Twitter and Microblogging: Political, Professional and Personal Practices... 10-12 April 2013

Whew!  What an amazingly full few days.  I feel very fortunate to have been able to attend, and have learnt a huge amount. 

Probably most significantly, I have discovered how to use Twitter more fully.  Somehow what is obvious to a teenager (dont they always seem to have the 'knack' of technology) - is not straightforward to me!  I needed to be gently advised of how to get the most out of Twitter.  My thanks go to various presenters for enlightening me more fully regarding the background to the system of organisation Twitter uses.  This definitely helped to appreciate how to get the most out of tweets, retweets, modified tweets, mentions, hashtags and hyperlinks.  I had previously thought I had a 'handle on Twitter', but now see that there is a skill to use.  I aim to improve! 

My thanks go to Sandrine Roginsky - within her presentation, I was left with a definite pause for thought as to whether Twitter is not a tool to interact with the man in the street, but rather to foster an organisations E-Bubble.  

It was clear within various sessions that microblogging enabled some level of activities co-ordination or record, reputation management and enabled a relationship or awareness to be formed between the blogger and their audience. The ability to retweet, modify tweets and give information tweets enables knowledge to be shared, offering social information to be shared, distribution of news, comment on articles etc.  Of course, the ability to now link to media is also fabulous (tempting cupcakes were shown as an example of this - yum!).  Twitter evidently has benefits - although with this comes potential risks, and there was evidently a need for responsible use. 

Twitter has existed since 2006.   It is widely used for research, entertainment and news.  Whilst it does not have the number of users that Facebook has, there has been significant growth in the number of users (16% of Americans are now using Twitter).  For those within the UK, the analysis site Alexa shows today that Twitter is the 12th most frequently accessed website. The potential reach of any given tweet is significant - potentially seen by all followers (assuming they were looking at the time), and then retweeted on to their followers and so on.  It would be possible in this way for many thousand people to see a single tweet.  The use of hashtags also means that a person who had no relationship with the blogger, but who had an interest in the subject, would be able to locate the message through the hashtag (essentially enabling Twitter to file it in a specific index). 

Perhaps it is unsurprising then that Twitterverse is continuing to expand.  Of those using Twitter, Dr. Ruth Page's study showed that 51% followed companies or brands.  They used this to enable comment - including complaint.  Given the potential reach that this complaint could have, it is unsurprising that many companies are now trying to work hard to monitor and respond to these.  In the microblog of 140 characters or less, this is potentially challenging without being brusque. There is further research being done in this area and this will make for interesting reading.

I learnt a lot within the conference, I gained a lot of knowledge, met some fabulous people and had my interest piqued in many directions.  I need time to review all my notes now (notes, not tweets - typing is too slow for me!).  A very positive experience perhaps summed up by pennyb's tweet:-

Penny Andrews ‏@pennyb 12 Apr

Sad #LUtwit is over. I learned a great deal and met wonderful folk. My research will be better for it, as will my life.

Doorstep selling and mobility aids - do you know your rights?

The Office of Fair Trading has launched a consumer awareness campaign following unfair sales practices being identified - especially for those buying mobility aids.  

Take this quick quiz to see if you know the facts: http://www.oft.gov.uk/shared_oft/scams/Quickquiz1.pdf 

Advice to consumers buying on the doorstep

The Office of Fair Trading has launched a doorstep selling consumer awareness campaign.  This has specific emphasis on mobility aids to empower consumers against unfair sales practices. They are running this campaign in partnership with consumer groups and charities. The campaign aims to provide consumers with practical tips and informs them of their rights including the following:

• Think twice before you buy and if you are made to feel under pressure to make a purchase, have the confidence to say no.
• Be wary of time-limited or exclusive offers that need to be signed on the spot - this can be a high pressure sales tactic.
• Double check the facts. Do you fully understand the costs and know whether it includes extras like installation, on-going serving charges or warranties?
• Always shop around to compare products and prices.
• Talk to someone you trust for a second opinion. 
• If you spend more than £35 with a trader on the doorstep, you usually have seven days in which to cancel (subject to certain conditions). If in doubt, call the Citizens Advice consumer service on 08454 040506 or visit www.adviceguide.org.uk.

Why are the Office of Fair Trading worried about mobility aid selling?

The office of fair trading identified that the mobility aids sector may not be working well for consumers in early 2010.  Whilst the mobility aid is often a vital necessity for the consumer, the Office of Fair Trading found unfair sales practices targeted at elderly or vulberable consumers.  They had received more than 4000 complaints in respect of mobility aids sales to Consumer Direct for each of the last three years.

So, they completed a market study to review the following mobility aids: wheelchairs, scooters, stair lifts, bath aids, hoists, adjustable beds and specialist seating.

They found that a small minority of firms were engaging in unfiar sales practices, whether high pressure or misleading practices.  They  also identified that this type of experience was often under reported.

