THE ROLE OF OCCUPATIONAL THERAPISTS
THE ROLE OF OCCUPATIONAL THERAPISTS
While many of the signs and symptoms of PSP, CBD and MSA appear similar, understanding the issues specific to each disease can help occupational therapists develop and implement more successful treatment strategies.
Progressive Supranuclear Palsy( PSP)
Treatment Strategies
• Patient and caregiver education about disease
• Caregiver training in assistance techniques
• Prism glasses for double vision
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Fall prevention training
• Focus on the importance of always scanning the environment( via a downward head tilt) during all functional mobility and ADL in both in the home and outside in the community
• Appropriate assistive devices; swivel-wheeled rollators with brakes generally work well
• Teach safe turns during ADL training( i. e., in the kitchen during meal prep and in the bathroom during self-care)
• Using U-turns in open areas in the home or when out in the community
• Always avoiding pivot turns or crossing one foot over the other to turn; instead move right foot first to turn right, left to turn left
• Home modifications / adaptive techniques / compensatory strategies / AE / DME
Compensatory Tips
• Always use a wide and staggered stance while performing all ADL tasks
• Use a shower bench with back and grab bars to eliminate LOB and to promote good posture and energy conservation
• Use a hand-held shower to eliminate turning while removing soap / shampoo
• Use a long-handled sponge to eliminate bending over and potential LOB
• Use liquid instead of bar soap to compensate for decreased coordination
• Install nonskid surface into tub / shower( nonskid strips)
• Tilt head down to assist with lack of downward eye gaze during all functional mobility and ADL, especially eating
• Always dress in a seated position to eliminate LOB
• Raising the height of plate / bowl to face level during meals to compensate for lack of downward eye gaze
• Use of rocker knives, deep spoons and food guards to assist with self-feeding skills
• Reduce background distractions
• Break down tasks to one step at time
• Allow for increased response time
• Try to face the patient when communicating and restate for clarification during conversations
• PT and SLP consultations