Emma Rothwell, Senior Physiotherapist
6.45am Leave the house and travel into work… Hopefully beating the rush hour traffic!
7.45am First things first – a quick cuppa and some breakfast in the office before the day begins!
8am The day starts with a catch up with the Therapy Team to make sure the service is covered for the day. Our team of five (two Physios and three Occupational Therapists) cover the ward at Sobell, the Day Centre and the community. Communication is essential within the therapy team as many of our patients use the different services at some point and we like to support each other to offer the best treatments.
My responsibility is to look after patients in the community along with my OT colleague Kate across the whole of Oxfordshire (apart from the far North and the far South East, as these areas are covered by other hospices).
Kate and I usually meet to discuss the community referrals for the week. We receive referrals on a daily basis from the Sobell Community Nurses, Ward Therapists and Hospital Teams. We spend some time prioritising the referrals and collecting any additional information we need. This allows us to be as responsive as possible to any urgent needs.
After our catch-up we head our separate ways – Kate goes to the Community meeting with the nurses and doctors for any updates and to discuss complex patients. Charlotte (OT) and Jessica (Physio) have Day Centre covered today, and Nichola (OT) is busy on the ward.
9am I head out to my first visit to see a lady in her 50s with widespread bones metastases. I’ve seen her at home a few times to create a tailored exercise programme to support strength and bone density to avoid bone fractures. Her previous hobby was swimming but due to lack of confidence she has been unable to do so. We have been working hard to set small reachable goals to achieve this. I was able to deliver some good news that she has secured a place at a local hydrotherapy session to help improve her function, increase her confidence and support her general wellbeing. We have a good catch up, go through her exercise programme and discuss what equipment she may need to take with her on holiday next week!
10.30am I planned to head back to the office but received a call from Kate to see an urgent patient at home in Bicester. I call the family en route and speak to the patient’s Mum, Joan*, to confirm my visit; she was there to greet me at the door shortly after. Joan filled me in on the challenges of supporting Sam* – who is in his early 50s – at home with a brain tumour. I introduce myself to Sam and explain that I am here to help provide a safer environment to care for him at home. He demonstrated little insight into the struggles and therefore I was heavily reliant on family for information. Joan shows me around their home, and I tell her about pieces of equipment which may be helpful. I call the office and arrange for the Sobell drivers to deliver the equipment later today. Joan gratefully accepts my offer to visit again tomorrow to fit and assess Sam with the equipment.
Sam’s sister, Alice*, arrives and I provide emotional support to her and Joan. They were hopeful to support Sam at home for as long as possible so we spend some time discussing what other services are available including the care provision in the area. We discussed activities that will help to engage Sam, whilst improving his mood and functional ability. Alice felt Sam would benefit from going to the park with her and her son James. I place a referral to the wheelchair centre to help facilitate this.
12 noon My next visit is in the South of the county so I head in that direction and stop off for lunch near Wallingford. Lunch breaks are the perfect opportunity to explore local villages you never knew were there! I send a quick text to the therapy group to make sure everyone is OK and let them know I’m safe.
After a challenging morning, I meet up with Kate and head out to see our “90s club” – a couple of chaps at home who require double-handed assessment.
1pm Our first gentleman has a live-in carer called Jenny* who updates us on Mr Smith’s* health. Mr Smith has prostate cancer and heart failure, therefore at times he can be very short of breath and fatigued. I first met Mr Smith at home last week to assess his current function, prescribe some bed exercises and support him with breathlessness management. Today is very exciting as we are going to get him out into a wheelchair and into the garden for the first time in months. We introduced a piece of equipment to the carer called a hoist to support Mr Smith out of bed. Kate and I explain how this is used and demonstrate. We were able to get Mr Smith comfortably into his wheelchair, the family are delighted when they arrive to see him out. They make the most of the sunshine and take him into the beautiful courtyard garden. The family are aware that Mr Smith may be approaching the last few weeks of life so we talk about what equipment may be needed at home to facilitate this.
2.30pm Our next chap in his 90s is a little more active and a really lovely rehab story! Kate and I have been out twice before with assistance from his wife, Sally*. On our first visit, Peter* had been bedbound for a few weeks and myself and Kate managed to transfer him out of bed and into a chair for a short time. Sally followed our advice and assisted the carers to get Peter out of bed every day and slowly built up his tolerance to sitting out. On this visit, I teach Peter some exercises to complete in sitting and standing to help maintain his functional ability. I provide Peter with a wheeled walker and he demonstrates his ability to mobilise outdoors.
4pm We both head home after a busy day to finish our notes and prepare for the next day of visits.
A quick update…
A week later, we called Peter’s wife, Sally, to find out how things were. Peter has now been able to get upstairs and they have been out on some day trips together! Peter feels that his quality of life has significantly improved with our help, which we were so pleased to hear.
*Patient names have been changed for anonymity.