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Video reviews

Handling People with Special Needs

Centaur Training Ltd, Station Business Centre, Station Road, Redcar, Cleveland TSlO 2RD

1998. 282 min f 699 Tliis video is part of a course which covers very comprehensively all aspects of niariual handling - legislation, anatomy and mechanics of the spine, patholqgy of spinal injury and correct lifting and handling techniques for people working with cliiltiren and adults with special needs.

The course can be used in two forms, presenter-led or open learning. It is divided into modules, some use videos, some are demonstrations for practical sessions. There is a workbook with revision questions, written exercises and a training record. The presenter-led conrse supplies overhead transparencies, master photocopies and all documentation required to organise a course. ‘Ihe open learning course has two course books that learners work through with the videos at their own pace, with the help of one or more supervisors. This is essential not only f’or overseeing the practical work but also to ensure that the lcarriers are working at the right level.

Some of the work on spinal anatomy and injury, although bemtifitlly explainrd and illustrated, uses medical terminology, and anyont. without prcvious knowledge may find this section diffictrlt without help.

A physiotherapist colleague working with musculoskeletal problcms was concerned about the emphasis on the negative side of‘baclis - how small the back muscles are compared to the largc leg musc:les and how disastrous it is to have a back injury as one may never recover. While taking the point that back injuries in-c t o be avoided a t all times, modern rehabilitation is more positive, encouraging pcoplc to move their backs without fear and to expect to resume their normal lives. Anyone who has r v r r had some back pain ( a n d who has no t? ) may lose confitlcncc in thrir manual handling ability after watching this.

‘I’he units 011 hoisting and slings are well done, providing a very iisrful library of techniques and equipment.

The iinits on handling special needs people addresses the question of how much they should do for themselves as part of their therapeutic programme and how much they should be mechanically handled for the carers’ sake.

Many examples of people with special needs moving or being moved safely as part of their therapy programme or ADL are covered. However, I was at a slight loss to know to whom the information is addressed. Is i t intended to be a refresher for

occupational and physiotherapists or an initial training course for carers? Or both? Surely carers would not instigate these techniques without an assessment and care plan from a trained therapist.

I think an explanation would have been appropriate that these are examples of how a therapist may wish carers to help and supervise their clients, but that therapists should teach the techniques initially with their particular clients. However, the information could be used at any level with proper supervision.

Overall this is a very thorough guide to handling people with special needs provided it is used with supervision from people who are aware of the learners’ needs and abilities as well as those of their clients.

Sue McKechnie MCSP

Back Care for Health Professionals

Available from the National Back Pain Association, 16 Elmtree Road, Teddington, Middlesex T W I 1 8ST 1998 32 min part 1 , 45 mm part 2

produced by the University of Southampton and the National Back Pain Association f295 + f51.63~ VAT This video pack fo r trainers is designed to be used in conjunction with the fourth edition of The Guide to the Hundling of Patienls published by the National Back Pain Association in collaboration with the Royal College of Nursing. It consists of two videos and an accompanying instructors’ handbook 0 1 guidance materials siiilable for converting into transparencies and handouts.

The material presents an holistic view of back care for health professionals with the emphasis on ‘24-hour back care’ using a wide range of examples from home life as well as the work environment. Equally importantly, moving and handling are looked at from the patients’ perspective.

T h e two videos a re divided in to well-defined sections presented in a logical sequence to form the basic structure of a training programme. This format allows trainers to expand and develop the contents of each section according to trainees’ individual needs. Video 1 highlights the impact of back in,juries on health professionals by interviewing three nurses who have had to give up their careers owing to cumulative trauma. This introduction

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leads naturally into a ‘Spinal awareness’ section which could have been enhanced by more dynamic 3D graphics.

In succeeding sections, ‘Safer handling’, ‘Assessment’ and ‘24- hour back caw’, key principles are succinctly and effectively reiiiforccd by good examples from daily activities at home, at work and during recreat.ion. Information about legislation is incorporated appropriately arid in context. I/ideo 2 demonstrates the the practical aspects of moving and haridlirig patients in hospital from the perspectives of both h c a1 t h c a r e profession al s an d , most sign i fi c a n t 1 y, patients themselves. It covers using hoists arid helping a patient to turn, sic forward, move up the bed and transfer from bed to trolley. It a l so presents diflicult scenarios, such as i fa patient has a cardiac arrest, or falls and needs help to get up from the floor.

