Single-handed care - An Occupational Therapist's experience
Single-handed care is very much the ‘hot topic’ in the moving and handling field at the moment, but what does it mean or what expectations do people have?
The meaning or expectation can be very different depending on your standpoint. A commissioner may see this as an overall strategy to reduce the costs of care packages in their areas whilst a client could see it as a more dignified approach to their care. To an Occupational Therapist this may be simply an outcome following a holistic assessment and risk assessment.
Here is an example of Single-handed care – An Occupational Therapist’s experience.
This has always been an option for Occupational Therapists, so what is the difference now and why all of a sudden has it become a trend in moving and handling?
Advances in technology, such as easier to handle ceiling track hoists, more improved gantry options, patient turning systems, slings and moving sheets to name but a few have made the possibility of single-handed care a reality.
Ever increasing pressure on health and social care budgets, leading to a need to cut costs has also raised the agenda on the back of these technological advances.
When carrying out an assessment the Occupational Therapist always considers the holism taking on board the thoughts, feelings and wishes of their patient and carers alike. This has often meant that single-handed care has been ruled out in the preliminary stage.
I’ve often found that the infrastructure or understanding has not been there to implement single-handed care. For example, carer agencies conducting their own generic risk assessments and then continuing with a two-person hoisting approach due to finance and not the client’s needs, or due to a lack of training available for carers around competent single-handed care.
The speed of provision of specialist equipment such as ceiling track hoists, gantry hoists or bed positioning systems can be slow, often meaning lengthy waits for the end service users and the need for conventional packages of care being in place for prolonged periods until equipment can be approved and installed. This has taken months in some cases and has left me, my clients and carers frustrated at times.
I’ve had success, in particular when family members have been the carer to a loved one. This has maintained family unit privacy and dignity, empowering clients and family members alike, supporting their choices, giving them choice and control over care.
I’ve also had success where areas have started to understand the changing social care climate, trained their carers in the use of equipment and in the understanding of single-handed care. Occupational Therapists can make sure their social work colleagues are aware of the agencies that can deliver singled-handed care packages.
As stated above, single-handed care can be made possible where equipment has been made readily available. Equipment stores who hold a stock of gantry, ceiling tracks hoists, specialised slings and bed positioning systems should have arrangements with suppliers and manufacturers to supply, deliver and install quickly to ensure that they provide an excellent client-centred service.
Having the above infrastructures in place can make the single-handed option for our patients and their families much more of a reality. Ultimately, it always revolves around the individual risk assessment being carried out as the moving and handling operations in question must be safe for that particular case.
To conclude, in my experience single-handed care comes down to completing a holistic and individual risk assessment. The major impact is the advancement in technology, which enables single-handed care to be considered in more situations which would have previously been risk assessed as too complex. This, alongside economic pressures, has ensured that the option is more at the forefront of the assessor’s mind.