L.I.F.E. (Leisure Inclusion For Everyone)

1. L.I.F.E.(Leisure Inclusion For Everyone) By Alison Harkess Staff Nurse – Learning Disabilities

2. Introduction • Physical Health • Mental Health • Health Promotion • Social Skills/Social Inclusion

3. PHYSICAL HEALTH • To improve baseline fitness levels • Healthy BMI • Improve core fitness • Maintain/improve mobility • Off set co-morbidity

4. MENTAL HEALTH • Reduce Depression • Reduce Anxiety • Increase motivation • Improve wellbeing/coping ability

5. HEALTH PROMOTION • Promote healthy lifestyle • Explore how exercise affects the body and mind • Increase personal expectations • Safe/realistic goal setting

6. SOCIAL INCLUSION/SKILLS • Community resource • Increase social opportunities • Promote independence/skills • Transferrable skills

7. IMPLEMENTATION • Made proposal and secured hours • Secured group access cards • Identified clients, obtained permission/physical examination by RMO • Identified gym and risk assessed suitability • Completed physical readiness questionnaire • Identified appropriate mental health assessment tools x4 and obtained baseline recordings • Induction at gym including fitness test, introduction to equipment and fitness programme setting • Commenced twice weekly, 2 hour sessions

8. RESULTS • Resting pulse rate reduced • Blood pressure reduced • Some weight reduction • Co-morbidity effects challenged • Motivation increased • Well being increased • Anxiety reduced • Depression reduced • Independent/social functioning increased

9. CLIENT FEEDBACK • Client questionnaire completed • Enthusiastic response • Commitment of clients • Would like other opportunities to engage in physical exercise • Feel they are achievers • Same as everyone else

10. CONCLUSION • Physical exercise is cost-effective • Inexpensive to deliver (cost to NHS Lothian NIL!) • Inexpensive to participate in • Minimal adverse side-effects compared to pharmacological interventions • Can be indefinitely sustained • Exercise is a valuable transferrable skill • Holistic and individual • Trinity of treatments (mind, body and soul)

11. L.I.F.E ‘Case study’ ‘Kevin’

12. Kevin’s pathway of care to NHS Lothian LD services Up to 16yrs:Special School and lived at home Residential home2 yrs Supported by Social Work 2 yrs Placement broke down due to behaviour that challenged Parents found it difficult to cope and challenging behaviour and physical aggression Placement broke down due to challenging behaviour Residential accommodation 8yrs Aggressiveoutburst Admitted to the REHshort term Similar aggressive outburst Inpatient LD resourceNHS Lothian(March 2008) Back to same residential placement(one night) Police custody then respite care (three weeks)

13. ‘Kevin’ - profile

14. Treatment/management Food restriction/supervision Daily structure/routineRegular exercise Firm rules Hormone treatment

15. Kevin and the L.I.F.E programme Kevin joined the project - morbidly obese (115 kgs)- High blood pressure (medicated)- challenging behaviour Goals:assist with weight reduction increase confidenceimprove CV functioning reduce anxiety decrease blood pressure promote coping abilitiesimprove muscle tone Reduce co morbidities Extend life expectancy Programme:2 x per week – Edinburgh Leisure30 minutes cardio and range of equipment useWalk to/from gym (2 miles)

16. Results…