Each section is introduced by ‘a patient’ who is played by an actress for practical and ethical reasons. This approach is very effective because the actress eloquently portrays the patient’s point of view before rach manoeuvre is demonstrated and the commentator explains the key points.

As well a s reviewing a range of moving and handling options, video 2 reinforces key points from video 1. It emph riced for ha i id l r r s t o gu ide arid teach patients to move tliemsclves whencver possible and to use appropriate small handling equipment and hoists with more dependent patients. ‘The section o n hoists is particularly well p resented and explained.

The package does not claim to cover everything or all of the

Who Should Care?

CONCAH (Continuing Care at Home), Church View, Sunninuwell Villaae. Abinadon. Oxon OX13 6RD

1999. 30 min Narrated by Maureen Lipman f 14.95 includes postaae. packina and trainina booklet

F o u r conditions are highlighted in this video: stroke, sero- negative arthritis, epilepsy and Parkinson’s disease - which are, ;iccctrding to the producers, the conditions most commorily sccn in a typical primary care practice. Most of the points made woiild apply to a variety of‘ other disea

‘I’ht: piirpose of the video is not to teach professionals or patients about the conditions colicerrled -- but to stimulate discrissiori and leariiirig about the contribution healthcare professioiials of’ many disciplines cari make to continuing care at home. It is accompanied by a training booklet.

Tlie four conditions are represented by b u r patients, and in some cases their carers who include, as well as husband and wife, a school-age daughter.

The patients o r relatives describe without euphemisms the effect of‘ illness on their lives and that of their families - the toll of incontinence (and constipation), aphasia, inability to work, scxual dysfunction and social isolation.

The film would not grab attention unless it was interesting and enjoyable to watch, and this video equals the standards of

approaches in The Guide and, although the techniques shown in both videos are in widespread use, they may differ from those taught in an organisation’s in-house programme, especially if trainers have themselves been trained in a particular approach. We, for example, apply the principles of one of the other approaches in The Guide, Lesley Crozier’s ‘ncuromuscular approach’.

This dynamic approach is based on principles of efficient movement which can be adapted and modified to meet demands in d i f fe ren t circumstances a n d situations. In comparison, the advocated techniques employ static postures and squat positioning. In order to maintain consistency of training and to avoid confusing trainees, trainers will need to ensure that the demonstrations of handling complement their own org‘anisation’s preferred approach to manual handling and moving.

This caveat apart, the pack is a useful training adjunct which summarises key points of manual handling and gives valuable insights into patients’ experience. Explanations are clear, demonstrations of the selected techniques are flawless and training can be supplemented with slides and handouts of illustrations that can be freely duplicated from The Guide. In cornparison with other video packages it also appears to be value for money.

Janette Lees MCSP PgDipHSSM

‘talking heads’ style television reportage. The down side is that the selected patients are s o intelligent and articulate, with attractive personalities, that the seriousness of their handicaps cari be disguised. It is a pity that the gentleman with Parkinson’s disease cannot go out, but with such a charming wife it seems no hardship to be housebound. The young woman recovering from a CVA has learned to speak again so well and can enjoy many one-to-one social encounters, so she can hardly miss not being able to cope with noise and crowds. And in spite o f their reduced income, they all seem to live in enviable housing, however many stairs they must negotiate to the front door. A grumbling old woman living in a slum with a downtrodden daughter might be more realistic, but perhaps would not co- operate with the director or inspire the will to help.

CONCAH is a charity devoted to improving the quality of life of people living at home with chronic illness or disability. It aims to do this by advancing the knowledge and understanding of carers and professionals providing services to sufferers.

Whether the package will help to achieve this can only be determined when it has been used for its intended purpose among healthcare professionals from several disciplines. To that extent it will depend on the quality of the audiences and their contribution to the discussion after each showing. The ‘stars’ and the producers have created an informative and attractive presentation. We must hope that it will lead to improved understanding and provision of care.

Jill Whitehouse BA

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