During the Covid-19 crisis, our patients have been unable to come into our gym to access essential services to build strength and mobility. Instead, our rehab team have been running video classes online and making home visits to keep patients mobile. Angie Steel, a physio technical instructor at Martlets, explains how the rehab service has adapted to changing times.
“I’ve been at Martlets now for two years. When the coronavirus pandemic started we couldn’t offer rehab services as we had done. Patients couldn’t come in because of social distancing measures so I couldn’t work with them in our gym.
For about six weeks, I changed roles and worked on the inpatient unit as a healthcare assistant. They really needed extra support on the ward, so it made sense to do that. I was supervised by the clinical team and learnt a lot. I was also able to bring my physio experience into assisting patients who were in bed to move about when appropriate. I could also make sure that patients who were in for respite or symptom control stayed mobile. Then they were in the best shape possible for when they returned home again.
People have been staying in and sitting down for longer periods during the lockdown. But it’s important that our patients stay mobile and continue to maintain their strength as much as they can. Most of them know what they should do in terms of exercise, as we set them up with individual routines. But they just need a very gentle nudge from us to keep it going. They miss that personal interaction and the banter they had in our gym, so I’ll call them to check in. We either speak on the phone or via Zoom video if they are happy to do that. Then I can keep them motivated, offer advice if their condition has changed and have a chat.
In the gym, patients would often talk to us about things that might be on their minds. It would give them a chance to open up if they wanted to or just chat. Sometimes that can be as important as physical wellbeing. If appropriate we would suggest they access our expert counselling team for further support. I still try and give them space to talk openly on a phone call, but there’s something about talking while they’re active in the gym that helps.
On a one-to-one call I’ll try to address any specific issues a patient has and give them exercises and advice. They might tell me something I can pass on to the rest of the team. Then we can reassess them further to make sure they’re getting the support they require as their needs change. For example, they might benefit from mobility equipment in the home to make their lives more comfortable.
Online rehab on zoom
We’ve been offering a group exercise session once a week via Zoom videoconferencing which is going well. I’ve recently expanded it to do some strength and balance work too to help with preventing falls. Some patients are used to doing Pilates so we’ve also added in some stretching for them based on that.
The Zoom class can be done seated or standing and is for varying levels of strength and mobility. Patients with shortness of breath might start by standing but end up sitting. It’s very gentle mobility and strength tailored to each person.
When patients are in front of you on the screen during a Zoom call it’s great. You can correct them and make sure they’re doing the exercises safely. They get more from it that way. It might be about their movement or their breathing. You can just check in with each person to make sure they’re ok. It’s not just delivering the exercises, it’s getting feedback and making sure they let me know if there are any issues.
Most people can use Zoom, but we’ve also tapped into the wonderful support from Martlets’ community team. They’ve had volunteers helping patients to get set up on Zoom and to understand how to use it. This has been a real positive to come out of this challenging time with Covid-19; coaching people into using Zoom and online ways of connecting. I really hope it’s something everyone can continue to use to stay in touch with family and so on. Everyone has been so positive during the Covid crisis and saying ‘we’re not going to let this get us down’. I’ve got to know people individually in a different way online.
Home visits and further support
If patients aren’t keen on using Zoom we can send them short videos or exercise programmes via email or in the post. We might also consider doing some pre-recorded classes soon that might be useful for some people. Patients’ needs can change on a daily basis though, so having regular check ins and ‘live’ sessions is important.
Occupational Therapy (OT) has been busier than ever during the pandemic as it’s community based. The OT team are going out and doing home visits to assess people, but they’re also doing a lot of videoconferencing. They’re ordering equipment and making sure people have what they need for daily living and to improve quality of life.
The team are currently working out the logistics to be able to get people back into the gym. This does look possible as you can walk around the outside of the hospice to a fire door. This means that people could enter the gym through this door without walking through the hospice. Fingers crossed that will start soon!”