Pass Plus Experience by Hannah Langford

I passed my practical driving test in August 2014, which was an important milestone for me.

As I have a Motability car, I was encouraged to undertake the Pass Plus course, as this can lower insurance premiums and improve driver safety. Even if this had not been the case, I would still have been keen to undertake this course because the Pass Plus tuition focuses on motorway driving and adverse driving conditions.

I completed the Pass Plus with my driving instructor in 2 x 3-hour lessons.

I found the experience very worthwhile, as it improved my confidence. The Pass Plus is a very good way to expand your driving experience after passing the practical test as it develops your awareness of risks and how to deal with different situations. During the lessons I was given helpful tips and advice about breaking down on the motorway, night driving, driving in adverse weather conditions and general driving on motorways.

As part of the course I was able to drive into Manchester, which is where I work.  This is a route that I had not done before and was something I was a bit wary of, but I now feel more able to tackle this route.

I was also required by my instructor to simulate breaking down on the motorway, so that I could see how it felt to move onto the hard shoulder and then re-join the motorway. Hopefully this will not happen to me when I am out driving, but I now feel more prepared for this situation should it occur.

I am very glad that I completed the Pass Plus and would recommend it to others who have recently passed their practical driving test.

Motability covered the cost of The Pass Plus tuition as I am between the ages of 16 and 24.

If you would like more information about learning to drive or adapting your vehicle please contact Sue Walker at NMC who will be able to signpost you in the right direction.

Pass Plus Tuition

What is Pass Plus?
The Pass Plus Course is a practical training course that was set up to make newly qualified drivers safer and better drivers. It takes at least 6 hours. Whilst it can be taken at any time, it is most useful to new drivers in the year after passing their test.

Booking Pass Plus
* You need to book Pass Plus with a Pass Plus registered approved driving instructor (ADI).
* DVSA Pass Plus Team – passplus@dsa.gsi.gov.uk Tel: 0115 936 6504

Discounts
* The cost of taking your Pass plus Test will depend on where you live, the instructor or driving school, and how long your training takes.
* Some local councils offer discounts off the full Pass Plus training costs. Check out your local council. Please note that ALL local councils in Wales offer discounted Pass Plus courses. Go to Pass Plus Cymru for more info.

How Pass Plus training works
Pass Plus training takes at least six hours. It has 6 modules, covering driving :

* In town
* In all weathers
* On rural roads
* At night
* On dual carriageways
* On motorways

All the modules should be practical lessons and usually you will spend 5.5 hours driving. You will be assessed throughout the course and to pass you will have to reach the required standard in all modules.

After you have successfully finished your training you will be sent a Pass Plus Certificate. Many car insurance companies offer a substantial discount to drivers who have successfully completed the Pass plus course.

Pass Plus is available to anyone.

For more information: DVSA Pass Plus Team, passplus@dsa.gsi.gov.uk Tel: 0115 936 6504 Visit https://www.gov.uk/pass-plus/overview

Important Benefit Informaton– for DLA claimants born on or before 8th April 1948

Changes to contact numbers for those claimants of DLA who were born on or before the 8th April 1948.

From 25th February 2015 claimants in receipt of Disability Living Allowance whose date of birth is on or before the 8th April 1948 will transfer to the Attendance Allowance Unit. The reason for this is because claimants in receipt of DLA who are 65 years of age or older do not need to be assessed for the new Personal Independence Payment. It has therefore been decided that all pensioners in receipt of a disability benefit should now be dealt with by the Pension Service.

As a result from the 25th February claimants in receipt of DLA whose date of birth is on or before 8th April 1948 should contact the Attendance Allowance Service Centre on 0345 (0845) 605 6055.
 
Those in receipt of DLA whose date of birth is on or after the 9th April 1948 should continue to contact the DLA Helpline 0345 (0845) 7123456.

Claimants calling the DLA Helpline will hear a message advising them to contact the Attendance Allowance Service Centre if their date of birth is on or before the 8th April 1948.

Gov.uk will be updated to reflect these changes.

The Personal Independence Payment Enquiry Helpline will continue with its existing number 0845 850 3322 whilst new claims to PIP can be made by calling 0800 917 2222.

New website focus on technology enabled products - www.telmenow.com

The website is the brainchild of a company established to highlight and create opportunities for leading-edge health technology to help more people live independently in their own homes. In many cases, the biggest barrier is not cost, it is accessibility. Visit: www.telmenow.com/ for easier and more comprehensive access to technology for independent living. Tbhe site brings together information
about the range of assistive technologies available, the people and their conditions that items would be suitable for and, crucially, whether selected products will work together.

Lasting Power of Attorney – Sue Walker

Lasting Power of Attorney
After recently attending training, and then having to assist my mother with setting up lasting power of attorney, I thought it would be a good time to pass on some information and experience.

There are two types of LPA and you can set up one or both types:
1. The property and affairs LPA which allows the attorney you appoint to deal with your property and finances, as you specify.
2. The health and welfare LPA which allows  the attorney you appoint to make health and welfare care decisions on your behalf, only when you lack the
mental capacity to do so yourself.

