Breathing Space with Tanio

Overview of the Initiative

Awen Cultural Trust continues to work in partnership with Tanio (https://taniocymru.com/breathing-space/) to offer weekly creative arts groups to anyone who is struggling with loneliness or isolation, living with poor mental or physical health, or would benefit from seeing a friendly, welcoming face or meeting new people. Participants can try art, music, movement and creative writing in a friendly support environment, at a number of Awen’s venues in Bridgend County Borough. Participants don’t need any experience to take part, all the materials and equipment are provided and all the groups are free of charge.

Key Benefits/Outcomes

• Reduced need for medication
• Building support networks
• Improved feeling of wellness
• More social connections
• Making new friendships
• Understanding and managing emotions
• Developing communication skills and empathy
• Improved self-esteem

The Challenge that We are Trying to Overcome

• Loneliness and social isolation
• Poor mental or physical health

Results and benefits

“Because it’s something to be part of, it gets me out of the house and helps me deal with isolation. I have come every week since I started and find the group really supportive and I have made new friends.” – Participant

“It’s informative, I try different things I wouldn’t have chance to do otherwise.  It’s very friendly and enjoyable. The space is nice and staff are really supportive – I always feel like I can ask if I need help with anything. It’s very creative, I like making all the different things and the getting new skills.” – Participant

“I find it very relaxing and my mood always lifts. Like today I hadn’t been out the house this week until I came along and it made me feel much better.  Creating the art has a very relaxing effect on me – it helps my brain slow down which I need sometimes.” – Participant

“This group has really help pull me through after a very difficult personal situations at the beginning of last year – I don’t know what I would have done without it.” – Participant

Takeaway Tips

• Environment has an impact, a nice open and well lit space helps set the relaxing tone.
• All projects take time to build, some may come regularly others less so but being welcome and remembering people each time helps to build a sense of community.
• Freedom in creating is an important part of the process, being on hand to guide when needed.

Meno Active: Empowering Women through Exercise, Nutrition, and Well-being during Menopause

• Strength training helps build physical strength and resilience, which can have a positive impact on self-confidence and self-esteem. As women navigate the changes and challenges of menopause, feeling physically strong and capable can boost their confidence, promote a positive body image, and enhance their overall sense of self.

Meno Yoga

Sessions are tailored to help with reducing the emotional symptoms of menopause and relax the body.

• Menopause can be accompanied by increased stress levels due to hormonal changes and various life adjustments. Yoga incorporates deep breathing techniques, meditation, and mindfulness practices that help activate the body’s relaxation response. This can reduce stress levels, promote a sense of calmness, and provide tools to manage stress more effectively.

• Hormonal fluctuations during menopause can contribute to mood swings, irritability, and feelings of anxiety or depression. The physical movements, breathwork, and mindfulness cultivated in yoga can help regulate emotions and enhance mood. Yoga encourages the release of endorphins, the body’s natural mood-elevating chemicals, leading to an overall sense of well-being and improved emotional balance.

• Insomnia and sleep disturbances are common during menopause, which can further impact mood and overall well-being. Meno-Yoga promotes relaxation and stress reduction, preparing the body and mind for restful sleep. Specific yoga poses and sequences can help relieve tension, relax the nervous system, and establish healthy sleep patterns, leading to improved sleep quality.

Meno Pilates

• Menopause can sometimes lead to changes in posture, such as rounded shoulders or an increased curvature of the spine. Pilates exercises target core strength and promote proper alignment, helping individuals improve their posture and body awareness. Enhanced posture can positively impact self-confidence and contribute to a more positive body image.

• Pilates emphasises the mind-body connection, focusing on controlled and precise movements that require concentration and body awareness. This mindful approach can help individuals in menopause develop a greater sense of self-awareness and mindfulness, allowing them to better manage and regulate their emotions.

• Participating in group Pilates classes can offer social interaction and support from classmates and instructors. Pilates studios often foster a welcoming and supportive environment, allowing individuals to connect with like-minded individuals and build relationships. This sense of community and camaraderie can provide emotional support and a sense of belonging during the menopause transition.

Meno-Workshops

Meno Workshops

The Meno Workshop was a 6 week programme designed for pre and post menopausal women to gather, connect, and share experiences related to the menopause journey. This welcoming and supportive environment brings women together to openly discuss their symptoms, exchange tips, ideas, and provide mutual support while enjoying a cup of coffee or tea.

During each Meno Workshop session, a variety of topics relevant to menopause was explored such as:-

1. Maintaining Bone Health and Strength: Learn about the importance of bone health during and after menopause, and explore exercises, dietary recommendations, and lifestyle modifications to promote strong bones and prevent osteoporosis.
2. Sleep Solutions for Menopause: Discuss common sleep disturbances experienced during menopause and share sleep hygiene practices, relaxation methods, and natural remedies to improve sleep quality and combat insomnia.
3. Hormonal Changes and Hormone Replacement Therapy: Gain insights into the hormonal changes occurring during menopause and explore the pros and cons of hormone replacement therapy, including alternative options and lifestyle adjustments.

Collaboration with Public Health Wales and the Department of Work and Pensions:-

Since the launch of Meno-Active it lead to Newport Live  successfully collaborating with Public Health Wales and the Department of Work and Pensions (DWP) to research the impact of menopause on women’s employment prospects. Newport Live attended a 50+ (age) employment outreach event to understand the challenges women face during the menopausal transition to help research strategies to support their employment and wellbeing. The report provided qualitiative insights into the difficulties women encounter due to menopause-related symptoms, such as reduced confidence and cognitive difficulties, which can affect job prospects.  The evidence generated from the report and its findings is the first of its kind in this research field. It emphasises the need for awareness, accommodations, and support in the workplace to empower menopausal women and enhance their overall well-being during this significant life stage. 

