1
(Pifco), is given by the physiotherapist. Effleurage is employed if the massage is done manually, and if the electrical method is used the smooth rounded head of the massager is moved in circular motion using gentle pressure. The massage is started on the unaffected side of the trunk, front and back to clear central lymph pathways, and then moves to the affected side, and finally down the affected limb finishing at the fingers. Where possible a suitably-sized compression sleeve (Pan Med) is applied which the patient is encouraged to wear at all times, and active and passive movements to the limb are given. The arm is elevated so far as possible on pillows when the patient is resting. Passive therapy When a patient is no longer able to take an active part in treatment, efforts continue to ensure comfort. Passive movements of the limbs are given to any unresponsive patient t o ease stiffness of joints and facilitate correct positioning for prevention of pressure sores and general nursing care. Treatment continues to within hours of death. Day Unit Patients Any of the modes ot treatment already mentioned may be appropriate to a patient attending the day unit. A high proportion of the day unit patients are elderly and live a fairly inaciivz life, and for this reason a class of exercises is given each day. The structure is varied - it may be a ~ ~ ~~ formal table of exercises, exercises to music, competitive games, a mental exercise, action songs or a relaxation class, but it is always fun. It is impressed on patients that they are allowed to opt out of any exercise that might cause them discomfort, and because of this it is a useful vehicle for assessing patients' capabilities. The aim of the class is to stimulate both physically and mentally, to promote circulation, to maintain muscle tone and to improve respiratory function. The patients are encouraged to continue exercises during day unit closures at Christmas and in the summer. Teaching Commitment St Luke's is a teaching unit and the physiotherapists are responsible for in-service training, lecturing to interested parties from the community, and for teaching medical per- sonnel from similar units or spheres with allied interest. Conciusion Physiotherapy is as rewarding and important in caring for the terminally ill as in any other field of health care. If a man is to live his life to the full he is deserving of and entitled to the same quality of care and attention in the days before his death as he experienced in the days after his birth. REFERENCE Williams, J I f 1986). 'Physiotherapy is handling', Physiotherapy, 72, 2, 66. Videos With a Little Help and Celebrating Age. Available from Healthwrse Productions Ltd, 9 , l O Bat!ey Enterprise Centre, 51 3 Bradford Road, Batley W F i 7 8JY. 20 minutes each. €35 each excluding VAT and postage. As videos are more commonly used in a seminar-type setting, these were reviewed by four people, in order to assess their suitability, potential to stimulate discussion, and value as a teaching aid. 'With a Little Help' describes the community services available to elderly people and their carers. It features three older people and the services they are receiving. The presentation is lively, cheerful and positive, with a 'jingle' playing in the background for most of the production. Unfortunately, we found the video very superficial in its approach - there was no information on how the services are co- ordinated, or on the differences between social services and community health services. There was no analysis and no discussion on some of the problems facing Community services. The overall message was that whatever service you need in the community you will receive, whereas those of us with experience in the community know that this is not the case. In the 'blurb' accompanying the video the company states that it has been designed with carers, relatives, health care profess- ionals, social services students, and career officers in mind. We do not agree - we felt it was too simplistic for health professionals and students, and it does not give enough information to help carers through the often bewildering maze of how to go about getting help. The only area where we felt this video could be useful is in day centres or old people's clubs where it could be used to give a simple overview. 'Celebrating Age' is on health education for older people. It begins by asking people in the street their opinion on when they think someone becomes old. This is used as a starting point to stress the difference between disease and the ageing process, and the importance of recognising illness so that it can be treated. The video emphasises the importance of keeping fit in old age and considers diet, foot hygiene, and so on. By looking briefly at hospital admissions and reasons for admissions it touches on the problems of decisions being made on behalf of older people, and warns that old age can be 'the age of no consent'. The presentation of the video is again very lively and cheerful; in fact we found the music intrusive at times. Although we fully endorse the production's message. We found that overall it lacked information, eg in mentioning the importance of foot hygiene it did not give any actual inform- ation on what to look for or what to do. According to the producers, 'the film has valuable lessons for all age groups, and particularly for professionals from all walks of life involved in the caring of elderly people'. We dispute this - it does not have such a wide remit, and its use is mainly limited to lay peopleiretirees as a possible introduction to the wide topic of health education. We found too little information in it to be of use for professionals. ANNA SMITH MCSP SHARON CAMP MCSP SUE ETHERINGTON MCSP SHEILA WALKER MCSP Publications The Disability Scene: A library reference list for designers and makers of equipment for people with disabilities (2nd edn), compiled by Anne Rehahn BA ALA. Available from London College of Furniture Library, 41 Com- mercial Road, London El 1LA. €4 including postage. This bibliography was originally compiled in 1985 to support the London College of Furniture's postgraduate course in equipment design for the disabled. The recent growth of interest in this field has prompted the author to update the work, and make it available to a wider audience. The eight sections cover 'Welfare of the disabled', 'Disabilities', 'Environments for the disabled', 'Towards rehabilitation', biblio- graphies, periodicals, trade information, and there is an extensive index. The 1987 supple- ment updates all of these sections, and adds information on audio-visual materials and sources of further information. How to Push a Wheelchair, by David Griffiths and David Wynne. The Disabled Motorist's Club West Midlands, Unit 2a. Atcham Estate, Upton Magna, Shrewsbury SY4 4UG (tel 0743 77489). lllus. 24 pages. 50p per copy (discount for 5 copies or more). This publication aims to be of use to both disabled people and their families. The book- let provides a sound knowledge of wheelchair use for safety purposes, emphasising that considerable harm can be done to a disabled person who is the victim of mishandling. Topics such as pushing a wheelchair with an attendant, transferring unaided, pushing yourself up and down kerbs, difficult obstacles, and choosing a suitable wheelchair are all mentioned. ~ ~ ~- $6 Physiotherapy, January 1988, vol 74, no 1
