A social approach to lower limb care at Weymouth Leg Club

Hi, I'm Demelza. I set up the five leg clubs in Weymouth and I'm the lead nurse. We are absolutely delighted that we are part of the Venus Awareness Week. You know, there's such a high prevalence in venous disease in the world and it's really important that, you know, that everyone is educated about it, you know, how to recognise it and treat it and what can be done. You know, lots of people will get venous ulcers. First of all, they'll knock their leg or something and, you know, they'll manage it at home. Then, you know, they might, they'll get worse basically and they don't wanna go to the surgery. Whether they feel intimidated, they're embarrassed, you know, I don't know. But then trying to manage it at home, it gets worse, it leaks, there's an odor, then they're embarrassed to go out, they get isolated and, you know, it's a downhill spiral and it can have terrible consequences. The leg club, it's great for this, it's welcoming, it's social, it's not clinically threatening. Everyone's welcome. They come in, we treat their lower limb care, and when we heal the wound, and we then do what we call well-maintenance care, we prevent reoccurrence, which is really important and a key part of the leg club. And we follow the psychosocial model, Also, it's not just treating the lower limb, it's the whole person, it's holistic care. People, they get reintegrated back into society, into their communities, they make friends, they form bonds, they empathize with each other. And it's a really important part. They have a cup of tea, a bit of cake, play games, we have exercise classes, dietitians, plastic load consultant, nurse, lots of things come and help. like a real community, a real big family and I believe it's these little things, you know, really little gestures that we do that can make an overwhelming and big difference to people's health and well-being and that's why, you know, it's really, you know, important that during this pandemic when, you know, lots and lots, you know, thousands of people are becoming isolated that we had to rethink how to keep the leg club going and, you know, we have, you know, managed this even though, you know, operates different on the appointment system but we have managed to keep that social interaction going. So you know these things are essential and then that way we can keep you know treating everyone you know for lower limb disease and like I say education which is just a key factor because you know it's that prevention of reoccurrence and to maintain healthy legs in the long run and like I say that's why it's so essential we let the public know and they're well informed about venous disease but um yeah so that's the way we play club and and like I say you know it's a great success everybody loves coming you know lots of people who you know they were quite reluctant to come at first and they come and you know that's the highlight of their week you know it's you know it's really heartwarming when you see it and like I say it's these little gestures that you know can make a great big difference to someone's life and it's really important that we carry on. I seem to be able to do more. With these being a spoken word subject, I'm going to be able to innovate a lot more. Well, I'd say they're doing a marvellous job, you know, I mean, this has helped a lot of people, you know, I mean, I've been to Canary Islands, I've been to a lot of big I've been coming to the lectern, it's been seven months, and since I've been there, everything's changed. I mean, my family can't see, but these people, what's making these is marvellous, and these people are marvellous. And of course, what I like about the lectern is you can have a laugh and a joke, you can talk to people, I make the oats, I mean, my mum does, but it's great, otherwise if I didn't have that, I'd be stuck in the ocean until the Covid's gone, but now they are for people. We're talking about new products that are coming out, and there's always new products, even though we've not seen you that long ago, there'll be something else that's come out. And it does make people more independent at home, and they don't like the bandages, because it makes people often feel that they're being singled out as ill and in a bandage, Whereas if you're in a medical support, it's more supportive, it's easier to accept, and you can manage it at home, particularly once your wounds are healed, you can take them off, have a shower and put them back on again. I've never been out, so it's like Tuesday and Friday when we come to the leg club. That's the only time I'll be getting out. But, yeah, it's been alright. As I say, it's given me a chance to rest my leg up, while this virus is about. For the last few weeks, I've been working. For the last year and a bit, I've not been out at all, really, apart from coming to the counties, they've come, yeah. It's harder on the phone, isn't it? I haven't seen my parents for quite a while, so they've got a lot of work, but, yeah, it's by phone, really. It's harder on the phone than that. I haven't seen my parents for quite a while, but it's by phone really. Yeah, so it's nice, it makes a change coming out a couple of days a week. Watch a lot of TV, and that is not much else, not much else I would do really. aren't we? So for neck, necks, all of that. It's been said. You can find it. Well, I mean, I used to go to my doctor's where they can't, sometimes come in, come in two days a week. I need to get on top of it because I must say, I've never come to think that I've been, maybe a chance, I've lost my neck. It was so bad. I wouldn't have got to know if I'd been happy or not. I haven't been in and out of it in six months, so I'm hoping to be fine. I hope that doesn't happen too soon, that's a relief. Hello to Miles and Sarah, thank you very much for participating in this Fade & Weak project in coordination with the Rivin Foundation. I would like to ask you both really just a brief overview of your thoughts on the latest compression therapy, the new generation technology on wraps, toe caps and bandages. My second question is the importance of disseminating shared care journal with your leg club members. Do you see that as the future of how we're going to be going with care or do you see it as complementing the leg club in this day and age of social distancing and pandemics? Regarding leg ulcer compression garments you know there's lots and lots of things on the market there's the obviously compression bandaging, we have short stretch, we have long stretch, we have leg ulcer hosiery, you know, toeless open toe, they have zips, you know, all sorts of things that make it simpler. There's wraps and lots and lots of things that we can do and there's obviously foot pieces and toe caps and there's lots on the market. How I tend to choose what I use, it's very member orientated really. Everybody's individual and what suits one doesn't suit another. Some people get on with the wraps they're brilliant they manage them at home it's part of shared care and they do a wonderful job other people they they don't get on with it they don't feel confident and they don't apply them