Key Benefits/Outcomes:

The Meno Active program has yielded significant results since its launch in November 2022. Here are some key benefits, outcomes, and data from the program:

1. Total Engagement: Over the past 8 months, a total of 103 individual women have actively participated in the Meno Active program. This demonstrates the program’s reach and effectiveness in engaging women who are seeking support and resources during the menopause transition.
2. Pilates Attendance: The Pilates sessions within the Meno Active program have been well-received, with a total attendance of 248 spaces filled. This high attendance indicates the popularity and effectiveness of Pilates in addressing the physical and mental well-being of menopausal women. Pilates exercises are known for improving core strength, posture, flexibility, and overall body conditioning.
3. Meno Strength Attendance: Meno Strength sessions have also seen significant participation, with a total attendance of 259. Strength training exercises are crucial during menopause to maintain muscle mass, promote bone health, increase metabolism, and enhance overall strength and vitality.

These attendance figures demonstrate the positive response and engagement from women who have enrolled in the Meno Active program. The program’s focus on various exercise modalities, including Pilates, strength training, and yoga, allows women to choose sessions that best suit their preferences and needs.

The Meno Active program’s success lies in its ability to provide a comprehensive approach to menopause management, addressing physical fitness, emotional well-being, and overall quality of life. By offering a range of sessions tailored to the specific needs of menopausal women, the program empowers participants to take control of their health and experience the numerous benefits associated with regular exercise during this life stage.

• Meno Active supports women in regaining a sense of control, confidence, and well-being during menopause.
• Targeted classes: The program offers a range of exercise classes tailored to address the specific needs and challenges of menopausal women.
• Comprehensive approach: Meno Active encompasses exercise, nutrition, and well-being advice, providing a holistic solution for menopausal women.
• Supportive group environment: Women can connect with others experiencing similar challenges, fostering a sense of community and support.
• Increased knowledge: Participants gain a better understanding of the physical changes that occur during menopause and are equipped with practical solutions.
• Improved physical health: Meno Active helps combat decreased bone mass, insulin resistance, weight gain, and loss of strength.
• Enhanced mental well-being: By addressing brain fog, energy levels, and temperature fluctuations, Meno Active supports women in achieving greater mental clarity and stability.

The Challenge: 

The initiative was developed to address the numerous challenges faced by women during menopause, such as physical changes, decreased confidence, and a lack of support and understanding.

What They Did: 

Newport Live Leisure Trust established Meno Active as a comprehensive program that combines exercise, nutrition, and well-being advice. The initiative was designed to offer a supportive group environment where women could connect with others and receive guidance from knowledgeable instructors.

Results and Benefits:

• Positive feedback from members: Numerous women have expressed that Meno Active has significantly improved their lives and well-being.
• Increased collaboration: Meno Active gained interest from Public Health Wales, leading to a collaboration that aims to empower more women to prioritise their health.
• Testimonials from participants: “Meno Active has provided me with a supportive community where I feel understood and empowered. I have regained my confidence and physical strength.” – Claire, Meno Active participant.

Overcoming Obstacles: 

Throughout the implementation of Meno Active, the initiative faced challenges such as addressing misconceptions surrounding menopause, creating a safe and inclusive environment, and ensuring the program’s accessibility to all women. However, by providing accurate information, fostering a supportive atmosphere, and adapting the program as needed, these obstacles were successfully overcome.

We recognise the importance of inclusivity and the need to overcome obstacles in engaging men. While men do not experience menopause directly, they can play a significant role in supporting their partners, friends, or family members who are going through this transition. By increasing awareness and encouraging men to become engaged in the program, we can foster a more inclusive and supportive environment for everyone involved. This will be part of the implementation strategy in phase two for us to overcome.

Takeaway Tips:

1. Provide women with accurate information about menopause, helping them understand the changes their bodies are experiencing.
2. Foster a sense of community and understanding by bringing women together in a group setting where they can share their experiences and support one another.
3. Offer a comprehensive program that addresses exercise, and well-being, acknowledging that menopause affects various aspects of women’s lives.

By implementing Meno Active, Newport Live Leisure Trust has successfully supported menopausal women in regaining control, boosting confidence, and improving overall well-being. The program’s comprehensive approach and supportive environment have led to positive outcomes, inspiring collaboration with Public Health Wales and empowering more women to prioritize their health during the menopausal transition.

Testimonials

“Just wanted to say that since I joined everyone I have met has been so lovely and helpful – it has really enabled me to get into positive habits and attend. 

The instructors are lovely, giving me my meno strength induction week 1. I loved working with Bryony and have attended a few velo classes and had a health check with Giovanna too.  I would be grateful if you could pass on my positive experience and thanks” Claire Hill (Newport Live Member).

“I’ve been a gym member at Newport since September 2022. I have enjoyed using the facilities at all venues and attending taught classes, including yoga, pilates, and body sculpt. I recently discovered the Meno-Active classes on the app and have attended Meno-strength. This class has given me the confidence to use a wider range of gym equipment  which I used to be reluctant to use. It has also been informative regarding my bodies needs and changes during menopause and how important it is to increase muscle strength and bone density during this time in my life. I look forward to continuing to participate in these classes, and I am open to new menopause fitness plans as Meno-Active evolves and the new sports centre is built in Newport City Centre.” Julie Jones (Newport Live Member).