Your Attorneys
It is important that you take care to appoint attorneys that are trustworthy and have the appropriate skills to make any proposed decisions. It is a good idea to appoint more than one attorney so that they can act jointly on your behalf and responsibility is shared.

Certificate Providers
This can be one or two persons. They sign as witnesses to show that you understand the LPA, and they also provide statements to say how they know you and that you are able to make this decision for yourself, and are not being put under undue pressure.

Named persons
These are people that you want informing that you are registering LPA so they can raise concerns if needed. If you have two certificate providers you do not need to have any named persons because already there are joint responsibilities for decision making.

Setting up LPA
Setting up LPA does not mean that you give up control and it will only be used when circumstances, and you, decide it is needed. If LPA is not in place when it may be needed the Court of Protection will appoint a deputy to act on your behalf.
If you leave it and you are not able to make the decision yourself it becomes very difficult and expensive.

To set up your LPA you can:

1. Work with a solicitor - legal fees on average £350 - £500 + vat. In addition the court fees are £110 per document (one for property & affairs, one for health & welfare)
2. Another option is to download the forms from the internet, complete them yourselves and send them to the Court of Protection. The cost is just the court fees £110 per document. Keep photocopies of all the documents in the event of any issues.

 If you have a large portfolio of property, land and savings it would be advisable to work with your solicitor. This increases the costs but they provide legal support. If your property and affairs are more straight forward I think it is a good idea to look at doing it yourself. We downloaded the forms from the internet and found them very easy to fill in.

We had two people who have known my mother a long time to be certificate providers. They needed to say how they knew Mum, how long they had known her and that she was making this decision herself. As a family we decided to only apply for the property and affairs LPA. In our circumstances we didn’t need the health and welfare LPA. We had a small problem where the certificate provider had written a separate letter and it should have been on the form, and as a consequence we had to match up the dates to the original documents. The court official was great with advice and it did not cost us anything extra. My mother now has LPA and is relieved that we can support her.

Please note that LPA has completely replaced the existing enduring power of attorney because the new powers include Health as well as Property and Affairs.

Two Useful websites: www.gov.uk/power-of-attorney/overview www.which.co.uk/power-of-attorney

Cough Assist Machine, A Patient’s Perspective – Andrea Duckworth

It was whilst at a routine home appointment to replace my ventilator (which I use at night), that the nurse explained that she felt my breathing seemed slightly laboured and I seemed a bit hoarse.

She suggested a few things, one of which was a Cough Assist machine. A few weeks later she came back to visit, armed with the Cough Assist Machine and the Respiratory Physiotherapist.

They both explained how the machine worked and took me through it step by step. Firstly they had a go just to illustrate how it worked. Then it was my turn! It took a bit of getting used to but they adjusted the settings until I felt comfortable with them. The pressure is quite forceful but the key is to get into a good rhythm.

It took me a little while to feel really comfortable using it. The idea is that I use the Cough Assist machine prophylactically (as a preventative measure) to keep everything clear and flowing smoothly, rather than waiting to get a bad cough or cold and then really needing to use it, but actually feeling to tired and weak to use it. It is quite a forced pressure but one that you can get used to.

I try and use the Cough Assist morning and night so that once I get out of bed in the morning I am able to clear any secretions that have developed overnight, and again before I get into bed in the evening so that I clear any secretions before I lie down at night.

It is another gadget to store but it’s just under my bed and I just pull it out to use it. I have really found that this has helped me – it makes my throat feel clearer, my breathing seems better and I feel more alert. I feel I am doing as much as I can to help my breathing be as effective as possible within the disease limitations. I hope that I do not pick up coughs and colds but I am reassured that my Cough Assist machine will help that bit more if I do get one!

Cough Assist Machine – A Clinical Perspective Jonny Smith

Cough assist (or Mechanical Insufflation-Exsufflation) is a chest clearance device which uses negative air pressure to simulate a functional human cough. The machine works by delivering a preset 'breath in', or inhalation, which fully inflates the lungs and moves air behind secretions. It then rapidly switches to a preset 'breath out', or exhalation, which draws secretions mouthwards to be cleared from the chest. This is typically performed through a mouthpiece or mask and the newer machines have various settings to tailor the treatment to the individuals.

Chest infections can be extremely dangerous, particularly if you are unable to clear your chest effectively. Regular use of a Cough assist prevents accumulations of secretions within the chest, which in turn removes favourable conditions for bacteria to multiply and helps to prevent chest infections. In addition, in the event of a chest infection, the cough assist removes infected secretions to clear the airways and improves breathing - just like a functional human cough!

Individuals may require a cough assist when they have weak respiratory muscles - those such as the diaphragm, muscles of the ribs and abdominals - and can no longer effectively clear their chests independently. The guidance for individual need of a cough assist is contained within the British Thoracic Society guidance on Neuromuscular Conditions, which was published in 2012. Cough assist machines are becoming much more widely used because of the advantages they confer over other chest clearance options (such as suction or manual-assisted coughing) with relatively few drawbacks. The most effective method of using a cough assist device is to use it every day, even when you are feeling well, to fully inflate the lungs, keep secretions moving and prevent issues such as chest infections from ever occurring.