properly and obviously you know the venous leg ulcers they don't heal and this group they prefer you know perhaps having the short stretch or the long stretch bandaging in place where they feel confident you know that it's it's working rather than they don't come to leg clubs and you know that it's healing well and that we take maybe a key role in their care and obviously between the bandages we we choose you know the short stretch may suit somebody who's more active perhaps others perhaps they're not so mobile you know the long stretch may be a better option and obviously lots of other things to consider as well in that decision when with the compression garments some people like the simple hosiery the stockings others find these struggle to get on. Some people like zips, other people worry they might catch the skin in a zip. Toe-less option is very good, especially for people who have diabetes perhaps, because if they have neuropathy and they can't feel their toes, then perhaps they wouldn't be aware if there was any rubbing or pressure on their toes, so that could be a better option there. Obviously, toe pieces and, sorry, foot pieces and toe caps are very good as well, because obviously managing the lymphedema and with the lymphatic drainage we want to make sure you know it's not just push down we don't have edema in the feet and the toes so it's good to have the whole everything covered and like I say there's some brilliant there's some brilliant brilliant options out there now and lots of different options there's devices to help members get them on and there's you know some brilliant things out there but again how I specifically I think they've all got a place, they're all good, but it's very much down to the individual which one suits what person really. In relation to the shared care booklets, I would envisage and I would hope that they would complement the leg clubs really in the future, however I do feel with how things are with the pandemic that perhaps they will be the future of care. I think if they were the future, I think it would be a bit of a shame because I think The shared care, you know, it's not for everybody. Some members, you know, they prefer for us to take control of their care. Obviously, they're still involved in decision-making, but they prefer us to do the larger proportion of their care and to manage their wounds for them and their lower limb care when they come to the leg clubs. Whereas other people obviously, you know, feel comfortable in taking some responsibility for their lower limb care and getting involved and managing it themselves and as a joint process. But like I say, I would hope, personally, I would hope that it would complement the leg club, because as I say, it's not for everybody and everybody's individual. But like I say, I do, you know, I'm not worried, but I do think perhaps it will be the future with how things are. But like I say, this would be a shame. And I do hope that it has a complementary part of the way with leg club. Hello, I'm Ellie and I'm delighted that you've very kindly agreed to take a question from me today. I really would like to know about your role as a volunteer because the backbone of the psychosocial necklace model for lower limb care is absolutely reliant on the role of volunteers. From day one when the model started in 1995, the whole ethos of the model is around the volunteer. So in this day and age of lockdown and social isolation, could you just tell me what you gain as a volunteer from coming along to support the nurses, most importantly the members who attend every week and the roles you undertake as stroke secretary, input of data and general running of the leg club. So I really welcome your open comments on this. I took early retirement which I thought was a good idea but no. I found I lost my reason for existence and did not do, doing nothing with my life very well. I realised I needed a reason to get out of bed in the morning. I needed to rechannel my life. I had a friend who managed a care home and she asked if I would work for them as a maintenance man. This I did and soon found maintenance men did far more than fix things but were also major socialisers and I did this for a little over ten years. Then two years ago I lost my wife for 50 years and wither went once again my reason for existence. I knew I had to rechannel my life once again. I eventually heard that the local leg club needed support in the form of volunteers so I joined them. It turned out this was a great choice. My socialising experience in the care homes fitted well. At any one session, two or three volunteers attended. They welcomed members, booked them in, sat them down, offered tea, coffee, cakes, biscuits and socialised with them, chatted with them. We had the wonderful nurses doing their magic and the volunteers doing theirs but not separately we operated as a real and successful team and funnily enough our members embraced the situation and together we moved forward. I started off attending one session it then went to two and eventually to three morning sessions. I must admit it is wonderful to be once again the member of a very worthwhile team. Hi, my name's Val Latham. I'm a practice nurse from the Bridges Surgery, which is one of the local surgeries here. As I'm part of the team, I come in regularly on a Tuesday to help with the sessions. The reason we come from general practice is, obviously it's a very small team here, but without the leg club, we would not be able to survive in general practice because as I'm sure you're aware, it takes a long time to do a full leg dressing or an assessment or both together. So if you're taking sort of 40, 60 minutes out of a day in general practice, that's five, six patients that could have been seen. So we are so grateful for the Leg Club and we support it by practice nurses coming from all the other surgeries. I think there's five surgeries that actually send nurses in. We're all trained to do leg ulcer dressings and compression dressings, but we're always learning. There's always new things coming out, which we're very grateful for, and then we can take it back to the practice. It's been a lifesaver. The one thing that has been a lifesaver is the Doppler. In general practice, that would normally take up to an hour because patients would come in, lay down for 20 minutes, half an hour. we'd have to find veins, we'd have to do the full process, which is quite correct, which we still do in general practice, but our new Whizzy machine here, you know, they're in and out and done in 15 minutes and it's absolutely brilliant, so we're very grateful for that. Because more and more patients are needing Dopplers and obviously every patient before compression needs Dopplers, so. But the team here is wonderful, it's a great team to work for, the patients really appreciate it I'm not just blowing our own horn here but it's great and we work in different parts of Weymouth so the access for patients is better as well. Yes I think that's about all I've got to say. I could get on my soapbox and talk for hours about a leg club but yes but thank you for starting it, very much appreciate it, keep supporting us and yeah ta-da! you