“As a fitness instructor for the Meno Active strength training class, I am thrilled to witness the incredible sense of team spirit, comradery, and support that our participants bring to each session. It is truly inspiring to see women coming together, sharing their experiences, and forming strong bonds as they navigate the challenges of menopause. Strength training helps women maintain muscle mass, increase bone density, and improve overall strength and balance. These physical benefits are crucial during this stage of life when hormonal changes can impact our bodies.” Kayleigh Greening – Newport Live Group Exercise and National Exercise Referral Instructor (ABHB).

“Within my specialist NHS Menopause clinic, Newport Live Meno Active has been specifically mentioned by two patients who described the programme as ‘lifesaving’. They both highlighted that the programme allowed them to regain their sanity and the peer support they received was invaluable. This programme beautifully demonstrates collaborative working and holistic care.”  

Dr Michelle Olver, Consultant in Sexual + Reproductive Health and Menopause Lead, Dept of Sexual and Reproductive Health, St Cadocs Hospital, Aneurin Bevan University Health Board.

ends

Using the arts to support positive change and transitions for adults accessing Cwm Taf Morgannwg University Health Board services.

The M Word began when Carolyn Jones, one of Freedom Leisure’s fitness instructors in Penyrheol, found herself struggling with menopause and the symptoms it comes along with. She knew other women were also finding menopause a challenge so she decided, alongside the Penyrheol management team, to do something to address it. 

Some women sail through menopause; some women have minor issues; many women find it physically and psychologically distressing and troublesome, and for a minority of women — but even one is too many — they harm themselves or kill themselves while going through the change of life. Perimenopause, which can start as early as your 30s or early 40s, can also be difficult. At this time in a woman’s life, it can feel as if you’re losing your ability to enjoy your life, and you can feel as if you’re losing your mind. There can also be a sudden drop-off in energy, as well as many other debilitating symptoms.

After some discussion the team came up with the concept of the ‘M Word’ – yoga for menopause. 

The M Word is held once a month. The class is made up of circle discussion where women in the class share their thoughts and experience and exercises to help combat symptoms. 

The team in Penyrheol have tackle the stigma of menopause head on and are empowering women to do the same. 

When we asked Carolyn about The M Word, her response was brilliant: 

I should emphasise that my line manager, the centre manager (Emma Evans), the whole team at Penyrheol, and the area manager, have all been hugely supportive. My friend Diane, who acts as the ‘meeter and greeter’ in my classes, as well as my husband, have also been very supportive and helpful. And the customers have been absolutely lovely, appreciative and helpful to each other. This isn’t ‘my’ project — it belongs to all of us and would not be a success without teamwork and mutual support.

A true representation of how Freedom Leisure Active Communities is part of everyone’s job.

Testimonials

“What shocked me about THE CHANGE was the sheer violence of it. The harmony I work hard to keep between my body and mind had suddenly gone. The good news is that over time I made an accommodation of this new me.”

Jane Johnson, former nurse and participant

“I am telling all my friends in work about the classes! They always ask me what we’ve done. I find the ‘legs up the wall’ pose really helps me to relax before I go to bed. I feel more ‘normal’ after our chats knowing that others are going through the same things.”

Cheryl Poiner, participant

Outcomes

• Remove the stigma around menopause 
• Bring women together to help share experiences and create a safe space for discussions 
• Encourage women to stay active during menopause 
• Highlight the benefits of being active

ends

This video produced by Freedom Leisure showcases the range of tailored services our members provide to support the community improve their health and wellbeing.

Aura Leisure and Libraries was recently thrilled to receive a touching email from a local couple who wish to remain anonymous. Within the email they explain how their lives have been altered after receiving a phone call from one of our Fitness Instructors, Gavin Jones,  who took the time to reach out to enquire about their health. What happened next is inspiring! They decided to make a huge commitment to improving their physical wellbeing,  and continue to show fantastic determination to reach their fitness goals. Here’s what they  had to say: 

“Dear Aura Wales,  

In the summer of 2016 I suffered heart failure and, upon admission to Glan Clwyd Hospital,  my heart output was less than 10%. Thankfully, things improved and I was eventually referred to the Cardio Rehab programme at Deeside Leisure Centre.  

I was later contacted by Gavin Jones of Aura Wales for follow up sessions. I was intermittent in attending and, I suppose, apprehensive of the effects exercise would have on my heart.  After a few weeks’ absence, and totally out of the blue, at 6.50pm on a Thursday evening I  received a telephone call from Gavin enquiring about why I hadn’t been to the gym for  weeks. I explained I had been finding it hard and I had had another health scare. He said:  “Well, I’ll see you Tuesday at Deeside at 1.15pm”. 

Once I put the phone down I considered what had been said. Rather than asking a question it sounded like Gavin was stating a fact. Why on earth would he be ringing me at that time of  the evening? It suddenly struck me. If Gavin is so committed to me, I should be committed  to me! I did meet Gavin the following week and joined the gym. I went home and told my  wife – we’ve been married 38 years and do everything together – and she also joined the  gym. 

We are both managing two hour workouts 5/6 days a week and attend Jade Jones Pavilion, Flint. We have been following a carbohydrate restricted diet and have lost approximately 20  kilos each since October. Gavin really did make a telephone call that changed two lives! We love the social aspect of coming to the leisure centre, we talk to lots of different people; you  don’t feel intimidated at all. 

Our energy levels have soared, and life is very different. We are so determined to achieve  our goals.  

