Hospice Without Walls

Published by the Calouste Gulbenkian Foundation, London. Available from Turnaround Publishing Services Ltd, Unit 3, Olympia Trading Estate, Coburg Road, London N22 6TZ 1999 (ISBN 090 3319 861) 96 Daaes

by Andrew Bibby f5.99 plus f2 postage This concise and factual l,ook tells the story of the m'est (:iimbrian Home Hospice from its beginnings in 1987 to the present day and contains a foreword by H R H The Prince of Wales and also a brief outline of the hospice movement.

It tells of the first public meeting in 1987 ~ v h e n a pthei-irig of many local organisations and churches and GI's in the area was held at Whitehaven and from this the enthusiasm and will to have a hospice evolved. Because of the large area covered by tlic West Cumbrian Health Authority encompassing small towns, hut also Far-flung villages and isolated houses, it was decided that no centre could cover the whole area. A Home Hospice was the plan of choice.

During the first l'ew months the hospice's application for registration as a charity was gi-anted arid the pi-ohleriis of funding were explored. Many hurdles u'ere encountered regarding the setting up of the service, but with skilled advice tlie problems of

Video Review: Physiotherapy Ma nag er Acute Surgical Patient

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Presented by Alice Jones, Assistant Professor, Department of Rehabilitation Sciences, Hong Kong Polytechnic University. Filmed at United Christian Hospital, Hong Kong, 1996. Available from Mrs Milly Mok, Office of Media Resources and Services, The Hong Kong Polytechnic Universitv, Huns Hom, Kowloon, Honq Kons Runnina time 15 minutes

f13 includina Dostaae

This short pi-cscntation of the early physiotherapy inanage- merit of patients who have undergone surgery is directed at pre- clinical students and would serve ucll to stipplemerit the theory taiight in this area.

An appropriate well structiired commentary is initially siippleirientetl by on-screen text, which summarises the niairi points being made and also gives indication of normal blood biochemistry values.

The dernoristration hegiiis a s the physiotherapist arrivrs on tlic ward on the first post-operative day. M'liilt. the vicxvcr- watches the examination and asscssinent of the patient, the benefits of'

reading about thc surgical procedure i n the case notes, liaising

nursing personnel and an office in which to base the organisation were overcome. By the end of two years, 56 patients were being cared for by a bank of nurses and the first day centre had been formed, to be followed by several others to satisfy a local need in the larger towns.

The medical service remains under the care of the patient's GP hut with a palliative care consultant available to visit patients and advise.

The book goes on to give more details of services run in conjunction with tlie hospice, including a lymphoedema service, drop-in sessions and equipment supply and a great m a y volunteers who help, particularly with the day centres. Thr funding and the management seem to run very similarly to a conventional hospice but with the slight differences cncountered because there is no central building to focus upon. At the present time the niimber of patients has risen to approximately 140 a year and about 70 nurses are on the bank caring for them.

This book made interesting reading and would be risefill for anyone wishing to set up a similar service. It worild have been good to know a little more about the input from other professions such as physiotherapists, occupational therapists and social workers to name a few, but overall it gdve a clear picture of this successf~il Home Hospice Service.

Jackie Gauntlett BSc MCSP

with nursing staff, examining the wound and assessing pain control are described. Strangely though, the importance of noting past medical and social history is not mentioned.

Although not filmed in this country, there appear to be no more variations in practice than between centres in tlie UK. Some clinicians might, however, question the advice given on 1i;indling arid moving a surgical patient, in which the therapist is advised to 'take most of the weight'.

The presentation contiiicics with an explanation arid demonstration of the treatment methods which might be employed. These include the active cycle of breathing techniques, limb exercises, circulation exercises and mobilisation of the patient.

I feel that the video's strength lies in the usc of an actual ward patient, giving viewers insight into an appropriate pace arid re, 1 ' . istic . aims of treatment, and also the aiiiount of'

encouragement and reinforcemerit which might be needed. The running time of this video is very short and at 15 minutes

i t aims t o provide no more tlian an overview of the management rather than be a substitute for- other teaching methods. Alicc. Jones presents an holistic and thorough treiitiiieiit of a general sui.gery patient which might be iisefiilly used in educational establishments to summarise the management of a surgical patient.

I would also recommend this video for- medical and nursing students where a brief overview of physiotherapy for surgical patients is required.

Alison Gilbert MSc MCSP

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