Exchanging notes on capacity


Not that long ago the Dementia and Mental Health of Older Adults CEN (previously the psychiatry of old age CEN) wrote an article on the roles an SLT may take on when dealing with issues surrounding the mental capacity Act (Devereux et al, 2016). These were developed from a workshop we ran at one of our study days where we discussed the breadth of our roles and the responsibilities these roles may be accompanied by. The bulletin magazine (Royal college of speech and language therapy practice magazine) article in July 2016 summarised these discussions.

More recently another group of clinicians (Bamford, Dixon, Mather et al, 2017) have responded to this with another article in the Bulletin magazine. This article builds on what was previously written by delving into the roles and providing clinical examples of where SLTs have acted in these roles in response to clinical situations. The article showcases some wonderful examples including a case where the SLT acts as an assessor in examining the decision making capacity of a young women with a learning disability around using the Internet. The authors also provided a great example of the role of the SLT as a trainer; they describe two training sessions delivered to a group of 40 social workers on the role of the SLT. The authors emphasise how this type of training can support other health professionals to engage with SLT support more appropriately in terms of our role in assessment and best interest decision making.

How wonderful that we as a discipline can have this conversation. When health professionals do not feel competent in an area of practice they are less likely to engage In work in this area. SLTs are starting to feel more competent in this area. SLTs are having more conversations, doing more research and providing more examples of great practice.

The Dementia and Mental Health of Older Adults CEN (previously the Southern Psychiatry of Old Age CEN) are planning to do more learning around advance planning. I feel this is an area where SLTs can really support people in engaging in advance planning, for example creating appropriate documents and tools to support people to express their wishes and preferences. I look forward to hearing the next stage in the debate!

The smaller joys of a career in research


Warning: gratuitous listing of what makes being a PhD student pretty cool

If you have been considering a career in research and are currently working in the NHS then do read on. I have now been doing a PhD for just over a year and have been surprised by the smaller pleasures I have discovered on route. These are generally perks no one had previously mentioned to me. This may be what makes them so nice:

1. Independent working
This sounds ever so obvious but really I hadn’t anticipated what this meant. I have a wonderful relationship with my supervisors. Basically they are there when I need them but they trust I will get on with things. I keep them informed of my comings and goings but they are comfortable for me to do what I need. One of the great bonus’ here is that if my children need me I can be there for them without losing out on work hours or feeling terrible for cancelling a patient’s appointment. For the most part I can shift my hours to when is convenient for me.

2. Christmas
For the 14 years prior to embarking on a PhD I have worked in some way over every Christmas and certainly every Easter (although unlike many nurse and doctors I have not had to work as an SLT on Christmas Day itself). In order to apply for a day off I would previously have to apply many moons in advance, often stating a reason for needing the day off and then this would be considered by the senior team before being put forward to the manager for approval. This painful process was not without good reason- ensuring patients needs are met is the priority for the service. Now as a PhD student I am amazed by the fact I don’t have to work over Christmas or at least I can work from home if I so choose.
3. I am valued
I didn’t really anticipate that other very senior members of the department would consider me an expert. I find there are times when people defer to my knowledge and experience as a speech and language therapist who specialises in dementia and mental capacity. I feel valued by the department.
4. Development is key
Previously I have had to ask my manager every time I wanted to do any courses or attend any talks. Developing myself as a researcher for a future career beyond my PhD includes looking out for opportunities and taking them! This is also about developing new skills and collecting knowledge to apply to current and future research. I confess I find this rather addictive.

In short if you have written a New Years resolution to try to do some research or embark on further study – do it. There are hidden benefits that can improve your working life.