People with Alzheimer’s at greater risk from head injuries

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People with Alzheimer’s disease are 30% more likely to experience head injuries and 50% more likely to experience traumatic brain injuries than those who don’t have the disease, a recent study from University of Eastern Finland shows.

This is the first study that has assessed the incidence of head and traumatic brain injuries among people with Alzheimer’s. Falls are the most common cause of head injuries in older adults, and those with Alzheimer’s are known to have a higher risk of falling. The findings of this study highlight the importance of fall prevention, as head injuries can shorten the life expectancy and deteriorate functional capacity. When people with Alzheimer’s experience head injuries, this can dramatically reduce their ability to perform daily tasks and live independently, even at early stages of the disease.

The study included all ‘community-dwelling’ people who received an Alzheimer’s disease diagnosis in Finland between 2005 and 2011. From the overall cohort, 67,172 persons without a previous head injury were selected for the study. For comparison, a matching person with neither Alzheimer’s disease nor a previous head injury was identified with respect to age, sex and university hospital district.

Dr Chatterjee looks at the real causes of depression in new podcast

Dr Chatterjee1GP, Author and TV Presenter, Dr Rangan Chatterjee looks at uncovering the real causes of depression in part one of his latest Feel Better, Live More podcast.

Rangan talks to author and journalist, Johann Hari, who says although we have been told a story that drugs are a solution to depression and anxiety, in many cases the cause is not in our biology but in the way that we live. He argues that being depressed or anxious does not mean that you are crazy, weak or a machine with broken parts, rather that your natural psychological needs are not being met.

They discuss  how loneliness affects us and how social prescribing can transform lives; how societal values have been corrupted and the affect this is having on our health; and the role of the workplace, and how having autonomy and choices can reduce the likelihood of depression and anxiety.

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In the interview Johann Hari talks about Sir Sam Everington, who he describes as one of the heroes of his book, Lost Connections. Sir Sam Everington is one of the pioneers of social prescribing and will be familiar to FHT members as one of the speakers at our 2018 FHT Conference, where he spoke about how he has implemented social prescribing in Bromley By Bow, London.

Listen to the podcast here

 

 

College of Medicine publishes Complementary Medicine Roundup

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The College of Medicine has published its latest Complementary Medicine Roundup. Written by former barrister, Richard Eaton, the February roundup is packed with a wealth of information on the latest developments in complementary therapy, from research and advocacy, to current challenges and areas of progress.

The latest roundup begins with a mention of the 2018 FHT Conference, highlighting how Dr Michael Dixon spoke about a ‘”new horizon” for complementary and alternative medicine and integrated health and of its increasing acceptance by younger members of the (conventional) medical profession’.

Richard goes on to say that this increased acceptance of CAM is not limited to the UK, with progress being made in other countries, including the USA, Switzerland, Germany, France, Australia, India and the Netherlands.

As Richard notes, the ethos of a new horizon is reflected in the All-Party Parliamentary Group For Integrated Healthcare (PGIH) report, which we have also talked about on the FHT blog.

The roundup also looks at what could be next for CAM after Brexit, some research initiatives from Bristol University and an overview of research supporting the use of reiki.

Dr Leon Chaitow 2.jpgRichard ends the roundup by paying tribute to Dr Leon Chaitow and Dr Peter Fisher, who both sadly died last year. Dr Chaitow and Dr Fisher were highly influential figures, championing the use of CAM for many years, and will be missed. Dr Chaitow was an author and academic at the University of Westminster, who published more than 80 books on therapy, and was editor-in-chief of the Journal of Bodywork & Movement Therapies. Dr Fisher was director of research at University College London Hospital for Integrated Medicine and physician to the Queen, and was committed to holistic and compassionate care.

Read an interview with Dr Leon Chaitow in our online Reading Room

 

Read the full February Complementary Therapy roundup here

Mindful March

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Being more mindful and living in the moment is the main focus of Action for Happiness’ (AFH) Mindful March action calendar.

AFH publishes monthly calendars, available in 12 different languages, offering daily suggestions on the theme of the respective month. Mindful March follows Friendly February, where daily actions aimed to bring happiness to others and improve relationships.