The Office of Fair Trading's report also identified other areas of concern including:

• Evidence that around half of consumers are not shopping around so could be paying too much for mobility aids. The Office of Fair Trading found there can be a wide disparity in the price of identical products, for example the price of one brand and model of scooter varied by £3,000. Around half of trader websites and advertising material that were checked did not quote any prices.
• The public sector's fragmented purchasing structure and some buying patterns can make it difficult to procure the best value wheelchairs.

Information about their findings can be found in the Office of Fair Trading press release here:
http://www.oft.gov.uk/news-and-updates/press/2011/105-11#.UTkVqFeuR8E

The Office of Fair Trading are continuing to review these issues.  But do you know how to identify market prices? 

If  you know exactly what it is that you require, then it is worth shopping around.  However, if you are sure what the issues are, but not necessarily the solution, then it is worth speaking to an Occupational Therapist or Physiotherapist to obtain further information.  This could avoid an expensive mistake.  It can also ensure that you have clear guidance as to what the options are for your equipment purchase - as well as a number of possible suppliers. 

What benefits / support is available?

Finding benefit information out can feel like a minefield - both for the individual with a disability and for a carer.  There is a lot of information out there - but knowing where to look can feel very complex and confusing.  This is a short introduction which aims to provide some information and signpost for further information or support.  

For overall information look up the GOV UK website:  www.gov.uk/browse/benefits  This provides current information - which is rapidly changing in today's world - so it is well worth while to revisit and review the information here periodically.
  
Failing this there is support available from the local Citizen's Advice Bureau www.citizensadvice.org.uk/.


Benefit enquiry line (they can talk you through the range of benefits available and tell you where and how to apply) Freephone: 0800 882 200 Textphone: 0800 243 355 Monday to Friday, 8am to 6pm


Carer's Allowance
Telephone: 0845 608 4321 Textphone: 0845 604 5312
Monday to Thursday 8:30am to 5pm Friday 8:30am to 4:30pm
  
The person you look after may be entitled to a range of benefits for things such as:
 
Disability living allowance: a tax free benefit paid at different rates depending on the disability - subject to assessment (This will change to a Personal Independence Payment - PIP for people aged 16 - 64 - from April 2013).

Attendance allowance: for those aged 65 plus, to help support personal care needs.  This has different rates within it, so if the circumstances change, it is worth reviewing this.
 
Pension Advice: For enquiries or to report a change in circumstances: Telephone: 08456 060 265 Textphone: 0800 731 7339 Monday to Friday, 8am to 6pm
 
Pension credits: additional money to "top up" pensions to a minimum amount - the Pension Advice Line above can advise on this.

Income support: for those on low / no income
 
Council Tax support:  A reduction in the council tax bill
 
Housing Benefit - help with paying rent or the interest element of your mortgage.
 
Winter Fuel Helpline: Telephone: 0845 915 1515 Textphone: 0845 601 5613
For those born before 5 July 1951
 
Disabled Facilities Grant  - money to pay for adaptations to your home - further information on this can be found in a separate blog post.
 
NHS Low Income Scheme.  This provides support with

• prescription costs
• dental costs
• eye care costs
• healthcare travel costs
• wigs and fabric supports

To apply for the low income scheme, see: https://apps.nhsbsa.nhs.uk/LISWebAppStaticData/begin.do or

Phone 0300 330 1348 for the dental services help line
Phone 0300 330 1343 for the Low Income Scheme help line
Phone 0300 330 1341 for queries about medical exemption certificates.
Phone 0300 330 1341 for queries about Prescription Prepayment Certificates.
Phone 0300 330 1349 for the prescription services help line
Phone 0300 330 1347 for queries about tax credit certificates
Phone 0845 610 1112 to order a paper copy of the HC12, HC11 or HC5 forms
For all other queries call 0300 330 1343

The Blue Badge Scheme - to enable the holder to park in designated places allowing easier access to community services, shops etc.  The blue badge scheme relates to mobility, and there is specific criteria which one needs to meet to qualify.  Information regarding this can be obtained from:https://www.gov.uk/apply-blue-badge

Disabled Person's Bus Pass - subsidised or free travel. This is administered by local councils.  Some councils also offer a taxi scheme.  It is definitely worth discussing with the council the options that they have available.  

Disabled Person's Rail Card - gives a third off tickets: www.disabledpersons-railcard.co.uk/
 
Motability Scheme - cars, scooters or powered wheelchairs: www.motability.co.uk/
 

Shopmobility Scheme - this is a scheme which lends manual wheelchairs, powered wheelchairs and powered scooters to members of the public who have limited mobility to shop and to visit leisure and commercial facilities within the town, city or shopping centre. It is open to anyone, young or old, whether with a temporary or permanent disability.  Further information can be sourced via: http://www.shopmobilityuk.org/ 

Twitter - Research Help!

