Michelle Tennyson, Assistant Director of Allied Health Professions, Personal and Public Involvement and Patient Experience, Public Health Agency. To view our complete series of COVID-19 blogs, click here.
As we pass the peak of the COVID-19 pandemic in Northern Ireland, our thoughts turn to the growing need for rehabilitation of those recovering from COVID-19, restoring and rebuilding our rehabilitation services, and crucially, hearing the voices of people using services with ill-health or disability.
After a six week stay in intensive care with COVID-19, James* has returned home to his wife and four children. He hopes to be able to return to full time work and to supporting his family. He is experiencing lingering breathlessness and fatigue. During his illness he was on a ventilator, and the breathing tube has impacted his voice so talking is a chore, and even swallowing is difficult. He looks on as the children play.
Margaret* contracted COVID-19 in the care home where she lives. Recovery has been slow. The fever has settled, however her cough remains troublesome, and loss of taste and smell has put her off food. Margaret finds it difficult to get out of bed and she tells us she feels anxious and panicky. Her carers are worried about her weight loss – she was always very slim and this has been a real challenge.
These are some of the stories of people recovering from COVID-19 in Northern Ireland – people who have had the virus and entered a different period in their recovery, during which their needs have changed. Those recovering from COVID-19 have told us about their fatigue, shortness of breath, problems walking, swallowing, dressing, loss of appetite, weight loss, poor planning skills, forgetfulness, boredom, anxiety, depression and flashbacks to their experience of being acutely unwell with COVID-19.
Physiotherapists, dietitians, occupational therapists, speech and language therapists, podiatrists, music therapists and art therapists each have a unique and professional skillset to support people in their recovery from COVID-19, in various settings across Northern Ireland.
The Minister for Health last week highlighted the challenges facing Health and Social Care Services in Northern Ireland, and discussed a plan for restoring services and capturing innovation in response to COVID-19. The pandemic has reshaped how we deliver services and enhanced innovative approaches to rehabilitation. Speech and language therapists are using technology such as iPads to support nurses and care home staff in managing residents whose ability to swallow has deteriorated. Physiotherapists and occupational therapists are using video consultations where appropriate to assess and treat people outside of the hospital setting, enabling rehabilitation while reducing the risk of the transmission of the virus. Measures to prioritise safety, for example, wearing personal protective equipment (PPE) and employing safe distancing, has and will continue to impact the provision of rehabilitation as we enter the next stage of COVID-19 recovery.
Rehabilitation is, to coin that phrase, ‘everyone’s business’. It underpins all conditions and involves multidisciplinary teams from various agencies with strong links to local voluntary and community services. Rehabilitation is essential for the individual and society, enabling people to live independently, and reducing costly hospital admissions. The key to an effective and responsive health and social care system is listening to people who are recovering from illness, understanding how it has impacted on their lives, and the challenges they face at a local level accessing health services and rehabilitation. COVID-19 has had a particular impact on people in care homes, so it is very important that we hear and listen to these people and their carers, so we can plan for the future.
We are learning more about the emerging rehabilitation needs of COVID-19 survivors in Northern Ireland and the needs of those who have ongoing health needs impacted by a temporary changes in their care, for example those with heart disease or cancer.
What is clear is that rehabilitation is essential to support people who are recovering from COVID-19, or impacted by the pandemic. It can help achieve Health and Social Care rebuilding ambitions; in particular preventing further ill-health, reducing demand for health services and supporting people to optimise and take control of their mental and physical wellbeing. Utilising advances in technology and smarter ways of delivering rehabilitation is key to planning service delivery in the wake of the COVID-19 peak. Action planning for the anticipated increased rehabilitation demands of adults and children affected directly and indirectly by COVID-19 will require whole system support. Crucially, understanding the holistic needs of people recovering from COVID-19 will require active listening and learning from experiences, so we in turn, can provide person-led rehabilitation and support people like Margaret and James as they return to physical and mental health and wellbeing in the days, weeks and months ahead.
*these stories are based on real live experiences of people in Northern Ireland recovering from COVID-19. For anonymity, the names are pseudonyms.
To view our complete series of COVID-19 blogs, click here.