Suggestions for Mindful March include the following:

  • Start today by appreciating that you’re alive and have a body
  • Cultivate a feeling of loving kindness towards others today
  • Listen to a piece of music without doing anything else
  • Stop, breathe and just notice. Repeat regularly during the day
  • Have a device-free day and enjoy the space it offers

Download the calendar

NHS England to recruit 1,000 social prescribing link workers

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An army of advisers will be recruited to help patients live fitter, healthier lives and combat anxiety, loneliness and depression under recent plans by NHS England to ramp up social prescribing.

Around half of GP appointments are not directly related to medical conditions, according to experts. Growing evidence shows that referrals to community services such as exercise or art classes, history groups and even ballroom dancing can boost health and wellbeing more than dishing out pills or other treatments.

Now NHS England plans to recruit 1,000 social prescribing ‘link workers’ as part of the NHS Long Term Plan. The link workers will be able to give people time to talk about what matters to them and support them to find suitable activities that are a better alternative to medication as part of a step change in the provision of ‘personalised care’.

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Dr Michael Dixon, Chair of the College of Medicine, welcomed the news. The GP and social prescribing campaigner said: ‘This is excellent news for general practice, which is on its knees. This extra support of pharmacists, physiotherapists, social prescribers and others will make a great difference to the workload of each GP.

‘Patients want a return to the time when they had ‘their doctor’. These new developments will greatly help that, but we will also require more GPs at a time when their numbers have actually been going down during years when the number of specialists has vastly increased.

‘Enabling practice to provide accessible, personal and continuing care should now be the NHS’s number one priority as all the research shows that this is the best way to reduce deaths, improve health and enable the NHS to be financially sustainable.

‘This announcement is also a paradigm change for general practice. Every GP and patient will in future have access to social prescription.

‘It is recognition that medicine now needs to go beyond pills and procedures and that the future sustainability of our health system will depend upon enabling people and communities to maximise their role as agents of health and healing themselves. This is a red-letter day for the College of Medicine, which has pressed the cause for change during times when medicine has been too narrow and biomedical.’

Michael will be offering FHT members some tips on how to connect with these new link workers in the Spring issue of International Therapist magazine.

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School for thought

FHT’s Editor and Communications Manager, Karen Young, visits the NHS Natural Health School team in North Yorkshire

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From left to right: Karen Young, Gwyn Featonby, Beverley Harrison, Sarah Grant, and NHS Natural Health School student, Lorraine Cole

One cold morning in January, I travelled from Southampton to Harrogate to meet with Gwyn Featonby, Sarah Grant and Beverley Harrison – three members of the award-winning team that head up the NHS Natural Health School, based at Harrogate District Hospital, Harrogate and District Foundation Trust (HDFT).

I only had time to spend a few hours with this lovely trio but it was well worth the 500-mile round trip (actually, make that 507, because I overshot Harrogate station, checking emails on my phone!).

The school, which was officially launched in May 2018, is the first NHS-approved and owned complementary therapy school, run by NHS employees. It was developed to create a self-sustaining model of care for patients, delivered by therapists trained to the highest standards of care expected of any health professional working within the NHS. But as the team will be more than happy to tell you, this didn’t just happen ‘overnight’ – it took four years and a lot of hard work to get to where they are today.

When Sarah took on the role of Patient Information and Health and Wellbeing Manager at the Sir Robert Ogden Macmillan Centre, HDFT, in 2014, part of her responsibility was to develop and improve the existing complementary therapy service. At the time, it comprised of six self-employed therapists, who took turns to provide four hours of treatment a week to self-referring patients. While the therapists offered a very good level of service, there was no consistency for those accessing treatment, and no measures in place to show the true value of the service to patients and staff. As such, it was seen as more of a ‘nice to have’, informal spa, than a service that offered real therapeutic potential.

Sarah quickly set to work to future-proof and improve the complementary therapy service. As well as securing dedicated space for delivering therapies and training within the newly built Centre, Julie Crossman, MFHT – one of the original therapy team members – was tasked with overseeing an audit of the complementary therapy service using MYCAW*, so that they could start to build an evidence base of the treatments provided. A little later Sarah brought Gwyn on board, to develop a therapy training programme that would meet both CQC (Care Quality Commission) and industry standards and equip students with the necessary skills and knowledge to work confidently and safely with patients with complex health needs.

