with people. It’s gonna sound like a downside. It sounds like I am gonna be self-critical here. But I am not, hopefully. OTs can feel like they are a jack of all trades, master of none. And over the years that I have been an occupational therapist, I have learned to see that as a strength. And we are good at giving that holistic wraparound support. We are good at building that relationship with people, making sure that they are the center of everything that we do, and learning to go at the right pace for people. But we also have a... One of our core skills is activity analysis. And so all that observation time that we have, we are checking out people what can they do, what are their strengths, and how are their cognitive abilities impacted by a diagnosis they may have had, what are their motor skills like, how can they function, how is that impacting on their goals. And so there’s a lot of analysis that goes on behind the scenes, but I always see it like that iceberg analogy. And just what you should see walking into a golf club or any kind of occupational therapy service is what you have described. You should see the OT forming really, really good relationships. What you don’t always see is that thinking and that analysis that the OTs are... They may have assessment tools that they use. But again, these aren’t assessments to work out more about a person’s diagnosis. They are assessments to work out how somebody’s functioning. And so going through that. What their cognitive skills like? And how is that impacting on their ability to play golf? Is there anything that we can do in order to make their experience of golf better? However, we might also notice that there are various things that we as OTs cannot do. And that’s okay. Because we have got a whole variety of different services around us, or the family might have a whole variety of different skills around that person that we can utilize. So I think that kind of “jack of all trades” comes into our strength, because we are actually and we should be really good at recognizing what we can’t do, too. But maybe other people can, or we can signpost or we can ensure people get the right amount of support. That’s not to say there’s always the right amount of support available. But we can at least do our best. I think that’s really crucial. And from our first working together down in Charnwood Forest, the two students we have there, who were amazing, they basically started putting together a resource pack based on the needs of carers in particular. And I think that’s an important thing to mention about this project is we are not just looking at the people with a diagnosis and improving their health, well-being and giving them opportunities to achieve their hopes and dreams of the future, but we are doing exactly the same with the carers. And the one thing I found really useful is how that resource pack whilst it wasn’t all needed all at once because you know it’s a big document — it’s like 60 odd pages — but ultimately as and when a challenge comes up in a carer’s life in particular, there’s a reference point there, where they can get some top tips about how to deal with something in their moment of crisis, which is, let’s face it. They have to deal with it. They are the first responders. So having that resource easily accessible and available and already talked through gives them greater confidence to deal with that situation rather than feeling isolated. And with all due respect to everybody out there trying to do some great work with help lines and everything else, sometimes they need more than just that helpline. They need that resource in their hand at that moment in time just to deal with the emergency as it’s unfolding in front of them really. And I think that’s been a real good resource that we have already pulled together. And we will develop even further during this program. And the way that you thought about the carers and the person living with the diagnosis, and you building support around both individuals, simultaneously, I think is what excites me most about this project. And I will be honest with you, we could not do this as Golf in Society alone. So the opportunity to work with like-minded organizations who have shared ambitions. And all we are doing really is facilitating all of these health and well-being improvements and access to the professional sport these people need at local golf clubs, who have got the beautiful green space, who have got the built infrastructure. They have got everything in place. And all we need to do is get the people here to access the professional health support and their lives can be better. And we are showing a different way. We are showing it. It doesn’t have to happen in a hospital environment. We are not putting extra pressure on the already stretched resources within the NHS. We are actually looking to create new spaces, new places, new resource to deliver that will help us all give our aging population in particular, the opportunity to live that happier, healthier, independent life and not need the interventions of that secondary care system. Sounds wonderful. So those are some of the ambitions we have got here with the project. And just to give a little bit more of a flavor, we are going to be piloting a 12 week program. And at the moment, we are just about to put a package of marketing together really. Because the big thing we have got to do is we have got to overcome a couple of barriers really. We have got to overcome the barrier to golf clubs. We have got to overcome the barrier to golf. And I suppose that’s my job. So we have got to re-imagine and re-word everything so that people understand the benefits of getting involved. And then we need to give people the confidence and understanding of what they are getting involved in. And I think that’s a key message we have got to get across through the referral networks in particular in terms of how people can access the program and what’s in it for them. So Liz, in terms of those key messages to families out there at the minutes, if you were sat there at home with