3 minutes with Luz Carvajal

Chelsea Pensioners live at the Royal Hospital Chelsea, a retirement community and nursing home in central London. The 320 male and female residents are former British Army soldiers or non-commissioned officers who served in the ranks. I am based on site at the Margaret Thatcher Infirmary, a care home and GP medical centre that opened in 2009. It can accommodate 100 pensioners and there are four wards: two residential ones for people with very limited mobility and difficulties in performing daily activities, one for patients with dementia patients and the other for patients with acute illnesses and palliative care needs. Their ages range age 70 to 102 years and about 65 residents in the infirmary are aged 90 to 100. The oldest patient here is a lovely gentleman, aged 102, who does chair-based exercises twice a week and participates in the sensory-stimulation sessions.

 

I have always enjoyed the older people’s field, and the chance to work with British veterans has proved to be an honour. I offer a rehabilitative approach, working with the pensioners to achieve their goals. I encourage them to improve their general fitness with the aim of preventing early admissions to the infirmary. They might have musculoskeletal (MSK) problems, acute and chronic neurological conditions, heart disease, chronic obstructive pulmonary disease, and so on.

 

The pensioners can refer themselves for physiotherapy. In most cases, we can offer appointments in three days and can see urgent cases straight away. I see about 35 patients a week, but this can rise to 50 in busy weeks. I get referrals from the GP or nurses through the daily email system. Every morning I head to the wards for my daily rounds with the occupational therapist. We have a verbal handover from the nurses in the acute and palliative wards on what is needed or who requires an assessment.

 

Working with an extended team of allied health professionals, GP, nurses and volunteers is a great pleasure. We are like a big family who all know each other and work together to improve the residents’ general wellbeing. We attend, and even participate in, military ceremonies and other high-profile events. If needed, we also escort and support residents to attend a range of annual events such as the Royal Horticultural Society Chelsea Flower Show, which is held every summer in the Royal Hospital’s grounds.

 

There is a treatment room in the therapy area next to the gym. The infirmary patients with MSK problems are taken to this treatment room and to the gym. This is well equipped with parallel bars, pulley wall bars, therapeutic balls, Therabands, free weights, arm and hand therapy equipment. We also have four bikes, two treadmills, a well-equipped multi-gym, balance machine, cross-trainer, electric stepper and so on. A group of patients comes to the gym for circuits and other classes.  We also hold pulmonary rehab classes three times a week. Other residents use the gym regularly as a way of staying fit. They receive individual assessments and goals, and can access the gym from 8am to 4 pm. 

 

In a report published in November, the Care Quality Commission (CQC) described the infirmary’s services as ‘outstanding’. The inspectors said: ‘We saw that staff treated people with respect and kindness, and promoted their dignity and independence. People told us staff were incredibly kind and compassionate which had a positive impact on their lives.’ Their verdict was an excellent recognition of all the hard work done by all the nurses, carers and, of course, therapy colleagues. We also have the support of volunteers, some of whom are physio students. 

 

Yes! We have many plans. There is scope for lot more therapy input and we will focus on prevention, health promotion, falls and pulmonary rehab to enable the residents to maintain their independent living.