Matty, one of the instructors, wrote a programme for us both and it is working so well, he is amazing! Nothing is ever too much trouble for the staff here. We wish to place on record our sincere gratitude to Gavin for his commitment to a one time “Gym Dodger”, and for his  continued support and encouragement. We would also like to thank the other instructors at Flint for making the gym a pleasure to be in rather than a burden; they are so friendly and  helpful! The whole idea of Aura is brilliant.  

That night when Gavin rang – I even remember where we were – it was as if it was the call  that was meant to happen, and I’m so glad it did. We haven’t looked back since.”  

Aura sends many thanks to this wonderful couple for sharing their kind message and wish them the best of luck with their fitness journey.

ends

Escape pain – NHS programme 

Overview 

The Escape pain programme based at Eastern Leisure centre is currently on its second cohort and is becoming increasingly popular. The centre is managed by charitable trust GLL the programme is currently run twice per week by NHS professionals from the Physio team and runs for 6weeks. 

Outcomes

Four members of staff from Eastern Leisure Centre have completed training in Escape Pain Knee/Hips and Escape Pain Backs alongside NHS professionals with the intention of co-delivering the programme. This has also provided an insight into the needs of these specialist populations with regard to exit routes. The centre fitness class programme is being adapted to cater for these clients by introducing additional “Basics” low impact classes at suitable times to provide these exit routes. 

Throughout the programme centre staff have opportunities to engage with participants and promote the new NHS membership offering to them, which in turn encourages them to use the centre independently making healthy lifestyle changes more sustainable. Having the direct link between the Physio team and the centre has been nothing but positive and already have seen some participants sign up to the membership scheme. This membership scheme was specifically introduced to support these groups into regular physical activity. 

Actions Taken 

• 6-Week physiotherapy run in local leisure centres as part of the NHS Escape Pain Programme closer to patients homes within a community setting rather that a medical setting.
• Discounted membership offer to patients completing the course to continue their health and wellbeing journey. 
• Development of exit routes and new co-delivered programmes to support health and wellbeing and provide long term activity options. 
• New low impact circuits classes have been added to the programme to cater for clients on completion of Escape programmes. 
• 3 more staff from Eastern Leisure Centre are booked on Exercise Referral course starting March 2022 to help support the programme. 
• 2 members of staff at Western Leisure Centre are now also trained in Escape Pain to help support the programme in the west of the city. 

Huw Davies AHP lead for Community Neuro Rehabilitation / Live Well Project Lead (Escape Team) said: “The joint work with Better health has enabled us (in Cardiff) and the Vale UHB to run high value interventions closer to patient’s homes. Running structured groups focused on behavioural change in the local community helps us to de-medicalise some conditions and improves patient long term health outcomes. Supporting NHS service users in the community to make positive changes to their health and well-being and the offer of long term activity options has really helped to keep people engaged and active beyond our programmes. 

The partnership work and joint training has fostered excellent relationships between Cardiff and Vale UHB and Better. We are now continuing to working closely to develop and roll out more activity options that are co produced between health and leisure. 

As a result of the success of the groups in Eastern leisure centre we have doubled our class sizes and started the role out to other centres in Cardiff. Our vision is to have these offers available in a number of locations in Cardiff and the Vale.“

Participant at Eastern Leisure Centre said: “The pain in my back is gone completely. I began with back, hip and shin pain. Now because of this group my back is completely fine.  My posture is a lot better and I’m ensuring I’m sitting and standing better. 

My fear of pain is gone now that I understand what it is and how it’s got to this point. It’s just so friendly and attentive which makes the whole exercise and pain management easier. 

I have started doing weights and bike in the gym which I would never have done because of my back.  Lost 2 stone and looking to continue losing weight and join the leisure discount.”

Good Boost is a program designed to improve individuals’ lives by incorporating gentle water and land-based exercises in a fun and social environment. The initiative aims to transform health management from a chore into a pleasurable experience. Good Boost utilizes technology developed by musculoskeletal specialists to deliver individually tailored rehabilitation. Powered by artificial intelligence, the Good Boost app is delivered on waterproof and rugged tablet computers, allowing participants to progress in their exercises at their own pace. This approach supports the self-management of musculoskeletal conditions, providing low-impact and low-pain exercises for treatment and prevention.

Key Benefits/Outcomes:

• Tailored rehabilitation: Good Boost uses AI-powered technology to deliver individually tailored exercises based on participants’ specific musculoskeletal conditions.
• Pleasurable and social environment: By incorporating fun and social elements, Good Boost creates an enjoyable atmosphere, making exercise a positive experience.
• Wide range of health conditions: The program is suitable for various health conditions, including musculoskeletal conditions, osteoarthritis, hip and knee pain, and rheumatoid arthritis.
• Improved musculoskeletal health: Users have reported positive results and benefits in managing their musculoskeletal conditions after participating in Good Boost sessions.
• Increased accessibility: The use of waterproof and rugged tablet computers ensures the availability of the program in both poolside and land-based environments.
• Empowerment through self-management: Good Boost supports individuals in taking control of their health by providing tools for self-management and prevention.

The Challenge: The initiative aims to address the challenges faced by individuals with musculoskeletal conditions and related health issues, including limited mobility, pain, and the need for specialized rehabilitation.

What They Did: Good Boost implemented a program that combines gentle water and land-based exercises in a fun and social environment. The initiative utilizes AI-powered technology to deliver individually tailored rehabilitation exercises through the Good Boost app, accessible on waterproof and rugged tablet computers.

