Background Personal symptom experience of breathlessness can mean not everyone is able to attend onsite to see an Occupational Therapist (OT) for help with their breathlessness (HWB), or manage effective telephone or virtual consultations. We needed to challenge our current service model. The team explored whether it was possible to provide this service in an individual’s own home.
Aim/s To provide equitable OT HWB service for all patients referred to our service. Understand barriers to community accessibility due to the individual’s own lived experience of breathlessness. Create opportunities to open functional/advance care planning conversations around living well at home, and future environmental considerations. Work collaboratively with carers, internal and external NHS services to support individuals managing their breathlessness both medically and ‘non-medically’.
Method 9-month Hospice UK grant-funding enabled the service to commence. Patients referred need to be under our organisation’s Consultants’ care and feel unable to attend the existing onsite service/s or effectively hold a telephone or virtual consultation. 1 x OT HWB home visit is offered in place of their onsite attendance. Person-centred (functional) goals are established alongside Likert scale and Barthel index. Follow-up visits are offered if clinically necessary such as equipment check reviews. Goal attainment is completed through telephone reviews alongside user/carer/wider professional feedback.
Results (ongoing findings): Physical and psychological safety can be a common factor in helping understanding someone’s breathlessness experience and community accessibility barriers. Assessing an individual’s home environment helps create personalised OT HWB strategies. Involving carers/loved ones adds visceral understanding of the impact of breathlessness on an individual’s lived experience. Collaborative networking helps support individuals and their loved ones make connections and future care considerations. Personalised goals and treatment plans can support acquisition of functional resilience skills. Outcomes measures through numerical data collection is, however, proving challenging.
Conclusion There has been a demonstrated need to provide Occupational Therapy home visiting for patients who cannot attend their onsite clinic, or manage effective telephone or virtual OT breathlessness management consultations. This has now formed an established part of the core OT service provision.
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