Please help me research the use of twitter by health professionals and persons with a disability. I need your opinion: http://www.surveymonkey.com/s/TwitterCare

I would be hugely grateful for this help - especially if you are a person with a disability, a carer, health care assistant, nurse, physiotherapist - perhaps even an Occupational Therapist. Many thanks to the speech and language therapists - who are well represented . However, don't let that deter you from filling this in!

Many thanks for your help in advance!

Footwear For Swollen And Bandaged Feet

We all understand the importance of well fitting footwear - it is comfortable, reduces the risk of falls or trips and can help prevent foot ailments caused by rubbing / squashing feet into shoes that are too small. However - what are the options if your feet / legs require bandaging? It is really important to maintain good blood circulation and to avoid pressure from shoes which are poorly fitting. Equally important, is to wear socks or hosiery of sufficient width to maintain comfort.

So, if you have swollen feet, or enlarged feet through the use of bandaging, what are the options?

There are many companies out there whom provide footwear, socks and hosiery - this is not an exclusive list - but has been put together after being asked by several people for any ideas / guidance.

• Wide Fit Shoes stock womens sizes between 3-8 and mens sizes 6-14. They have shoes available from E to 8E for both men and women. Their website is: http://www.widefitshoes.co.uk

• Hotter shoes stock womens sizes between 3-9 and mens sizes 6-12. They unfortunately only have standard width for men - though do have ranges with long laces and touch fastening straps to support a more bespoke fit,and EEE for women. Their website is: http://www.hottershoes.com

• Padders Comfort Fit Shoes stock womens sizes between 3-8 and mens sizes 3-13. They have widths for men up to G+, and EEE for women. Their website is: http://www.padders.co.uk

• Cosyfeet Shoes and Sandles stock womens sizes between 4-9 and mens sizes 5-13. They have widths for men up to HH+, and EEEEE+ for women. Their website is: http://www.cosyfeet.com Cosyfeet also stock socks and hosiery within their 'extra roomy range'.

How to measure feet?

To measure your feet there are many guides - and each of the specialist companies have their own advice to be given. However, to give a baseline, it is worth measuring in advance of contacting the companies. Guidance as to how to achieve this includes: http://shoes.about.com/od/fitcomfort/ss/measurefeet_4.htm

Accessing Foot And Toenail Care

A podiatrist or chiropodist will be able to support with footcare / nail care. In most areas of the UK chiropody is available via the NHS - but it will depend on the severity of the condition. To obtain a referral to the NHS chiropodist you would require a referral from your GP, practice nurse or health visitor. If you would prefer to contact a chiropodist, ensure that they are qualified and a member of the Health and Care Professions Council (http://www.hcpc-uk.org) as well as one of the following:

• The Society of Chiropodists and Podiatrists. http://www.scpod.org
• The Institute of Chiropodists and Podiatrists, http://www.iocp.org.uk
• The British Chiropody and Podiatry Association, www.bcha-uk.org

Helpfully, both the Society of Chiropodists and Podiatrists and the Institute of Chiropodists and Podiatrists have a search facility on their website for members.

Disabled Facilities Grant - Is It For Me?

The Disabled Facilities Grant is a provision aimed to provide adaptation of a property, enabling a person with disability to manage more independently within their home. It may be based on the recommendation of an Occupational Therapist. Discretionary grants have been restricted, but at present there are mandatory elements to the grant which is available to support recommended works. The Disabled Facilities Grant is non means assessed for children, but there is a means assessment for adults. Further details regarding the Disabled Facilities Grant can be sourced via: https://www.gov.uk/disabled-facilities-grants/overview.

Who can apply for Disabled Facilities Grant?

Owner occupiers, landlords or private tenants can apply for assistance to carry out adaptations, providing there is a person with a disability living in the house and the works are considered to be necessary and appropriate to meet their needs.

What is the value of the Disabled Facilities Grant?

The amount of grant paid depends on the approved cost of the work and your financial circumstances if the applicant is no longer a child. The maximum Disabled Facilities Grant mandatory provision is £30,000 if you live in England and £36,000 if you live in Wales. If the applicant is a disabled child under the age of 19 then there is no means assessment.

Barrier To Independence

I recently visited a client who had asked for a review via a charity. She lived alone, had a long standing joint condition and restricted mobility. She presented with shortened gait pattern with a tendency to foot shuffle. Her right wrist was swollen and she had high levels of joint pain for which she was regularly taking strong pain killers and was also attending a pain clinic for support. She lived in a council owned property and had no rental arrears. The property had evidently been looked after.

In the past she had been provided with a powered bath lift by Social Services. This had become impossible for her to access without help - a fact established after a near miss fall and then an actual fall. She subsequently requested support to adapt the property and perceived a level access shower would be the solution. There was an over-bath shower but she was unable to abduct her hips and lift each foot proud of the bath side to enable transfer into the bath using a board or the bath lift.