Results and Benefits:

Quantitative

Please find the analysis of participant data for the Good Boost musculoskeletal intervention below. The data covers the period from June 2022 to June 2023.

1. Total Participants: A total of 69 users have signed up for the Good Boost program during the specified period (June 2022 – June 2023).
2. The average age of participants is 55 years.
3. Aqua sessions have garnered significant popularity among participants. However, we are currently reviewing the land-based sessions to increase their utilisation and appeal.
4. The distribution of participants based on referral sources is as follows:
   • Physiotherapist or GP Referrals: 19% of participants were referred to the program by their physiotherapist or general practitioner.
   • Internal Referrals: 21% of participants were referred internally, possibly through organizational channels or recommendations from within the program.
   • Social Prescribing: 8.70% of participants were referred through social prescribing, indicating the involvement of community or social support networks.
5. The majority of participants in the program are female.

As we analyse this data, we can identify areas for improvement and growth. The popularity of aqua sessions suggests that they are meeting participants’ preferences and needs. However, the review of land-based sessions aims to enhance their appeal and encourage greater participation. Furthermore, the distribution of referral sources highlights the importance of collaboration with healthcare professionals, internal promotion, and social prescribing networks.

This data provides valuable insights into the demographics and engagement of participants in the Good Boost musculoskeletal intervention, enabling us to refine and expand the program to better meet the needs of our target audience.

Qualitative

• High demand and positive feedback: After one year of delivery, poolside sessions are predominantly at full capacity, indicating the high demand for the Good Boost program.
• Good Boost empowers individuals to take an active role in managing their health through self-guided exercises and prevention strategies.

Overcoming Obstacles: 

Throughout the implementation of Good Boost, the initiative faced obstacles such as adapting the exercises to various health conditions, ensuring user-friendly technology, and managing the high demand for sessions. However, by spending time developing the onboarding process of members to increase their confidence and increasing the number of session utilised as the demand increased we were successfully able to over come these obstacles.

Takeaway Tips:

We have implemented an effective onboarding consultation process to ensure a seamless sign-up experience for users interested in joining Good Boost. This process involves dedicating one-on-one time with each user, allowing us to provide personalised guidance and demonstrate the program’s activities.

During these consultations, our instructors play a pivotal role in facilitating the sessions. They actively engage with participants, ensuring they understand and feel comfortable with the exercises and routines. By being present in every session, our instructors create a supportive and inclusive environment, fostering a sense of trust and confidence among participants.

Through the implementation of Good Boost, individuals with musculoskeletal conditions have experienced improved health, reduced pain, and increased empowerment in managing their conditions. The program’s tailored exercises, fun environment, and AI-powered technology have contributed to its success and positive outcomes. With poolside sessions being consistently sold out, Good Boost has the potential to become a permanent and highly sought health intervention with Newport Live.

Testimonials

Louise Vitalini, a satisfied participant at Good Boost, expressed her enthusiasm:

“I love it! Good Boost has been incredibly effective for me. When I initially started attending, I had a noticeable limp due to a hip replacement. However, the program has greatly contributed to my recovery process, and now, I am thrilled to say that the limp is completely gone. I have enthusiastically recommended Good Boost to numerous people because of the amazing results I have experienced.”

David Parry-Jones, a participant at Good Boost, shared his experience:

“After being referred by the physiotherapist at St Woolos, I was recommended to try out Good Boost. Since November, I have been attending the sessions, and over time, I have found them to be incredibly beneficial and rewarding.

Towards the end of my time here, I even started using the gym, which is something I never thought I would do. Ellis, the wellbeing officer, has provided me with guidance to progress and make the most out of my gym sessions.

The exercises using noodles, floats, and aqua dumbbells have been particularly helpful. It’s all about the resistance of the water, and it has made a significant difference in my experience.”

Using virtual reality to support care home residents with dementia

Overview of the initiative

Virtual reality (VR) technology has been used to transport the residents of Bryn Y Cae and Tŷ Cwm Ogwr Care Homes on wildlife adventures, space flights and visits to cities across the world, from the comfort and safety of their own armchair, thanks to a creative wellbeing project delivered by Awen Cultural Trust and Bridgend County Borough Council. 

The project, which was funded by Welsh Government’s Transformation ‘Connected Communities’ Grant – administered by Bridgend Association of Voluntary Organisations – worked with Cardiff-based Rescape Innovation to also create 12 personalised VR experiences for residents with dementia, aimed at unlocking memories and provoking conversations.

VR technology is becoming increasingly popular within the care sector as reminiscence therapy, taking residents to places of interest and importance which otherwise they would be physically incapable of visiting. The films are shot in 360 degrees to make the experiences highly immersive, and residents use headsets, looking in any direction to get a different perspective.

Key benefits/outcomes

• Improved wellbeing of participants.
• Improved connectivity between family members, carers and participants.
• Development of new skills for carers and family members in utilising new technology.
• Opportunity to assess benefits of a new approach to treating anxiety and depression.
• The benefits to the participants included:
  • Enjoyment of the sessions, benefits from feeling of being outside in gardens etc. 
  • Elevation of mood during and after the sessions.  
  • Able to talk with staff and each other about their experience.

The challenge that We are Trying to Overcome

• Unlocking memories and provoking conversations.
• Taking residents to places of interest and importance which otherwise they would be physically incapable of visiting.
• Reducing social isolation. 
• Supporting care home staff.

