6 7 Meet the rehabilitation stars helping patients reach their goals A lot of us won’t give much thought to everyday tasks like making ourselves a sandwich or popping out to post a letter. But at the Neurological Rehabilitation Centre (NRC) in Edgware, patients are working hard to regain their ability to do these day-to-day activities or adapt to a new way of living. And it’s the team of over 60 rehabilitation champions based at the NRC who help patients with neurological conditions achieve their goals, either as inpatients or in the community. Caring for complex patients Nadia Jeffries has been clinical and operational lead at the NRC for eight years now. She said: “One in six people in the UK are living with a neurological condition. Most patients who come to the inpatient unit have a sudden onset condition, such as a brain injury post neurosurgery, spinal cord injury from a traffic accident, or a complex stroke. “Many are supported to go home but some patients may not regain full independence when they leave the unit, so we continue to help them manage their disability and minimise any complications.” The NRC hosts a 14-bed inpatient unit for patients requiring complex care, complete with a physio gym and mock kitchen for patients to practice different skills in. Speech and language therapist Nicki Subel works with patients who have difficulties swallowing or communicating. She said: “These patients are often here for a while and we see them every day. It’s quite intensive rehab but the best thing is getting to know the patient. We’re not just helping with function or skill, but with their quality of life.” Dipi Bhudia is a rehabilitation assistant and often works with inpatients in the gym. She shared a bit about her role: “I work with staff from all the disciplines and run sessions with patients – this could be swallowing exercises, washing and dressing, or visiting their home before they’re discharged. It’s interesting and you get to learn on the job.” Making a difference in the community There are 25 staff members who work in the community seeing some of the 800 patients on the long-term conditions register, including those with progressive disorders like multiple sclerosis (MS) and motor neurone disease. Jenelyn Dimatatac, therapy assistant, said: “This is my first community role and I love helping patients in their own home. It’s not the perfect environment, but it makes you think creatively about how you can offer the right care there.” Melissa Geron, community occupational therapist, added: “You see the patient functioning in their own home, and for me that’s the best way to see them. They might have a favourite sofa that means a lot to them, but which they can’t get up from. We can see that and put support bars on the sofa so they can use it safely.” Bhawani Mainali is the only MS community nurse in north central London and visits patients in their home or the community. Speaking about a key part of her role, she said: “When I first started, I noticed that there were so many MS patients in the community who didn’t have anywhere to share their experiences. I now run an MS coffee morning twice a month. Over 100 patients come to meet people in similar situations, and it encourages them to self-manage and seek peer support.” Modelling multi-disciplinary team working Occupational therapists, dietitians, rehabilitation assistants, physiotherapists, nurses and neurologists are just a few of the many roles at the NRC. Specialist dietitian Trena Houdek works in the community team, supporting patients with their eating, drinking and nutrition at home. She said: “The multidisciplinary team working in the NRC is outstanding. We’re all based in the same place and share advice in our clinical meetings. You never feel like you’re on your own.” Involving patients in their own recovery plan is also a key part of the process. “What our patients need is repetition and practice doing real life activities,” said Marketa Ramsay, clinical specialist physiotherapist and inpatient therapy clinical lead. “They’re actively involved in their goal setting, and we make an effort to find out who they are as a person and how we can help them get their sense of self back.” Occupational therapist Sarah Evans supports patients with any work-related goals. She said: “Occupational therapy is aligned with participating in meaningful activity and work is such a big part of that for patients – it provides a sense of purpose, value and identity. “Some people want to rush back to work as they can think that everything else will fall into place afterwards, and we need to reassure them that recovery is a priority. We listen to them and help them establish what their challenges at work might be and any reasonable adjustments they need.” L-R: Jenelyn Dimatatac, therapy assistant, Bhawani Mainali, MS nurse, and specialist dietitian Trena Houdek Members of the NRC community team Staff based in the centre’s inpatient unit We’re not just helping with function or skill, but with their quality of life “ “ You never feel like you are on your own “ “ The highs and the lows of rehabilitation Nicki said: “Sometimes it can be challenging as we focus on safe discharge, but that might not be what the patient is focussed on. They may want their speech 100% back to normal, and that might not be realistic. Our clinical psychologist, Holly, helps them understand and plan their goals.” “I’ve been working with a patient with progressive supranuclear palsy, a progressive disorder causing brain cell damage, who used to be a musician,” Melissa shared. “He can’t play an instrument anymore but for him and all our patients we will always look at exploring ways we can promote quality of life, even during hard times. And despite everything many patients still have smiles on their faces and express gratitude for the care they have been given.” Bhawani added: “Patients with complex needs have good days and bad days. You need to have a kind heart and a sense of humour.” “It’s quite emotional work,” Dipi said. “We’ve had patients who have walked out of the centre unaided after being told they’ll never walk again – that’s the best feeling ever.” Nadia Jeffries, clinical and operational lead at the NRC
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