your loved one and this opportunity to get involved in this project came your way, what would make you say, yes, I would like to do that? Well, first of all, I have got a few comments on various things that you have said. And the first one is just that focus on carers. I think that it’s so important. And I am so pleased that we are ensuring that carers are seen as important as the participants in this. And I think if we have got a short amount of time to impact positively on somebody’s life, then that acknowledgement and awareness that the carer is the key person involved in that person’s life that may have had a diagnosis of dementia. And we know how hard that they work and how important their role is. And so it’s brilliant that the OT and the physio will be able to use their skills with the carer too. That’s the first thing I wanted to say. Second is, you said something around barriers to access in a golf club. At Sport for Confidence, we have similar situation but it’s a barriers to access in a leisure center. And I am sure there’s loads of similarities there. And the fact is, we hope to be reaching out to people that have never dreamt of setting foot in a golf club. Absolutely. And maybe that slightly different to a leisure center. Because actually, I think some people don’t dream of going to a leisure center, but they know that it’s a community asset. They know it’s part of their community and almost they should be going or they should have an opportunity to go. So I think there’s almost like a slight difference in a leisure center and a golf club. But we work with people in Sport for Confidence that wouldn’t necessarily go to a leisure center, wouldn’t think of themselves as sporty. I am just thinking of a lady that I have spoken to recently. She won’t mind me saying her name. She’s just wrote a case study about her experience. Jennifer said to me, before I started Sport for Confidence, I spent 14 years in my bed. And that’s more or less true. And she never thought of herself as sporty. Her initial steps to join in sport for confidence were all about taking photographs. There were nothing to do with coming to the leisure center. And so that’s about a OT working with that individual to explore what’s meaningful and important to them, build up that relationship, and then gradually break down them barriers around, maybe you could come to the leisure center, Jennifer, and start to talk to her about how, why, etc. And I think we can’t underestimate the barriers to people accessing a sporting environment such as a golf club. And we will have to work with individuals to ensure that we understand that individual barriers, because, yes, there’s numerous barriers that I am sure research can point to that say, so many people have X amount of barriers to accessing various sporting opportunities. But what we do know is that we have individual barriers. And they are quite complex, often. Absolutely. If you just think about one person and the fact that they have never thought about playing sport or going to a golf club, it’s so far away from their world that actually that’s where you have got to work with them. You have got to meet them and connect with them where they are at and make sure that initial visit is as smooth as possible for people. Totally agree. That first welcome is so important. Yeah. So we have got some work to do. But it’s an exciting project. And I am looking forward to breaking down some of those barriers and then proving to people that golf clubs aren’t too rich exclusively places. That place is for all the community to enjoy. And together, I think we can definitely break down those barriers. We can. Thank you. So we are here at Hillsborough Golf Club this morning, conversation with Liz Fletcher from Sport for Confidence. And I want to finish off this little conversation around the future of the workforce, and in particular, occupational therapy, and the place that it has in the future of giving people that happy, healthy life that they deserve. Now, I know at the moment that we have a lot of pressures, Liz, within the NHS in terms of resource around workforce and the amount of people requiring support. So firstly, I would imagine it’s quite a stressful place to work in if you are an occupational therapist in an NHS setting. Wow, that’s one of the reasons, Anthony, that I don’t work in the NHS anymore. It is hugely pressured for not just occupational therapists, but healthcare professionals in general. And I am sure that the majority of health care professionals are just desperate to do a good job. And I think times are really tricky. And yes, it’s very pressured and very difficult. So do you think that roles like this within this type of setting, within this type of programming, that allows people to take their passion for improving other people’s lives, take their professional skill and learning, and put it into practice in, let’s say, emerging spaces and places like this, is a future to get more people interested in becoming an occupational therapist in particular, and where they actually have the opportunity to put everything into practice? I think the word “prevention” and “preventative health care” is not a new concept. It’s been talked about for years. And the idea of actually providing preventative health care is hard to make happen. It’s a hard reality to put into practice. And I see this as a golden opportunity to really put prevention at the heart of a service. I can’t describe to you the feedback that we get from the occupational therapists at Sport for Confidence, who are working in leisure centers, working in a non-traditional health environment, how we are able to apply our skills in the way that we are taught at university and how we are able to build those relationships and provide support in a different way in a different environment. I can’t tell you how much my heart and my head believe in providing health care in this way. Let’s just take the good bits from the old style of health care and create better bits too. What a great way to end. Thank you very much for your time. No problem.