Social Services reviewed the situation. It is unclear if the assessing visitor was an Occupational Therapist or Care Manager. They concluded that the bath lift was indeed less than satisfactory as she could not lift her legs independently and suggested a care package. This was declined by the client who retained the bath lift to enable support by her family when they visit. During the periods where she is not visited, the client understood the advice was to strip wash with a bowl of water to her feet, sitting on the toilet. This generated issues with her ability to lower a washing up bowl of water to the floor – and collect it again, as well as her ability to reach forward to the water.

So, what were the issues in this case?

Fundamentally the client did not feel able to access the bath, reported herself as not strip washing effectively and was afraid of falling forward trying to negotiate bowls of water. She had started to withdraw from social activities as she felt she may be ‘smelly’ or less than her personal standards of acceptable cleanliness. She was resistant to the idea of carers – although received income related benefits so would not have had to pay the full cost of this.

She had received a Section 47 assessment from Social Services. This relates to the National Health Service and Community Care Act 1990 and this, in essence, states that if it appears to the local authority that the person for whom they may provide or arrange the provision of community care services might need such services they are to assess the needs of that person. Here, she had been assessed as needing access to bathing which had a proposed solution of a carer to facilitate access.

The assessment had identified the most obvious and easiest way of managing the situation by care provision, but had not considered the provision of equipment or property adaptation to allow her to manage independently.

The client had hoped to receive an assessment for a shower adaptation. This would have been reviewed under the Housing Act within the Disabled Facilities Grant, the purpose of which is to modify an environment that is currently forming a barrier and therefore disabling the individual. The aim is to restore or enable independent living, privacy, confidence and dignity for individuals and their families. It is therefore an assessment which needs individualised evaluation. Unfortunately this lady appears not to have received an assessment from an Occupational Therapist who is qualified to review the needs, current risks, environmental options and fully appreciates the benefits of enabling independence.

Instead this client had received a care assessment identifying an assisted bath would be necessary, 3x a week with a carer visit for 45 mins on each call. The average cost of care per hour is £13.68 per hour. Assuming that the care agency would permit a 45 minute call and there was no travel cost charged, this client would have a weekly care time requirement of 2hrs and 15 mins, at a cost of £30.70. Over the first year this would have totalled £1600.56

To remove the bath, fit a level access shower and slip resistant floor and also renew the wash hand basin and WC would have cost approximately £4500.00

Assuming this was completed by a Disabled Facilities Grant, this would have a grant condition period of 5 years, so the cost of the adaptation per year is £900. This is considerably less than the yearly care cost. The care would equal the cost of the adaption in 2.8 years.

This client did not want to receive care support, feeling that this was inconvenient and invasive. She was independently minded and keen to remain self-sufficient. Fortunately for this client, she made contact with a charity that sourced an independent Occupational Therapist to review the situation and an application for a Disabled Facilities Grant was made. So, for this lady, the barrier is being addressed.

The question is, was this an unusual case? Are other clients also receiving care they do not want in place of an adaption to facilitate their independence?

Radar Disabled Toilet Key

I have been asked several times this week about the 'special key which allows access to WC's' - so I thought I would share the answer!

The special key is commonly known as a Radar key. It enables access to nine thousand toilets - these are in all sorts of venues - shopping centres, department stores, transport links such as bus and train stations and a variety of eateries such as pubs and cafe's.

The key is available via: http://www.radar-shop.org.uk or via 020 7566 0122. The key has a current (Dec 2012) price of £2.25 with £1.75 postage and packing.

To help locate the WC's when out and about they also offer an i-phone app from the App Store. This has a current cost of £4.99. Alternatively they offer a National Key Scheme guide which lists the locations of all the accessible toilets. The current price for this is £8.50.

Accessible Toilets

Changing Places Consortium are continuing to campaign for an increase in accessible toilets - and have now achieved 434!

The Changing Places WC is designed to enable children / adults to be able to access a WC / changing area with up to two carers enabling more people to 'make a day of it' - after all - who doesn't need a loo stop?!

The Changing Places toilets differ to standard disabled WC's with a variety of additional features. They are designed to have enough space to permit up to two carers to accompany as required. There are screens or curtains to permit some privacy, and there is equipment provided as standard including a height adjustable adult-sized changing bench and hoist.

You can check out where the nearest Changing Places is for the next trip planned by checking out: http://www.changing-places.org/Findatoilet/Locationmap/tabid/70/Default.aspx

Wheelchair Accessible Sink

A wheelchair accessible sink with a ledge to enable the client to have forearm support to steady themselves when moving forward to reach tap
.

Level Access Shower

A level access shower with thermostatic shower and a body drier. In this environment the ambulant client who could not support towels became independent.