How can a person-centred approach to occupational therapy practice in the community enhance independence for people living with complex neurological presentations?

Ghosh, Malabika, Bhagat, Priti and Cox, Diane ORCID logo ORCID: (2022) How can a person-centred approach to occupational therapy practice in the community enhance independence for people living with complex neurological presentations? British Journal of Community Nursing, 27 (9). pp. 426-430.

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Neurological long-term conditions refer to a group of neurological disorders with varying life expectancies, which show gradual deterioration, ultimately leading to death (NHS England, 2019). Conditions such as multiple sclerosis, motor neurone disease (MND), Parkinson's disease and multisystem atrophy are examples of conditions that fall under this category (NHS England, 2019). These disorders are characterised by gradually deteriorating function, increasing care needs and varying levels of functional dependence. A multidisciplinary, palliative care team approach is recommended for managing the care needs of people who have terminal disease (Høgdal et al, 2020). According to an NHS England paper, neurological conditions consume about 14% of the social care budget, with most deaths likely to occur prematurely. People with neurological conditions have the lowest health-related quality of life compared to any long-term condition and experience severe mental and psychological burden (NHS England, 2019). Moreover, if the condition involves gradually deteriorating functional ability, planning ahead to maintain independence at different stages of the disease trajectory can be very difficult. Occupational therapy intervention is recognised as one of the key components of managing functional decline in long-term neurological conditions (Høgdal et al, 2020). Tavemark et al (2019) recognise the significance of participation in activity to maintain independence, dignity and quality of life. However, there remains limited guidance on the specific nature of interventions involved that can help achieve this. Additionally, patients who are dying have individual needs, therefore making it difficult to generalise a list of interventions that may be used by occupational therapists. Furthermore, a study by Høgdal et al (2020) reports that patients with chronic advanced disease have high levels of unmet needs which they are unlikely to discuss with their doctors. This points to the need for including specialists like occupational therapists within the multidisciplinary team who can help manage these needs. Additionally, in a King's Fund paper, Coulter and Collins (2011) stress the importance of shared decision making and suggest that expert clinicians should work in partnership with their patients, involving them in their care decisions wherever possible. Not only is this ethically imperative, but there is rich evidence that patients who are actively involved in their healthcare have far better outcomes than those who are passive recipients of care. This review paper discusses a community-based patient case study, describing a person-centred approach to occupational therapy practice that uses easy-to-initiate innovations aimed at meeting specific individual needs. The aim of the paper is to highlight the significance of person-centred care which has the potential to impact on the quality of life and the lived experience of the patient and their family, especially for people who have progressive neurological conditions.

Item Type: Article
Journal / Publication Title: British Journal of Community Nursing
Publisher: MA Healthcare
ISSN: 2052-2215
Departments: Institute of Health > Psychology and Psychological Therapies
Additional Information: Openly accessible online here:
Depositing User: Anna Lupton
Date Deposited: 22 Sep 2022 09:37
Last Modified: 27 Feb 2024 09:30


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