{"id":777,"date":"2015-10-09T14:20:36","date_gmt":"2015-10-09T14:20:36","guid":{"rendered":"https:\/\/blogs.bmj.com\/ebn\/?p=777"},"modified":"2015-10-09T14:26:48","modified_gmt":"2015-10-09T14:26:48","slug":"mental-health-reablement","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/ebn\/2015\/10\/09\/mental-health-reablement\/","title":{"rendered":"Mental Health Reablement"},"content":{"rendered":"

Tomorrow is World Mental Health Day <\/strong><\/a>– 10 October. World<\/strong> Mental Health Day<\/b> is observed on 10 October every year, with the overall objective of raising awareness of mental health<\/b> issues around the world and mobilizing efforts in support of mental health<\/b>.\u00a0 Today we are delighted to welcome our first of two blogs on the subject.\u00a0 Our first blog comes from Daniel Oliveira<\/a>, Linda Graham <\/a>& Ann Fitzsimons who recently worked\u00a0on a project,\u00a0with the South Eastern Health and Social Care Trust <\/a>in Northern Ireland, to help relocate a number of long-term mental health patients from hospital to a specialist community setting.\u00a0 Daniel, Linda and Ann work at Lecale Lode Care Home<\/a>, part of the Four Seasons Health Care <\/a>group.<\/span><\/p>\n

\"fshc<\/a>\"fshc<\/a><\/p>\n

 <\/p>\n

Mental Health Journey- A New Life<\/strong><\/p>\n

On September of 2013, The South Eastern Health Care\u00a0Trust, in a joint partnership with Four Seasons Healthcare, began a resettlement project for the accommodation of 13 permanent long term mental health patients from hospital to a community setting\u00a0 as part of Transforming Your Care <\/a>Agenda.\u00a0 Although the mission appeared to be simple, challenges and barriers would undoubtedly appear along the way. Patient Focus and involvement from the families and the multidisciplinary team was\u00a0paramount for the effective discharge from the hospital ward to the care home setting.<\/p>\n

Models and theories in nursing were used as a scientific background to assist in the transition from the \u201cpatient\u201d to the \u201cresident\u201d \u2013 The Adaptation Model <\/a>from Roy and the Transition Model <\/a>from Meleis are excellent examples that clearly assisted on the assignment of a concrete plan to provide the safest transition possible to the inpatients from the Mental Health Unit.\u00a0 Roy explains that every individual is a bio-psycho-social being and is in constant interaction with a changing environment \u2013 to respond to a changing environment the person must adapt. Meleis, taking consideration of the concept of adaptation from Roy, also explains that for every significant change in the life of the individual there is also an experience of transition \u2013 this can have a positive or a negative outcome depending on internal and external variables. Meleis explains that the process of coping is paramount in every transition and the coping will eventually dictate the quality or not of the adaptation to a new environment.<\/p>\n

Taking the above in consideration Four Seasons Health Care designed and created a facility to directly respond to the needs of the patients \u2013 the focus of the facility was to create a safe environment that could empower and stimulate the patients to live their life\u2019s to the full in a community setting. This facility was only possible after numerous meetings between the South Eastern Health Trust and Four Seasons Healthcare. Over those meetings Four Seasons Management met with different professionals from the trust to find out the challenges ahead. Enhanced Care Pathway Meetings were held with all the multi-disciplinary team, Four Season Representatives, family and if possible, the\u00a0patient prior to the planned discharge date forming relationships between all.<\/p>\n

Individual management plans were assembled for every patient before discharge \u2013 detecting behaviours, triggers, risks and how to manage the same.\u00a0 Specific training in Mental health was provided to every new member of\u00a0staff that was\u00a0recruited and also existing staff to include support workers and nurses.\u00a0 Emphasis was given to the therapeutic relationship between the patient and the carer \u2013 the team from the care home was introduced to every single future resident months prior to the discharge so as to foster therapeutic relations.<\/p>\n

We clearly understood that an efficient adaption from the future residents would only be possible if the team was prepared and trained to assist individually every resident. By getting to know every resident prior to the discharge the first steps to an effective therapeutic relationship were created.<\/p>\n

We also understood that the individualities of each resident would be fundamental as well. The details of their past lives, their likes and dislikes, their personalities would be dictating their environment in the care home. The patients named the new unit they would be moving to and picked the d\u00e9cor for their bedrooms.<\/em><\/p>\n

By the time of the actual transition from an acute environment (hospital) to the community setting the foundations for a successful and effective adaptation from the patient to a new environment were established.\u00a0 An open day was held so the patients could view their new home and this proved a great success.\u00a0 On the arrival of the residents focus was given to positive distractions and meaningful activities \u2013 like cooking, cleaning, going to the cinema or going to the town to buy something \u2013 all of this would actively contribute for positive coping towards the transition.\u00a0 Preparation and study was undoubtedly critically for the success in the first weeks.<\/p>\n

 <\/p>\n

\"Lecale<\/a> \"Lecale<\/a> \"Lecale<\/a><\/p>\n

Firstly improvements were noticed in the resident\u2019s skills of daily living activities\u2013 with the assistance and supervision of carers residents were cooking, washing, creating relations with the community etc \u2013Roper Logan Tierney model was used to reflect the changes on every individual.\u00a0 The reduction of the use of PRN benzodiazepines was also observed \u2013 different strategies (e.g walks around the care home, low stimuli environment) were being used as a first line of treatment.\u00a0 Residents started to actively confide to the staff their likes and dislikes. Residents also became actively contributing to their own home environment by changing and personalising their rooms.<\/p>\n

The team clearly adopted a person centre approach which indisputably assisted on the success of the transition.\u00a0 But no success was achieved without challenges \u2013 the team often debated themselves with different approaches to reduce or even omit years of institutionalized behaviour from the residents \u2013 for example residents would queue outside the medication room every morning at the same time to have their medicines \u2013 although we agreed that routines were required to keep a balance and reduce stimulus that could unbalance their mental status we also agreed that small details could be changed in order to increase their quality of life.<\/p>\n

The success of the Slieve Patrick unit at Lecale\u00a0Lodge\u00a0is due to the excellent collaboration between the South Eastern Trust and Four Seasons Healthcare.\u00a0 Since the beginning, the\u00a0focus all of our attention was\u00a0on the patients\/future residents. It\u2019s the little stories and victories of the residents that makes us look optimistically to the future and for the opportunities that this collaboration brought.<\/p>\n

Daniel Oliveira<\/a>, Linda Graham <\/a>& Ann Fitzsimons<\/p>\n

Lecale Lodge Care Home, Four Seasons Health Care.<\/p>\n

 <\/p>\n

 <\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Tomorrow is World Mental Health Day – 10 October. World Mental Health Day is observed on 10 October every year, with the overall objective of raising awareness of mental health issues around the world and mobilizing efforts in support of mental health.\u00a0 Today we are delighted to welcome our first of two blogs on the […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":273,"featured_media":781,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[],"class_list":["post-777","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"yoast_head":"\nMental Health Reablement - Evidence-Based Nursing blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/ebn\/2015\/10\/09\/mental-health-reablement\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Mental Health Reablement - Evidence-Based Nursing blog\" \/>\n<meta property=\"og:description\" content=\"Tomorrow is World Mental Health Day – 10 October. 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