I was fortunate enough to gain a place on The College of Medicine’s (http://collegeofmedicine.org.uk/) Summer School for students of healthcare professions, hosted by the University of Birmingham Medical School in partnership with the Centre for Health Ageing Research at the shiny, new Queen Elizabeth Hospital (left). Approximately 70 delegates gave up 2 precious days of summer holidays or Vital Money-Earning Time to consider the issues surrounding healthy ageing for older adults. The professions of medicine, nursing, podiatry, osteopathy, physiotherapy, psychology, diagnostic radiography, nutrition and dietetics, pharmacy, dentistry, herbal medicine, chiropractic, radiotherapy and of course occupational therapy were all represented by students from around the UK. I think the ‘multi-disciplinary’ label was certainly justified! The event was very well organised and every team member was helpful and friendly throughout the very intense 2-day summer school. This post is simply a personal reflection on the summer-school.
The first day of summer school was very much the ‘food for thought’. We had seven 30-minute talks, each followed by 15-minutes question and answer time. The topics covered were vast. The most scientific talks included; ‘Ageing, Infection and Immunity’, ‘Nutrition in Healthy Ageing’, ‘Cognitive Health and Ageing’ and ‘Physical Activity to Support Healthy Ageing’, all of which were presented by leading professionals in the areas who were able to share their latest research findings to support their presentation. The more practical and ‘in-practice’ areas were represented by presentations about the ‘Move-it or Lose-it’ exercise classes for older adults (http://www.moveitorloseit.co.uk/) as well as Well UK’s Director presenting the Upstream Project (http://www.upstream-uk.com/) as an example of a ‘Community Based Model for Healthy Ageing’. The latter was the most akin the models I’m familiar with as an OT student and I found it fascinating that the programme was so focused on meaningful (often leisure) occupations as a central point of a social group, despite not having OT involvement. I found it refreshing to listen to presentations concerned with physiological processes of ageing. I found it enhanced my understanding of the process and also allowed me to consider the likely relevance to occupational therapy. The common theme was that moderate activity is vital to limit ‘unhealthy ageing’ and so I found myself wondering how occupational therapists can encourage this, particularly for clients who may not select physical activity as a goal they wish to achieve. Can a balance be achieved between health promotion while remaining person-centred in approach? Another common theme was that ‘connectedness’ and relationships were important determinants of well-being, by limiting social isolation and mental ill-health. This wasn’t ‘news’ to me as both an OT student and someone who has recovered from serious mental health problems, but the key learning was developing awareness that for some professional-students this was a novel idea and reminded me just how ‘medical-model’ some of the other professions are.
Day 2 mostly focused on small group workshops facilitated by service-users with an interest in a specific aspect of ‘older-adult-life’. These were; ‘spirituality, religion and ageing’, ‘sexuality in older age: an LGBT perspective’, ‘ethnicity in older age’, ‘mental health in older age’, ‘retirement and well-being’, ‘exercise in older age’. I was grateful to get into a more interactive style of learning after a long, albeit interesting, day yesterday. The facilitators of the sessions were all excellent. My only criticism was that some of the groups might have benefited from a co-facilitator that had a contrasting experience. For example someone who had been a reluctant exerciser, someone who struggled with the transition to retirement and someone who experienced mental health problems for the first-time as an older adult, not a working age adult. The students brought a range of personal experiences and it was all done in a reflective and open-minded manner. I was struck by how some of the topics being discussed were quite obviously ‘new territory’ for many of the students, particularly the workshop on LGBT issues. While I felt glad that at least the participants today may now be aware of their heteronormative use of language with clients, I felt quite sad that this was the first time they had ever considered it. The closing plenary was a summation of everyone’s thoughts and it was nice to hear the different ‘key points’ that people would take away. I was aware of how beneficial the summer school could be to other students, those perhaps who also need to challenge some of their assumptions.
What will I, personally, take away from the summer school learning?
Some of the professionals I work with are going to be very focused on diagnosis and symptoms. While this is not an approach I wish to take, the depth of their understanding of physiological processes is vital and will provide evidence for the interventions being provided by those with a more bio-psycho-social consideration of the person.
The physiological explanations of the ageing process and issues that determine the relative success of ‘healthy ageing’ were very helpful to understand. However, the practical ‘consequences’ mean that the approach for an OT focuses on occupations that support an active lifestyle and reducing social isolation, which would be similar for a working-age adult, adolescent or child. Furthermore, discussions highlighted how clients want to be listened to, not judged and have a clinician that doesn’t make assumptions as well as showing great kindness. Again, this is something I feel is important, irrespective of age.
As a representative of the OT profession I noticed certain issues repeating throughout the weekend. I anticipated having to answer the question of ‘so what does an OT do?’ but seemingly underestimated the frequency with which I would be trying to define and explain the profession. Fortunately it’s a topic I like discussing and was able to draw on the summer school content to put things into context.
One aspect that left me feeling a little sad was that in several discussions I noticed a marked change in peoples’ attitudes towards me when they discovered I had initially studied another degree at a prestigious institution, compared to when they thought I was ‘just’ an OT student. I am not an OT student because I can’t do any better, but simply because I think it is a profession that can make a real difference to people’s lives, in a way that fits with my own values and even ‘spirituality’.
Occupational Therapy’s Invisibility
The link to occupation was made on numerous occasions throughout the summer school, but never was it suggested that OTs could be crucial clinicians for encouraging healthy ageing. This, combined with the numerous ‘what is occupational therapy?’ questions, reminded me of some of the challenges the profession faces. I can’t help but feel that the answer lies in research and evidence production. There is clearly fantastic medical and physiological research available on this topic but unless this can be linked to the role of occupational therapy in enabling people to make the occupational changes in their lives that support good mental and physical health I feel we will always be invisible and misunderstood.
Areas for Continued Reflection
While a fan of evidence-based practice, I felt very aware that I spent a lot of time thinking that occupational therapy ‘just IS the right approach’. I suspect I need to challenge this and continue to explore the current evidence to evaluate this belief or moderate it accordingly. (For the record, after the numerous discussions with other-discipline students I do feel more content than ever embarking on a career as an OT, and equally I’m conscious of some of the frustrations I will, probably repeatedly, face.)