Results and benefits

Penny Griffiths, Manager of Bryn Y Cae Care Home, said: 

“It has been great to be able to bring new technology into the care home for residents to enjoy. Seeing their response has been a joy to watch especially when it was so real to them. I wasn’t sure what kind of reaction we were going to get from the residents with dementia, but it was wonderful. They were completely immersed in the experience, and for them to feel they were out in the garden and interacting with the flowers, after being isolated due to Covid for so long, was just lovely to see.

“Our hard-working staff have also benefited from the technology, by using the headsets to enjoy a short ‘escape’ to a tropical beach whilst taking a break from their caring duties. Whether it was 5 minutes of listening to the waves, or staring at a blue sky, this sort of mindfulness and sense of calm was particularly important during the lockdowns when no one could consider a holiday abroad.” 

Video link: https://youtu.be/3duD9Ktcym0

Image Dolly, aged 105. 

Takeaway tips

• Awen Cultural Trust had already developed good relationships with local care homes, which made the process of on-boarding more effective and efficient. 
• VR equipment is becoming much more affordable and accessible, with 360 degree films available to buy online. 
• Participants were sat in a wheelchair to enable the carer to change the angles of view. This made it safer and reduced the amount of pressure on their necks to look around, as some participants may have restricted movement. 
• A tablet (iPad) was used as an alternative platform to experience the video, if the participant was unable/did not want to use the VR headsets. 

Feedback from the participants (noted down by their carer):

Supporting people with dementia, loneliness and depression. A video case study by Halo Leisure.

Hywel Evans, Aquatics Development Manager for Wales attended a SPORTA & ASA workshop in Birmingham in March where a case study on Dementia Swimming was presented. Following that he met a customer with Dementia at Waterworld/Wrexham and was inspired to develop a Dementia Friendly Swim programme for Freedom Leisure Wales.

The aspiration was to develop a Dementia Friendly workforce and offer Dementia Friendly Swimming sessions 

3 key successes of the programme included:

• Partnership working between Freedom Leisure, Alzheimer’s Society-North Wales, Wrexham Dementia Friendly Steering Group, Active Wrexham, Black Park Group. Councillor Frank Hemmings.
• Workforce Development – staff attending Dementia Awareness Sessions.
• Marketing of the sessions –bilingual flyer, local radio, web site (work in progress).

A steering group was set up and a Task Plan was developed, consultation with local care home and dementia groups took place, 2 x staff upskilling sessions, regular steering group meetings to enable a weekly Dementia Friendly Swimming Session taking place at Chirk Leisure & Activity Centre. 

In Wrexham we will now develop sessions at Waterworld and Gwyn Evans Leisure & Activity Centres so we can offer sessions throughout the week to make it more accessible and in Powys we will be develop sessions at Flash/Welshpool, Maldwyn/Newtown, Brecon and Ystradgynlais.

“Over the last 6 months I have had the pleasure of working with Hywel and other staff members of Chirk Leisure Centre, and I couldn’t be more pleased with the enthusiastic response of creating a dementia friendly swimming session in the Chirk Leisure and Activity Centre.  All members of staff have been enthusiastic about finding out more about dementia but also how they can support someone accessing their services with a diagnosis. Staff attended the Dementia Friends Sessions and 4 people affected by dementia completed a walkthrough of the leisure centre. All feedback was received positively by Hywel and the team and changes were made to ensure the dementia friendly session on offer would be accessible.” – Jo Lane Regional Coordinator Alzheimer’s Society North Wales

Outcomes

• Created a dementia friendly session for the public and target groups, so they can relax and enjoy swimming in a safe and supportive environment.
• Developed a Dementia Friendly Workforce.
• Offering a range of dementia friendly swim sessions across all sites throughout a weekly period.

Moving More has Changed My life – A story of a rehabilitation journey with Freedom Leisure following a hip replacement.

Neurofit@NERS Case Study Torfaen Exercise Referral Scheme 

The Neurofit@NERS pathway was established in March 2022 after the Torfaen Exercise Referral Team noticed a gap in service provision and reached out to the Aneurin Bevan University Health Board Physiotherapy department to combine services. The aim of the Neurofit@NERS is to bring physiotherapists and exercise professionals together in complementary roles to prescribe physical activity and rehabilitation for neurological participants who require additional support. 

Collaboration between these two professions has led to better outcomes for participants, as they work together to develop tailored exercise programs that address the specific needs and goals of each patient.

Exercise Referral Manager Owen Thomas clarified: “Research indicates regular exercise has positive impact on the physical and mental health of people with Neurological conditions. This exercise pathway has really helped our Neurological conditions participants who need additional support to exercise independently and adhere to long-term activity. The program tailored to the participants abilities and preferences and are monitored using a range of outcome measures.”

Testimonial

My name is Linda Tremain and I am a neuro physio working in the Community Neurological Rehabilitation Service for Aneurin Bevan health board.

“It can be extremely difficult for people living with neurological conditions to find ways to keep fit and active. The research is clear that participation in moderate intensity exercise several times a week can have a significant impact on factors such as the risk of future cardiovascular events, it can help alleviate low mood and anxiety, it can improve walking speed and it can also reduce the risk of falls. Exercise has also been described as having a “neuro-protective” impact on the brain and nervous system and can slow down the rate that chronic neuro conditions can progress. So, there are multiple benefits to helping people with neuro conditions to be more active in the community.

