L.I.F.E.(Leisure Inclusion For Everyone)
By Alison Harkess
Staff Nurse – Learning Disabilities
Introduction
• Physical Health
• Mental Health
• Health Promotion
• Social Skills/Social Inclusion
PHYSICAL HEALTH
• To improve baseline fitness levels
• Healthy BMI
• Improve core fitness
• Maintain/improve mobility
• Off set co-morbidity
MENTAL HEALTH
• Reduce Depression
• Reduce Anxiety
• Increase motivation
• Improve wellbeing/coping ability
HEALTH PROMOTION
• Promote healthy lifestyle
• Explore how exercise affects the body and mind
• Increase personal expectations
• Safe/realistic goal setting
SOCIAL INCLUSION/SKILLS
• Community resource
• Increase social opportunities
• Promote independence/skills
• Transferrable skills
IMPLEMENTATION
• Made proposal and secured hours• Secured group access cards• Identified clients, obtained permission/physical
examination by RMO• Identified gym and risk assessed suitability• Completed physical readiness questionnaire• Identified appropriate mental health assessment tools x4
and obtained baseline recordings• Induction at gym including fitness test, introduction to
equipment and fitness programme setting• Commenced twice weekly, 2 hour sessions
RESULTS
• Resting pulse rate reduced• Blood pressure reduced• Some weight reduction• Co-morbidity effects challenged• Motivation increased• Well being increased• Anxiety reduced• Depression reduced• Independent/social functioning increased
CLIENT FEEDBACK
• Client questionnaire completed
• Enthusiastic response
• Commitment of clients
• Would like other opportunities to engage in physical exercise
• Feel they are achievers
• Same as everyone else
CONCLUSION
• Physical exercise is cost-effective• Inexpensive to deliver (cost to NHS Lothian NIL!)• Inexpensive to participate in• Minimal adverse side-effects compared to
pharmacological interventions• Can be indefinitely sustained• Exercise is a valuable transferrable skill• Holistic and individual• Trinity of treatments (mind, body and soul)
L.I.F.E
‘Case study’
‘Kevin’
Kevin’s pathway of care to NHS Lothian LD services
Up to 16yrs:Special School and lived at home
Parents found it difficult to cope and challenging behaviour and physical aggression
Residential home2 yrs
Placement broke down due to challenging behaviour
Supported by Social Work 2 yrs
Placement broke down due to behaviour that challenged
Residential accommodation 8yrs
Admitted to the REHshort term
Aggressiveoutburst
Back to same residential placement(one night)
Police custody then respite care (three
weeks)
Inpatient LD resource
NHS Lothian(March 2008)
Similar aggressive outburst
Needs 1:1 supervision
in communitysettings
Increased riskof Type II diabetes
Language comprehension
8yrs old
Need of clearboundries/
rules& structure
History of aggressive/
violentbehaviour
High bloodpressure
Morbidly Obese (115 kg)
Mild LD
Prader-Willi
syndrome
‘Kevin’ 29yrs
‘Kevin’ - profile
Mood swings/difficulty with
change
Behaviouralproblems
(anger/inflexibility)
Low muscletone
Learningdisability
Dental problems
Hormonalimbalance
Type IIdiabetes
High blood
pressure
Obesity/morbidobesity
Insatiablehunger
Prader – Willi
Syndrome
Treatment/management
Food restriction/supervision Daily structure/routineRegular exercise Firm rules Hormone treatment
Kevin and the L.I.F.E programmeKevin joined the project
- morbidly obese (115 kgs)- High blood pressure (medicated)- challenging behaviour
Goals:
assist with weight reduction increase confidenceimprove CV functioning reduce anxiety decrease blood pressure promote coping abilitiesimprove muscle tone
Programme:
2 x per week – Edinburgh Leisure30 minutes cardio and range of equipment useWalk to/from gym (2 miles)
Reduce co morbidities
Extend life expectancy
Results…
More confident
Improvedmusclestrength
More sociable/
happiermore in control
Increase CV functioning
(reduced resting HR)
Decreased Blood
pressure
66 kg (49 kg weight
loss)
KEVINNOW
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