Information

As measures have increased to inform and support people to understand the seriousness of this situation it is likely that many of our service users and staff may be worried about COVID-19.

These anxieties can be also be very infectious. Caution should be exercised in not exacerbating an already difficult situation.

This blog offers some good insight into coping and support needs: open future learning blog and why we might need changes in the future.

These are very difficult times for people who use our services to understand for a number of different reasons: many regular routines are affected,

• Possibly potential changes of staff with new colleagues on the units
• People possibly moving from one area to another to accommodate isolation areas
• Changes to the environment to protect from or control the virus.

If we are going to help people understand the situation then we need to think about how to chunk up the information. Some people may not have heard of COVID 19 but they might know what germs are, they may remember having a cold or someone else having one.

Understanding what a person knows will help you to help them understand more.

Be aware that some individuals may have communication difficulties so may not be able to tell you that they are feeling unwell initially e.g. with a sore throat. The person may show they are in discomfort through a change in their behaviour or level of interaction this needs careful monitoring and always consider a possible underlying physical cause for any changes seen first.

Once we know what the person knows, this can help us think about how to give more information to prepare for potential changes and the impact on them. Using credible sources to provide facts and information is really important.

There is a COVID:19 facebook group set up to specifically support sharing of appropriate, accessible information for people with learning disabilities. There is wide representation from multiple disciplines and providers as well as people with learning disabilities, parents and carers.

It is really important that we continue to encourage preventative measures.

We want to help people stay healthy in our services. We need to promote hygiene and follow the governments advice.

Coping with isolation and restrictions

We know that many people who use our services may feel disconnected from wider society and may not have insight for the need to self-isolate and decrease physical contact with others. This Wuhan article highlights some of the lessons learned and makes recommendations about inpatient mental health areas.

Balancing the level of information we give to our service users is important so that we can inform in a way that they can make meaning of but not induce further panic or fear. Be aware that news on in the background can be a source of anxiety for some people, particularly if the person has limited language skills.

Trying to maintain some sense of or a new sense of normality while there are restrictions in place on how we can move around and live our lives may mean trying to replicate some of the basics that we are all try to maintain, support people to try to stay calm:

• Waking up and going to bed- trying to keep to the same schedule
• Maintaining a healthy diet
• Taking exercise, we can leave the environment once a day to do this, there may be changes to the support we have to do this.
• We may also want to access some you tube videos or have our own exercise videos that we can do in an area at home
• Some preferred in house activities can continue, craft, listening to music, watching our favourite films or things on TV, jigsaws, mindfulness etc.
• Calling, face time or Skyping our friends and family
• Limit access to social media and the news

It is really important that if somebody does develop the initial symptoms of COVID:19 that they can self-isolate. For people already in our specialist services, we need to help them do that. We need to help people to understand why they must stay inside.

In our specialist services, we have created an isolation area. This might be on the same site that the person is in now or it may mean that the person needs to transfer to an area where they can be carefully observed and assessed.

If a person needs to move to the isolation area they will continue to be supported by staff from our services. Our staff will need to wear protective equipment to reduce the chance that they might also get COVID:19.

This might look different for the person and it might be frightening. Try to help them understand.

This social story has been developed for a specific person and explains what happens when people get poorly with COVID: 19. If you want to use it in your areas then do not use page 9.

Our Speech and Language therapists have developed a range of resources for individuals and you could ask them to develop something specific with you for a person who you need to communicate with.

It is always best to have a personalised story for the individual, written in a way that specifically meets their needs.

While the person is in the isolation area they will need to be kept safe, monitored and as far as possible be supported to continue to do things that are important to them, including activities and safe engagement with others. Thinking creatively about using social media, face time/skype etc.

If the person does not get better after 7 days or becomes very unwell then the clinical decision for them to go to an acute hospital for escalated treatment will need to be made. The decision to escalate care will be evidence based and reasoned and the person's wishes will need to be considered in relation to this. 

Our staff will continue to support the person in hospital and give advice about their specialist needs. If the person becomes well enough, they will be supported to return to a ward area.