My Third London Job

OK, I will try not to get distracted by Hugh Grants hair this time. Steady, steady,… OK I can do this…

As I said, I work at the Royal Hospital for Neuro-disability in Putney. This hospital started in 1854, allegedly at the pleading of Charles Dickens. Anyway, it started life as Hospital for Incurables. In reality, it is not actually a hospital; most of it is more like a very medical-like residential facility for people with very severe neurological injuries/disease. It is still in the original building, which is lovely as an historical monument, but rather awful for any practical use as a hospital or home, especially since it cannot be modified because it is a listed building. There have been numerous additions over the years. It really is quite lovely though.

In addition to the residential wards (one is all ventilated residents), there are several specialty rehabilitation units. One of them is a unit that specialises in minimally conscious states. The hospital seems to be known nationally for this particular unit. One of my posts is in one of the other rehabilitation units: the neuro-behavioural rehabilitation unit. It is in a separate, relatively modern building from the main hospital. The clients on this unit are exhibiting behaviours that are interfering with their therapy delivery, their relationship with their family and friends, or their own (and other’s) safety. These of course include physical / verbal aggressive and sexual disinhibition. However, for me the most challenging behaviour is the passive behaviours: when the clients refuse everything. But I have been learning and getting better at turning that around… The behavioural unit uses the Institute for Applied Behavior Analysis approach.


My other post is in the computer room. Three things go on in the computer room: (1)Clients access computers to do things like internet, email, facebook, games, word process. These clients need special equipment and software to accomplish these aims due to the severity of their conditions. One of my clients is a published author and has been publishing despite being a quadriplegic with only the slightest of movements in his left hand. (2)Clients use computers as part of their rehabilitation aims. One piece of interesting kit that we have is this hardware/software package where the client plays games but the movement is controlled by specific targeted movements that can be set using a device that measures a specific movement pattern such as bending your elbow or twisting your wrist, or by an amount of force like shift weight from your right to left leg or from your bottom to your feet whilst sitting, or just from a trace muscle contraction using an electrode sensor! (3)Clients are issued high-tech environmental controls or communication devices which we program and train the clients on. I have a client right now learning to use an eye-gaze system to speak, listen to music, email, and activate a nurse call as she has no movement accept for her eyes.

Believe it or not, occupational therapists where uniforms in this country. The green uniform is one of the many differences between occupational therapy practice in the UK and the USA. But it is wholly recognisable. More on that to come in a future entry!...