If you feel your cough is weak, or has weakened recently, to the point where you are unable to effectively clear your chest, you should alert your physiotherapist or specialist clinician as you may be in need of respiratory support. Even if you feel capable of clearing your chest when you are not unwell, the effects of infection and repeated coughing can leave you fatigued and adversely affect your cough strength. As always, prevention is better than cure! And it is better to have &
rarely need, than rarely need & not have!

Keeping Warm - Brrr.... it’s cold! – Sanjay Vaja

During the past few years, and more so since being in a wheelchair, I have found myself feeling the cold a lot more.  I've tried different ways to keep warm.  Ultimately, it’s been about learning what works for my body. However, there are some general things that I wanted to share, in case they help others.

For me, it’s about keeping my ‘core’ warm – my upper body / chest area. If my upper body is cold, my body says ‘right, time to conserve energy’ and literally switches off the heating to my feet. No matter how many thick socks or thermals I’m wearing, or sitting with the fan heater on, it doesn’t make any difference if the internal heating has been switched off.  

How do I keep the upper body/chest area warm?
Thin layers and long sleeved tops. Either a long sleeve thermal top, or cotton long sleeve T-shirts, or just an ordinary long sleeved shirt. Sometimes with, or without a short sleeve T-shirt underneath. Then a thin long sleeve jumper on top (eg a thin lambswool jumper). Those big woolly jumpers don’t do much for me, plus they are heavy and restrict movement. There’s also room for a fleece on top of it all if I’m heading out.

My neck
Mum always tells me to keep my neck warm – and she’s right – it makes a huge difference! If my neck is shielded from the wind and cold, I feel noticeably warmer. Plus it seems to be quite trendy these days to wear a scarf.

Shoes
My podiatrist ordered some insulating insoles for me. A thin polystyrene looking layer that can go on top of existing insole, or a thicker one that can replace the existing insole.  I can really feel the difference when I've got them in. Simple, but effective.

Socks
I tried some Bridgedale Comfort Trekker socks and also some Bridgedale Endurance Trekker socks. They are really warm wool socks and not too thick – the Endurance Trekker ones are warmer. Just be careful as you may need bigger shoes but for around the house, they’re great. The other ones I've found great are the everyday M&S wool blend socks – they look and feel like normal socks but are warmer.
http://www.amazon.co.uk/Bridgedale-Endurance-Trekker-Mens-Socks/dp/B000OIOQXA
http://www.marksandspencer.com/2-pairs-of-lambswool-blend-thermal-long-socks/p/p20027016

My podiatrist suggested I try ‘silver socks.’  They are recommended for people who have Raynauds. They’re designed to “minimise the radiative heat loss by actively reflecting 95% of the body’s energy back to the skin. This makes them a lot warmer compared to conventional socks.” I’m not sure if they worked or not – I need to try them again now that I've worked out to keep my core warm. Perhaps that will be a winning combination? They can be found at the Raynauds Shop: http://www.rsa-shop.co.uk/index.php

Other useful information about chilblains and keeping warm can be found on the Raynauds website under the Raynauds menu on the right: http://www.raynauds.org.uk/index.php

Gloves
For a while now I've used ‘magic gloves’ that are thin but have little rubber bobbles that help with grip. I used them to grip cold handrails or walking sticks or just because my hand is exposed on the controller arm. They are a ‘one size fits all’ and I've seen them for £1 in Macclesfield (if you want me to get you a pair!).
http://www.amazon.co.uk/Black-Warm-Magic-Gloves-GL313/dp/B004APQ0A0/ref=sr_1_5?ie=UTF8&qid=1423595499&sr=8-5&keywords=magic+gloves

Thermal tops
I've found some nice brushed cotton ones from Tesco, with a faux fleece inside. Long sleeve and nice and warm. Most outdoor shops also stock long sleeve thermal tops. My advice would be to make sure that they are not too heavy and that they don’t restrict your daily movement too much.

Thermal bottoms
I have tried a few. Some with a thick elastic waistband but that’s awkward when going to the loo and some with or without a fly (with is easier). I've recently found the pair that seem to work for me – Peter Storm (from Millets/Blacks). They have a soft finish, are stretchy and are slim fit which keeps me warm.  They have a comfortable elastic waist band and soft stretchy ankle cuffs. Everything ticked!
http://www.blacks.co.uk/mens/084170-peter-storm-mens-thermal-pants-
khaki.html

Diet and exercise
Diet and exercise are also important. A good diet gives you enough energy to keep warm, and exercise helps with circulation (and keeps physios happy!). Warm drinks and soups are great too!

Sleeping
I have an electric under blanket on my profiling bed. It’s on a timer so it comes on in good time to warm my bed, and switches off when I’m far away in dreamland.  It’s great but the one I’m using so far from Argos, seems to stop working after 4 or 5 months. Perhaps because I’m using the backrest all the time to sit up in bed?  Argos keep replacing it but we’re looking for a better one.

Hopefully there’s something in here that will work for you. If you would like any further information please do drop me a line. Please e.mail sanjman108@gmail.com

Take care and keep warm! Sanjay