When I walked into the Centre less than a fortnight ago, I have to say, it felt very calm and welcoming, and as if the NHS Natural Health School has been running smoothly for many years as opposed to months. Today, the model created by Sarah, Gwyn and the team means that for each cohort of students they have on a training pathway at a time, 72 patients are removed from the complementary therapy service waiting list.

Self-referring is also a thing of the past, with all patients now being referred by a health professional working at the Centre. Many of these health professionals have experienced the treatments first-hand, after accessing these when a patient has cancelled or been unable to attend an appointment. Others have simply seen how different therapies have helped to resolve issues such as pain management or sleep difficulties in patients, which previously might have required referral to a specialist, costing the NHS even more precious time and money.

Sarah also highlighted that an unexpected benefit of providing health professionals access to the complementary therapy service is that they feel valued and cared for, and as word travels fast in the medical community, this has vastly helped to improve recruitment at the hospital. Staff who feel valued are also more likely to volunteer to do overtime, because they’re happy to ‘give a little something back’.

So, what’s next? Once the team are completely happy with the model, they hope to introduce it to other departments within the hospital and then, ultimately, license it out to other Trusts, so that these too can benefit from a self-sustaining complementary therapy service, which has quality and patient-centred care at the core. It certainly seems to be a win-win situation for all involved – namely a struggling NHS system, over-burdened health professionals in danger of burn out, therapists in need of hands-on experience working with complex patients and, most importantly, patients in need of support.

Keen to learn more about the NHS Natural Health School and team?

Read an article by Gwyn about the NHS Natural Health School

Learn more about Gwyn winning 2018 FHT Tutor of the Year

Read about Gwyn and Julie winning a Complementary Therapy Award 2018

*MYCAW (Measure Yourself Concerns and Wellbeing) is a patient-reported outcome measure often use by complementary therapists working in cancer care.

Music therapy could help prevent falls in over 65s

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More than three million people are treated for fall related injuries during the winter months, with around 60,000 requiring hospital treatment.

Daniel Thomas, Joint Managing Director & neurologic music therapist at Chroma, the UK’s leading national provider of arts services, suggests winter poses a serious risk of falling to the elderly for a number of reasons:

‘Many older people take numerous medications that may have side effects including dizziness, which pose an increased risk of falling.

‘With age, sensation in feet decline, especially if there is an underlying condition such as diabetes, poor circulation, arthritis or lingering complications following a stroke. With decreased sensation, balance is affected. Slippery surfaces, such as those covered in snow or ice, can further reduce balance increasing the likelihood of a fall.

‘Many over 65s walk with an unstable gait, during any weather. Those who do not exercise have weakened muscles, increasing the likelihood of a fall.’

According to Age UK, falls in the over 65s costs the NHS around 4.6 million a day, and this could skyrocket, with this age group due to represent nearly half of the population of some areas by 2039.

Chroma believes the solution to fall prevention in the over 65s lies within neurologic music therapy (NMT) – the therapeutic application of music to cognitive, affective, sensory, language and motor dysfunctions due to disease or injury to the human nervous system.

NMT relies on engaging with patients to maintain exercise and physical activity, encouraging older people and patients to move more for therapeutic and health reasons. It recruits healthy and un-injured areas of the brain, rather than trying to fix the damaged or ‘broken’ part of their brain linked to the loss of function.

Rhythmic Auditory Stimulation (RAS) is an important aspect of NMT. Within RAS programmes, strong and predictable rhythmic patterns are used to guide the sensori-motor movements required for walking. Predictable rhythmic structure allows the sensori-motor system to move in sync with the beat. Stroke patients have reported improved stride length and symmetry with RAS.

Daniel suggests, ‘Music with high beats per minute (BPM) promotes movement, good cadence and walking speed, so songs like Nancy Sinatra’s These Boots are Made for Walkin, which has 85 BPM is ideal.

‘Walking speed correlates with functional ability and balance confidence. It has the potential to predict future health status, the risk of falls and a client’s fear of falling. BPM strongly correlates to step cadence, and therefore walking speed. Improved walking speed equates to improved balance.

‘Increased muscle strength, gait and walking speed are all necessary factors required to reduce the risk of falls in the elderly. NMT has proven itself to be a cost-effective intervention to help improve such factors, and as a result, enhance the wellbeing and health of the elderly and the healthcare sector simultaneously.’

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