Ceart, a HSE-funded centre, is proving a great source of support for people with an enduring illness or chronic pain, writes Sylvia Thompson
The Co Kilkenny town of Callan is home to a unique centre which offers a range of therapies to people with chronic pain conditions and other long-term illnesses.
Originally set up in 2003 in response to the lack of community-based rehabilitation services for people with acquired brain injury in the southeast, the HSE-funded centre now offers physiotherapy, acupuncture, massage, psychological therapies and other support services to people with chronic conditions including multiple sclerosis, Parkinson's disease and arthritis.
Called Ceart (Community Enterprise Action for Rehabilitation and Therapy), the centre operates as a charity and patients - referred by their GP or other health professionals - receive treatments free.
Ceart chairman Michael Walsh explains its origins: "It all began with the story of one man who had a brain haemorrhage in his mid-40s. Following neurosurgery in Beaumont Hospital, he was sent home and put on a waiting list for the National Rehabilitation Hospital in Dún Laoghaire. He was left paralysed on one side, unable to swallow and with impaired memory.
"After much lobbying by his wife, he was sent to a wonderful rehabilitation facility in Britain. However, for us here in Callan, his experience underlined the lack of community-based support for people like him."
At the time, Dr Pat Crowley, a GP based in Kilkenny, was also keenly aware of the lack of community-based rehabilitation services for people with chronic neurological, cardiovascular and musculoskeletal conditions.
"People were waiting for over a year for appointments to see physiotherapists or occupational therapists. That was unacceptable," he says.
Co-incidentally, as a voluntary group came together to develop its ideas for a community-based service, the then South East Health Board was reviewing its rehabilitation services.
Following this review, it awarded Ceart funding to operate as a pilot project delivering a rehabilitation programme to people with long-term physical health conditions.
Ceart opened in April 2003 with administration based in the old workhouse in Callan and therapies delivered from rooms rented from the nearby Camphill Community.
Last September, the administration and therapies moved into the renovated courthouse in Callan where they now operate. In the longer term, Ceart hopes to relocate to the workhouse in Callan which, when renovated, is also set to house a primary care centre and independent living units for people with disabilities in the Camphill community.
In the future, Ceart also hopes to develop programmes to help people self-manage their chronic conditions.
Julianne Maher, the project manager of Ceart, explains the philosophy behind the centre: "Our aim is to support people with long-term illnesses so that they can rebuild their self-confidence, maximise their quality of life and achieve their full potential despite having an enduring illness and/or chronic pain.
"People with chronic illnesses need time. Often they don't want to engage with the services initially because they are disillusioned with health services," she says.
"But we don't forget about them. We follow up with a call and it's usually on the second or third visit that things start to change for them."
Dr Crowley says that one of the key features of the centre is the teamwork approach drawing on the knowledge base of different disciplines.
"There is a different mindset when a health professional meets someone in the knowledge that they have the back-up of a team. You can tune into difficulties and explore them in a multidisciplinary team to find the best point of entry," he says.
"The relationship between the patient and the health professional has often been overlooked. But, at Ceart, we've rediscovered the value of that relationship.
"People learn to feel at ease about their problems and find ways to open up about them through psychotherapy or through art therapy. They sometimes don't get a whole lot better physically but they improve their coping skills and are healed in other ways."
Local GPs in the Callan area have found that patients referred to Ceart subsequently reduce the number of visits to their GPs.
Mary Hartery is one patient who has found great support from Ceart. A sufferer of arthritis for 20 years, she was becoming more withdrawn and less keen to go out to bingo or GAA matches.
"I had got to the stage that I couldn't move my arm and had bad pain in my feet, shoulders and hands. Although I was attending the local hospital, I wasn't getting any physiotherapy.
"When I came to Ceart, I began having physiotherapy every week over a year.
"The physiotherapist also taught me gentle exercises suitable for my condition," she says.
"I went to art therapy and relaxation classes and I'm much more positive now. I don't feel so alone anymore. The people at Ceart have shown me a way forward, given me back my confidence and helped ease my pain."
Robbie Lodge, physiotherapist to the Kilkenny hurling team, gives physiotherapy sessions at Ceart.
"The big difference in working here is that if we see someone who has emotional or psychological aspects to their condition, we can refer them to other team members," he says.
"I've seen how I can reach a block and can't move patients forward because they haven't been able to accept the physical deficit of their condition or the chronic nature of the condition.
"But, once they accept it, everything becomes easier. I practise routine physiotherapy and apply the same techniques as I would to players with injuries from a hurling match but the team dimension just makes me look at things differently."
As Ceart comes to the end of its fourth year of operation, an evaluation of the project is in process.
"We feel that we've exposed a need for such a community-based rehabilitation service," says Julianne Maher.
"As times goes on, we've had referrals from Carlow, Wexford and Waterford and we've set up an outreach service in Kilkenny city.
"We need more funding for what we do. But maybe, it's also time for services like ours to be replicated throughout the country."