“We have found that when people are discharged from rehabilitation services, they often lack the confidence to return to community activities such as going to the gym. We have collaborated with the National Exercise Referral Scheme in Torfaen, Newport Ebbw Vale and Caerphilly to help bridge this gap. We provide hands on support and advice on how to adapt the exercise programs to accommodate for many of the visible and hidden disabilities that people with neuro conditions live with such as pain, fatigue, visual impairments, cognitive problems and neurological weakness. We are also there as a safety net to signpost and refer people back into services if any issues crop up. It has been an extremely positive experience for all involved and we hope to support more and more clinicians to outreach into the community in this way.”

ends

During March–July 2020, in the first wave of Covid-19 pandemic, Aneurin Bevan University Health Board (ABUHB) reported 2,761 patients diagnosed with Covid-19.

On discharge from acute care most patients who suffer severe Covid-19 pneumonitis showed persisting signs of fatigue, shortness of breath, muscle mass loss and deconditioning; resulting in decreased exercise tolerance, reduced mobility and reduced functionality. Many had ongoing psychological and complex health concerns.

A bespoke face-to-face Covid-19 Multi-disciplinary Team rehabilitation programme was set up to maximise recovery. 

Actions taken

• All patients discharged from ABUHB critical care areas with Dx Covid-19 were identified
• Patients were invited to attend a face-to-face MDT appointment to assess suitability for rehabilitation
• If patients were identified as needing specialist intervention they were referred to appropriate services
• If patients were deemed suitable and consented a FTF pre-assessment appointment was offered
• Multi-professional outcome measures were established and measured
• 6 sessions of FTF rehabilitation commenced including an individualised prescribed exercise programme
• Full MDT support throughout the programme
• Post rehabilitation assessment was completed after 6 sessions and outcome measures recorded

Newport Live supported ABUHB through gaining Welsh Government permission to allow their facilities to reopen when the leisure sector was under enforced closure to deliver facility and wellbeing operations of gym and exercise. 

In addition, the multi-disciplinary team with support from Newport Live also delivered Virtual Pulmonary Rehabilitation during the lockdown as they recognised that this patient group were within the extremely vulnerable classification regarding Covid. This was a joint exercise program in a virtual setting, and the programme is still running.

Following from the Post Covid Rehabilitation program, the team then delivered a Post ITU Rehabilitation program. The multi-disciplinary team focused on patient cohorts that had been recently discharged from ITU with the aim of improving functional ability.

They have now launched the Neuro Fit program, which is a multi-disciplinary delivery in which Newport Live have combined their Stroke pathway with the lead Physiotherapist from the Community Neuro Physiotherapy Department. This is a first of its kind program that incorporates all aspects of Neuro Rehabilitation within a community leisure setting. 

2022 will also see the introduction of Physio led rehabilitation within Newport Live where an ABUHB Physiotherapist will deliver rehab programs to individual patients within Newport Live gyms. Once rehab is completed these patients will then be offered ongoing Newport Live membership or direct referral into Newport NERS.

Outcomes:

The primary measurable benefits of Covid Rehabilitation are a decrease in symptoms (mainly dyspnoea and fatigue) and an increase in exercise endurance.

These were measured by the Modified Borg Dyspnoea Scale, MRC Breathlessness Scale, six-minute walk test, sit to stand, modified fatigue impact scale and a handgrip test. Mental wellbeing was measured using the Hospital Anxiety Depression Scale.

Participants were asked to rate their improvement in function at the end of the six-week program compared to the start of the programme using a visual analogue scale (VAS). Reported perceived improvement ranged from 50% to 100% with an average of 84%.

The multi-disciplinary team has created a blueprint for health boards / NERS / Leisure Services on the set up and delivery of a Covid Rehabilitation program. The service has been presented to the British Thoracic Society upon request of the Covid Rehab teams patient outcome measures, and to the British Medical Journal as the service were nominated finalists under the 2021 Respiratory Team of the Year. 

The team also won the South Wales Argus Health and Social Care 2020 Team of the year. Newport Live – the leisure trust – won the Contribution to the Community Award in the Newport Business awards for the programme and the support delivered in 2021.

Results and benefits:

“From feeling so ill to now feeling so much better, both stronger and mentally. Amazing can’t thank you enough.”  – Patient

“We have seen quantifiable evidence that multi-disciplinary team working, when delivered within a community Leisure setting delivers significantly improved outcome measures among patient cohorts.” – Chris Pennington, National Exercise Referral Co-ordinator for Newport

Chris Pennington, National Exercise Referral Co-ordinator for Newport

As a leisure provider we have a historical relationship with Swansea Council National Exercise Referral Scheme. NERS is delivered out of Freedom Leisure sites. The culture within this relationship has been that eventually NERS clients will be handed over to Freedom Leisure on offered a concessionary health membership and remain active as a Freedom Leisure member. 

However, we were experiencing a lag when it came to the ‘handover’ process, NERS clients would be leaving a 4-month programme of 1:2:1 support and be expected to become independent. This handover was providing a poor experience for NERS clients and ultimately hindering the efficiency of the scheme. 

Freedom Leisure decided to invest in members of its gym team to qualify them as level 3 GP Referral Gym Instructors. They would become our ‘health champions’ at site. The aim was that they would work closely with NERS health professionals and be a part of someone’s journey whilst on NERS. Thus, making the informal ‘handover’ process better. It worked. NERS clients had a familiar face within the Freedom team and our Freedom staff knew more about the person coming into our services. 

The extra level of knowledge allowed NERS health professionals to feel more confident when weaning someone from NERS and into Freedom Leisure. It also meant they had a familiar face to go to, someone who they knew was passionate about helping those living with long term health conditions. 

