Management of the Physical Condition in People with Chronic and Severe Neurological Disabilities Living in the Community

When Staff Training isn't Enough: An Evaluation of a Collaborative Approach

“…A checklist was compiled which reflected both the content and learning outcomes of the workshop and essentials for good practice (Burge 1994, Rogers et al 1994, Pope 1997. It consisted of seven main sections (sensory impairment, positioning, equipment, food, eating process, communication and environment) each with a number of subheadings.…”

Physiotherapy research international

“…That does not mean the patient is abandoned if further ‘treatment’ is not justified. The overall physical condition has to be ‘managed’ in the long term (Pope, 1997, 2007) in order that the level of ability achieved is maintained and the otherwise inevitable secondary complications, consequent upon residual neural deficit and compensatory strategies, are minimized.…”

“…Fundamentally, it meant appreciating and accepting that the impaired neurological system will function differently, not abnormally , from that of the undamaged system. It also meant appreciating that a system functioning differently may also lead to unwanted consequences such as contractures/deformity, pressure ulcers etc., which had to be minimized, leading to ongoing ‘management’ as opposed to ‘treatment’ (Pope, 1997).…”

“…This change does not occur suddenly; it is a slow process with the gradual recruitment of like‐minded people. This opinion is not based exclusively on my own work experience (Pope, 1985, 1992, 1997, 2007); medical history is full of examples where change of thinking and practice took many years.…”

“…This is not to deny the importance of treatment undertaken to reduce impairment when and where justified. It must be kept in mind that it is possible to have management without treatment but not treatment without management (Pope, 1997).…”