Katie’s Success Story – Parklands
Katie, a 38-year old lady with profound multiple learning disabilities and complex needs – including cerebral palsy, moved to Parklands, a residential learning disability service in Newport, Wales from her family home, five years ago.
Parklands supports up to five individuals with profound multiple learning disabilities, including cerebral palsy and additional complex needs including epilepsy, physical disabilities, visual and hearing impairment and sensory loss. The team focus on ensuring the individuals they support can take part in activities and experiences that are meaningful and fulfilling; have opportunities to enjoy greater choice and control over their lives and can participate fully in community life.
In addition to PMLD, Katie has cerebral palsy, is physically disabled and is Peg-fed. Prior to moving to Parklands, Katie’s family looked after her at home and have always been very hands-on with her care and support, however, as Katie reached her early thirties, they wanted her to be able to enjoy greater independence and have the opportunity to enjoy more freedom and be her own person.
They realised that she needed a specialist environment that had the skills, training and knowledge to support her with her health issues and other complex needs and who could also support her to take part in activities that were stimulating and enhance her well-being.
Her family were initially anxious about Katie making the move to live more independently but after seeing how well she settled in at Parklands and how much her quality of life improved, their minds were soon put at ease.
At Parklands, the long standing and friendly team led by Service Manager Liam Lewis, take a person-centred approach and are proficient in a range of specialist communication skills such as the TEACCH programme and PECs, as well as Positive Behaviour Management approaches. They are also proficient in non-verbal communication.
Although Katie is non-verbal, she has lots of verbal responses and facial expressions which the support team have learnt to read. Service Manager, Liam said, “Katie communicates through body language and facial expressions. As a team we know her really well and can tell exactly how she is feeling.”
“When Katie is happy, she will have a huge smile and will vocalise in a calmer tone and vocalise sounds like ‘hiya’ and will laugh and giggle. She is also more relaxed and has less muscle tension so those feelings are evident from her whole demeanour. When Katie is unhappy the sound is more like a high pitch vocal and you can see she is distressed. The vocal sounds are also linked to her muscle tone and she will become very tense, push her feet in to her foot plates and flay her arms.”
“These observations guide us in our support, our interactions with Katie and in our understanding of the activities she enjoys as well as those that she doesn’t.”
As well as paying close attention to Katie’s body language and physical responses, the team also use a range of strategies to research, plan and help her get the best from what each activity has to offer.
Liam explains, “People with PMLD often have difficulty understanding what is going to happen next, so it can be helpful to provide cues to different activities. They may also process information slowly and need time to take in what is happening. Cues and time for responses are two important strategies that help us determine if she is enjoying an activity. Even aspects such as volume of the music or water temperature.”
“With some activities we will introduce all the elements to her before starting the activity to gauge her reaction and ensure she is comfortable with all aspects. If she isn’t comfortable, she will let you know, so cues and time for responses are vital to ensure she fully engages in the activity.”
“Using this approach we have been able to flex and adapt her Person Centred Plan (PCP), incorporating activities and experiences that she enjoys and derives a benefit from while avoiding any negative experiences.”
The support team incorporate multi-sensory therapies into all aspects of activities and this is closely linked with intensive interaction. The team use Intensive Interaction Speech Therapy (IIST) which involves using the sounds of different materials such as water, wet flannels and wind to match sounds within a sensory session. TAC PAC, a form of communication through touch and music is another therapy the team use which has achieved some fantastic responses from Katie.
“It can be as simple as matching breathing rhythm. With Katie the team have found that repeating her vocal sounds while making eye contact is a good way to communicate with her. When doing this she smiles and all the happy sounds she makes are far more repetitive. The team also use touch alongside this, including gentle strokes down her arms.”
Katie also really enjoys music therapy. “We use a disco ball with music and support Katie with passive movement. She really likes it when we put on the can-can music and move her arms and legs. She also enjoys having a pamper session where the focus is on touch and smell. We will give her a hand massage, paint her nails and use aromatherapy oils to stimulate her senses,” adds Liam.
Hand over hand is another approach the team use which involves the support team doing an activity with Katie’s hand over theirs. The team use this during various activities such as water and bubble therapy, cooking, planting pots, arts and crafts and any other tactile activities. Finger painting is also a good example of this as it includes lots of other sensory aspects such as touch and smell which Katie really enjoys.
Reflecting on the positive outcomes that Katie has achieved since moving to Parklands, Liam said, “Katie has really blossomed since being at Parklands. Having the team on hand 24 hours a day means she not only has the support she needs to manage her health and complex needs but also the support available to enjoy greater freedom and community interaction.”
“Katie’s parents are delighted with how well she is doing. Mum knows that she can trust the team to support Katie which has enabled her to have the peace of mind to step back and let Katie live an independent life.”