We are know exploring how we use our Health Champions to deliver bespoke exit routes to those on NERS in the form of ‘health maintenance’ classes. 

Not only have our Health Champions strengthen our relationship with Swansea Councils NERS team members but it has also opened doors to other health departments within the Swansea Bay Health Board. These departments include; occupational therapists, physiotherapists, neurologists and pain management practitioners. 

The Morriston Hospital Physiotherapy department visited The LC Swansea to have taster of our low impact classes, the team were exceptional and have given the physios a reason to have confidence in us when they refer patients to our services. 

Outcomes

• Invest in our staff who are passionate about working with those living with long term health conditions 
• Strengthen our relationship with NERS and link the services better 
• Instill confidence with health partners around our services

Feedback

“I was recently referred by my excellent singleton physio. To be totally honest was VERY apprehensive to say the least.I have always played & enjoyed sport all my life but I am NOT a gym person at all but was desperate to improve my fitness following hip surgery.  My instructor is Ryan McEwan, I have to say right from the beginning, the initial phone, call he has been brilliant with me. I have now joined the gym!  To be honest, I have found ALL the staff in the gym most helpful & approachable which is a big plus for me” – Mike Lewis Physiotherapy Patient

“I’m feeling as healthy as I ever have!” – Interview with Martin McCallion  

Martin McCallion, a previous participant of the National Exercise Referral Scheme (NERS) and regular participant of Wellbeing Fitness Classes as well as the gym, kindly told us more  about his fitness journey and how he is feeling healthier than ever! Here is what he had to  say:  

How many classes do you attend a week? 

I do one class a week – the wellbeing circuit class – but in February I had a gym  induction and since then I have attended the gym at least twice a week. There’s a really  friendly atmosphere, I’m very comfortable here in Deeside Leisure Centre. I was  referred to the scheme because I had arthritis and was really struggling. When I had the  gym induction with Jo Beevers, she showed me the pieces of equipment to use that  would be most helpful. I’ve been going from strength to strength since then; I’m feeling  as healthy as I ever have! A couple of years ago I was in an awful lot of pain on a daily  basis, but since I have joined the scheme I’ve gone from strength to strength.  

What has been your favourite thing about attending the scheme?  

There are all sorts! The main thing is my physical wellbeing now compared to what it  was; it’s so different. Nothing’s a challenge anymore, not like the way it used to be. I’ve  met some lovely people as well. At the moment I’m really enjoying running. Completing  the Flintshire 10K has boosted my confidence tremendously. I’ll take on any challenge  that comes my way now!  

Do you have any fitness goals in mind for 2019? 

I intend to run the Chester half marathon in May 2019. It has been a long term ambition  of mine. I’ll work my way up to doing the half marathon, starting in February with the  Ruthin 10K, then the Chester 10K in March, in April I’ll find another 10K run, and  hopefully by May I’ll be ready!  

Do you have any advice for anyone who is debating joining the Wellbeing Classes?  

Just do it! It changes your life for the better! As far as I am concerned it is the best thing  that has happened for me in a long, long time. You’ll never look back! 

The co-ordinator of NERS, Joanne Beevers, is “so very proud” of Martin’s achievements and  said: “he is loving running and he even beat me in the Flintshire 10K with his time of 57  minutes! He has been consistently training since January with a mixture of my classes and  gym sessions. He is one of our many clients who turn up every week to achieve their goals!”. 

Aura Leisure and Libraries would like to thank Martin for taking the time to share his  experience and wish him the best of luck for his future fitness goals!

Gareth was 28 when he started on the National Exercise Referral Scheme in Blaenau Gwent. He had just been made redundant and had started living unhealthy with high alcohol consumption and eating a processed diet with high saturated fats. He felt anxious, felt he was at the bottom of a pit, and did not recognise the person staring back at him in the mirror. He had cut himself off from family and friends and felt isolated.

Actions

• Gareth referred himself to his GP.
• The GP recommended the NERS scheme as a medication for Gareth’s mental health, physical well-being and to create new positive habits.
• The GP notified Aneurin Leisure that they had referred Gareth. The Aneurin Leisure team got Gareth booked in the following day. 
• During the first consultation, the NERS team got to know Gareth, what he wanted to achieve, what was stopping him, completed a body analysis, and physical (6-minute walk) and functional (RHR) tests. They completed all the relevant informed consent, SPAQ physical activity questionnaire, and put a plan together bespoke to Gareth. 

Outcomes

• Aneurin Leisure advised of the NERS sessions, including gym, fitness classes, and swimming to build the program of the activities Gareth liked. They met him for the first 2-weeks.
• The start of the third week Gareth did not attend, so they called him, and learned that his anxiety was at its worst point. They suggested him to make contact with friends and family, and informed him that they would contact him at an appropriate time.
• 3-weeks later they contacted Gareth, who by this point had repaired his relationship with family and friends and felt supported and motivated to start the NERS scheme again. 
• When the NERS team met Gareth again, he was a completely different person: focused, determined and motivation to see it through.
• At the 4-week meeting, Gareth had made significant improvements and the NERS team needed to change his plan accordingly to help him progress further. 
• At 12-weeks, Gareth found a new job. He felt that due to the scheme, his mental and social wellbeing along with his confidence and self-esteem had ‘skyrocketed’ which made him believe he deserved the job. 
• At week 16, Gareth had not only improved his lifestyle in the most positive of ways, but he had also become an advocate for the NERS service and wanted other people to know it existed and how much it had helped him. 

Results and Benefits

Gareth’s medical journey showed impressive progress in just 16 weeks: