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Occupational Therapy

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"Shmoozin' with Susan"
An Occupational Therapist's Perspective
 
 
 
 
 
 

A monthly column that is educational, informative, and entertaining to help understand and manage various topics and situations often encountered.

 

Susan Dorne is an occupational therapist licensed in the state of Florida, with over 20 years experience.  Susan also has MS.  Through the years, Susan has been an active volunteer in the MS community for various MS and healthcare organizations.  As a healthcare professional and an individual with MS, Susan can validate much of the information that will be shared.

 

This column is not intended to be a substitute for professional and medical treatment, diagnosis or advice.  Any information shared that is of personal interest should be discussed with your physician/healthcare professional.

 
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Please read the articles found below
 
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How Many Days until the Holidays?

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By: Susan Dorne, OT

Written: November 11, 2009

 

Each year I am always amazed how quickly time goes by. Once again I’m asking myself “How Many Days until the Holidays?  Didn’t we just finish shopping, having our dinners and going to parties? Well, here we go again!

 

Now is the time to get started. I thought I’d share some ideas to help conserve energy, simplify things and how to keep a calm mind!

 

Shopping….

 

For most people, shopping is preferred in stores. Although this can be challenging for some, there are ways to make it more manageable. Shop during the part of the day when your energy is at its best. The earlier you go, the less people there likely will be. Take into consideration weather, traffic and all that you have to do for that day. Space out what you need to do whether it’s shopping for gift, decorations, food, etc. so you don’t overdo it.  You can also call the stores ahead of time to make sure items you want are available.

 

Some people, like me, enjoy shopping online. I find it to be the easiest way to conserve energy, avoid frustrations, and find things I would never find in stores. Online shopping eliminates traffic, difficulty parking, dealing with crowds, standing in lines, (which only get worse as the holidays get closer) and of course after all that, needing to go somewhere else or simply drive back home. You’ll be surprised how easy it is to shop online by store name or key words and many have already started their holiday deals. You can also always check for discount coupons/promotional codes for other deal opportunities year round as well.

 

Holiday Meals …..

 

Simplify what you have to do for homemade food. Start by purchasing pre-cut/sliced/chopped and already prepared food items and add them to your homemade dishes. It’s one way to take out some of the unnecessary prep work involved. Prepare a little at a time, freeze as you go when cooking/baking early and get other family members or friends involved. You may also want to take into consideration if what you’re providing has to be homemade.

 

Another suggestion is to make the holiday meal pot luck. You certainly don’t have to do everything and guests typically don’t mind contributing. Avoid unrealistic expectations; you may have to change your own expectations and/or the expectations of others. Hire help, have everyone pitch in, change locations, and try to keep it simple.

 

Use paper and plastic so everything can be disposed of rather than washed. These goods come in all shapes and sizes and complement all occasions and decorations.  I also suggest using a disposable tablecloth, it makes cleaning a table so easy. Simply remove whatever you don’t want thrown away, then roll it up and toss it out. No crumbs to worry about there!

 

Overall

 

No matter what you are going to do, you need to prioritize. Give yourself permission to say no and ask for help. Plan ahead to help eliminate stress and deal with the unexpected.  Remember to work around your limits and do not overdo it as you may pay the consequence in the end.

 

Let the holidays be a time that you can take pleasure in, being with people is healing.  Do whatever it takes so that in the end you enjoy yourself and the significance of the holidays.

 

Warm Wishes This Holiday Season,

Susan Dorne, OT

 

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Home Safety

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HOME SAFETY - by Susan Dorne, OT

One of the biggest concerns I have as a health care professional is the safety of people. It’s amazing how many barriers are around us, many of which we are not aware of. For people without deficits, they can usually maneuver around obstacles with little or no harm or even thought for that matter.  However, when you have MS and your vision, mobility, balance, strength, endurance, and sensation may be affected, consequences are often inevitable.  It never ceases to amaze me when people reply “I Know But…” when I try to address potential safety risks and make recommendations.

To begin with, get rid of throw and area rugs as they are a significant safety hazard and one of the biggest causes of falls. It is best to use skid resistant rugs and mats to avoid the rug from sliding or folding over.

Flooring can be tricky. Tiles can be slippery while rugs can make mobility difficult. Challenges with rugs can occur when you have weakness in the legs or feet, fatigue, limited endurance and use of different mobility aides (such as a cane, rolling walker and a wheelchair when you have to push yourself). Choose flooring that best suits your needs and don’t be discouraged if you have to change it later on. No matter what, you always want to be aware of the surface you are walking on in and outside the home.

Rooms should be clutter free. Arrange furniture so that it is easy to move around safely and take into consideration any walking devices or wheelchairs/scooters used. Move cords so they are not in the way and make sure there is easy access to good lighting at all times. Use night lights for areas you go to regularly especially the bedroom, bathroom and hallways.

Couches, chairs and beds should be at a proper height to get into and out of easily. These surfaces should be at height equal to the back of your knees (use cushions or pillows to raise the surface), chairs with arm rests are easier to use, and avoid wheels whenever possible. Beds can be against the wall to serve as a protective barrier if there is a risk of falling off the bed during sleep. A side rail can be used for the open side if need be.  If you use a wheelchair, you will need 4 ½ feet on one side of the bed for access.

A common place for falls is the bathroom. Grab bars are used to maintain balance in tubs, showers and by commodes/toilets. They come in various shapes, sizes, and colors and I strongly suggest having them installed by a licensed and insured company or individual. Towel racks and soap dishes are not intended to be used as a supportive device as they are slippery and can easily break from the wall. There are also portable grab bars (attached by rubber suction) to use for stability in other places and rooms, if you’re renting, or to take when traveling.

Shower chairs and tub benches are used to help with limitations in standing, mobility, and fatigue. If a tub bench is required, you will need to remove shower doors and install a shower curtain. Whenever a shower curtain is used, make sure the shower rod is bolted or screwed into the wall and the clips attaching the curtain to the rod are sturdy. A hand held shower hose provides easier showering. Non-skid mats and strips are used inside tubs and showers as well as outside for drying off.

Sensory deficits are important to be aware of and to take proper precautions. Set your water heater thermostat to 110 degrees or lower to help prevent scalding. It is best to test water temperature by touch and if you are experiencing numbness, I encourage you to purchase a water thermometer. In addition, proper care must be taken while cooking.  Be aware as handles get hot, food splatters, oven racks and sides get extremely hot as well as all baking and cookware. Eliminate or minimize use of sharp objects (this is important for visual deficits and hand weakness as well). Some examples include: purchase pre cut foods to minimize using knives; use electric razors, and use blunt scissors instead of sharp ones (if you must use them at all).

Another issue I want to emphasize is the importance of using an assistive device if you are advised to use one. Walls, furniture and counter tops do not count as assistive devices so stop using them! Do not get a walking aide and use it without proper assessment, sizing and instruction from a therapist.

The information provided are just some examples of how you can have a safe environment at home. An occupational therapist (OT) can do a full home evaluation where suggestions and training will be made based specifically on your needs.

If you’re ever in doubt whether you can or should do something, wait until you have another person is available. It’s important to always ask assistance whenever possible regardless of the situation and don’t be afraid or embarrassed to do so.

I look forward to hearing from you with your ways of staying safe.

Regards,

Susan Dorne, OT

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ENERGY CONSERVATION TECHNIQUES

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My last article addressed fatigue and I referred to energy conservation techniques as important methods in managing fatigue. Although I submitted an article January of 2007, I have provided additional information and recommendations in the continuation of what we can do in dealing with the effects of fatigue.

Energy conservation techniques are ways to use energy more wisely, more efficiently. They are important actions to help limit and/or avoid fatigue. It is important to be proactive and incorporate techniques and strategies in your daily lifestyle to help manage the things you want and need to do.

Prioritize

Accept the fact that you can’t do everything even though you thought you could before. If you, or others around you, have expectations that exceed your abilities, then it’s time to reset those expectations. You need to take care of the necessary obligations related to home, work, even within the community and do what is required regarding those obligations. You want to take care of the tasks that are urgent, time sensitive or essential to your responsibilities. Concentrate on the things that must be done and consider it an additional benefit if you’re able to do a little more.

Plan Ahead

Break down tasks and prepare as much ahead of time whenever possible. This will help deal with the unexpected. Planning ahead will also help avoid rushing and allow you to work at a more relaxed pace. Consider combining or eliminating unnecessary steps to make things easier. This can help with your productivity as well.

Assess your energy level throughout the day. Then take into consideration the best time of day to do your activities that require the most amount of energy. Make a timetable to include all the activities you need to do on a daily and weekly basis (i.e. cook, clean, shop, laundry etc.) and follow a planned schedule as much as possible. Review the value attached to the activity or task to help determine the strength and endurance needed. When symptoms make it difficult to participate in something or complete a task, take the time to consider if it is something that must be done now or if it is something that can wait.

Calendar your events so work, activities and appointments are spaced out. You want to give your body with enough time during each day to be free from any obligations and given a chance to rest. Alternate your responsibilities and your work load to ensure use of energy is properly distributed throughout the day.

Learn Your Limits

Most people learn their limits through the use of trial and error. This allows you to see what you can do and when according to your needs and abilities within different environments. While you test your limits, it is important to take into consideration the necessary resources available for safety. Examples of resources include having another person with you, using an assistive device such as a cane, walker or scooter, or just knowing where there is a place to rest.

It is important to learn to stop before you get to the point of overdoing it. Do not push yourself to do too much at one time and be careful not to overextend yourself especially when you feel you are having a “good” day. Overdoing it can set you back and make you pay the consequence of it later. Learn to pace yourself especially when you have a lot to do.

Simplify

When you simplify tasks, you take into consideration alternative ways to do things. Assess what you need to do and think about ways to make tasks easier, requiring less energy. Eliminate unnecessary steps and combine steps whenever possible. A great way to remember simplification is thinking about KISS… Keep It Simple Silly!

Some examples to simplify tasks while meeting your needs include:

Shopping:

Shop online or by catalog. This will save time and energy by eliminating having to drive around to various stores to find what you want, avoid parking challenges, eliminates walking around stores and standing in lines, and you don’t have to worry about having enough energy to get yourself home! If you prefer to shop in stores, go early in the day. You can always call the store ahead of time to make sure the item(s) you want are available. When possible, make a list of what you need so you can stay on track of your shopping needs. It’s so easily to get distracted which can burn extra energy.

Meal Preparation:

For food items: use foods that are pre-cut, sliced and diced, consider already prepared foods that only need to be heated (often some grocery stores have food already hot that you can pick up and serve), frozen food – either from stores or extra food you have previously made, and you can use delivery service or pick up meals from local restaurants. Additional ways to simplify in the kitchen are to use disposable paper and plastic ware for easy set up and clean up, and to use electrical appliances such as can openers, blenders, and dishwasher instead of doing these things manually.

Schedule Rest Time

Rest is the best defense against overdoing it. The goal is to schedule as much rest as you can, as often as you can. It can be five minutes or 1 hour, the time doesn’t matter as much as the quality although every bit does help. Rest is an opportunity for you to turn your mind off and let your body relax. No need to feel as if you need to take naps throughout the day, just find an opportunity for quiet time. Read a book, listen to music, do nothing! Whatever it is, just take time for YOU.

Communication

Only you can decide who to tell, what to say, and how to say it. You will find that once people understand your situation, they have a better understanding of what your needs are and can be available to help. Take time to educate, a little bit at a time.

Rely On Others

Once people are informed of your situation, you will be able to build a support system and use your resources (friends, family, co-workers, community members etc) to help as needed. Don’t be afraid to ask for assistance or to delegate duties to others. You will find that people will be happy to help. Remember, you are part of a team at home, at work, and within your community. You would do the same for them, wouldn’t you?

There are many ways that we can conserve energy. I encourage you to use our blog section to share your thoughts and ways that you conserve energy. We learn best from others in our own situation. I look forward to hearing from you.

Take it easy!

Susan Dorne, OT

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Understanding Fatigue

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February 2, 2009

Fatigue is a normal response that occurs as a result of dealing with the countless responsibilities we have each and every day. Fatigue is a lack of energy and is not the same as feeling sleepy or drowsy. However, MS fatigue is different and is often one of the most challenging symptoms.

Fatigue is one of the most common symptoms of MS, affecting 80% to 95% of all people. It is a result of a lack of physical energy, mental energy or both. Fatigue can vary from just needing a little rest to significantly impacting everything you want and need to do. It is also one major reason for unemployment among people with MS. Fatigue is one of the ‘invisible’ disabilities which make it difficult for family, friends, employers, and even some doctors to understand the impact.

MS fatigue can be broken down into two types: Primary Fatigue and Secondary Fatigue.

Primary Fatigue is of the disease process itself. Common terms used for this occurrence is “short-circuiting” or “localized” fatigue. As a result, nerves of individual muscle groups are affected and tire with use. For me, it can feel as if I have been ‘unplugged’. The affect can be toward the whole body or a particular part.

Secondary Fatigue is not caused directly by the MS disease itself; it is usually a result of other MS symptoms or from the affects of external factors.

Although there are several factors that can cause and/or impact fatigue, I thought I would provide some of what I find to be the most common causes. This will include weakness, heat, sleep deprivation/disturbances, medication, and stress.

*Weakness entails the use of greater effort, requiring more energy output. As a result, muscles will fatigue faster during continued use as nerve fibers that have been affected by demyelination interfere with signals to the muscles. In addition, the ‘stronger’ areas work harder to compensate for the weakness you are experiencing.

*Heat alters nerve conduction. MS is a disease that affects nerve conduction so when heat is added, nerve conduction is less efficient and often completely fails.

*Sleep deprivation/disturbances can make a significant impact in energy levels. Common problems include spasms/spasticity, pain, anxiety, frequent bathroom needs, depression, stress, and side effects from medications (such as steroids which can make going to and staying asleep difficult). When something interferes with the ability and quality of sleep, especially on a frequent basis, it can lead to fatigue, sleepiness, and poor mental and/or physical performance.

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Medication can not only interfere with sleep but can also be the cause of fatigue and/or drowsiness as a result of side effects.

*Stress plays a crucial role, although there is no solid scientific evidence that it either causes MS or makes it worse. What is known, however, is that stress can make people feel badly and make symptoms worse. I have written an article recently in this column that you can refer to for additional information on stress and stress management tips.

Because there are many causes of fatigue and many ways it can affect you, I suggest writing/journaling about what you are experiencing. This is a useful tool to provide information to you and well as for your doctor. I recommend including information such as: What activities or exercises bring it on, what makes it better/what makes it go away, what time of day does it impact you the most, and how long does it last? I encourage you to provide as much detail as possible without going overboard! Continue to monitor your fatigue even if you start a medication or alternative treatment to determine its effectiveness.

Although there isn’t a universal treatment for fatigue, there are many options. There are several medications available that your doctor can prescribe. In addition, there are ways you can help yourself, here are a few suggestions:

1)Learn and use energy conservation techniques—this will help you use energy more efficiently

(I have provided an article in the past on Energy Conservation Techniques which will give you detailed information and ideas. It is located in the Library of MS Archives- type it in the search box. I will also be reposting it again as well);

2) Exercise-- to maintain and increase strength, improve weakness, and increase endurance;

3) Learn and incorporate relaxation techniques in your daily routine;

4) Limit heat exposure and take the necessary precautions when affected by it;

5) Learn to say no!

We all have to learn our limits, this is something I tell everyone whether or not they have MS. We have to realize we can’t do it all and need to prioritize things. Having MS makes it more difficult, as we know. It’s all a learning process and what may work well one time may not another. Do the best you can to educate yourselves and see what you can do differently.

As the saying goes, “Take Things One Day at a Time”. When you do your best, it’s always good enough. You may not be able to deliver someone else’s idea of the best but that is not your burden. You only need to take care of your responsibilities and fulfill your own potential.

As always, I encourage you to add comments and questions. Share your ideas; we learn best from others who can ‘relate’ to our needs.

All My Best,

Susan

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Setting personal Goals for the New Year

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Greeting the New Year

Setting Personal Goals

Many people enjoy ringing in the New Year and use it as a time for reflection and a time to look toward the future. However for many, it can be a difficult time as they are faced with challenges that impact their lives and uncertainties for the future.

As we look toward the year ahead, we have a tendency to set resolutions, to look at things we can do differently to better ourselves and/or others. For me, setting resolutions was something I would try to do annually but I was finding that most of the time they seemed to be the same ones. At one point I decided to create ‘rollover resolutions’…..why try to set more when in all actuality, they were just the same old ones said differently! Now I’m approaching this in another way, I have substituted resolutions with personal goals.

So what exactly do I mean by that? I will set one long term goal and a few short term goals (one or two) to get me started. Then as the time progresses, as I meet my goals (short term and long term) I set new ones, or modify them accordingly to enable me to reach my desired outcome. I know that with having MS, there are a variety of situations that can impact my life and change my course. I know there are also additional factors that come to play as well, such as changes in the economy, home, work, family, kids and so on. Not only is MS unpredictable, so is life! As a result, goals will change, just as life changes.

Goals need to be realistic, obtainable and rewarding, and I emphasize they can, and should be, modified appropriately. To start with, I suggest creating a list. Identify what you want to do or accomplish, break them down and form them in to short term goals. Find within that list something that provides an end result—that will be your long term goal. Once you identify your short term goals, they will be your steps toward reaching your long term goal. Remember to keep it simple. Be aware that you may not be able to accomplish everything on that list this year and that’s okay. We have plenty of time and plenty of opportunities.

If you would like some suggestions for setting goals or would like to share with others what you are doing, please post on our blog section.

I wish you a year of good health and happiness.

Regards,

Susan

Getting Ready for the Holidays

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Written - Nov. 24, 2008

Tis’ the season to be jolly….overwhelmed and exhausted! Yes, it’s that time again, already!  I am surprised every year how quickly the time has gone by and what little time there is to get ready for the holidays. There is so much we need to think about: gifts, attending parties, entertaining, visitors, decorating, and so much more.

 

I thought a great place to start would be shopping for gifts.  This is something I do all year long, let me explain. When I see something that makes me think of someone in particular, I buy it. Then I put it away and save it for their gift (ok, sometimes the timing may fall in time for the birthday but that’s ok, at least that’s taken care of).  I make a list, especially if I’ve already bought something, so I can remember what I have and what I still need.

 

I also suggest shopping online. I have done it for many years and have found it to be safe to do. It is much easier to find different items without having to drive around. Think about it, first you have to be able to drive to all the different places and then find a place to park which gets harder as the holidays get closer. If you do find a space, you need to make sure you can walk in to the store, throughout the store, deal with the crowds, stand in lines, make it back to the car, and still be able to drive home! Online shopping takes away from that big inconvenience and eliminates that stress. This also gives you the opportunity to shop for unique items that would be difficult or impossible to get in stores. I ‘Google’ different words relevant to the person I’m shopping for or I simply put in different words that take me to various sites that give me great ideas.  A little secret I like to share is to search for discount coupons or promotional codes for the store or website name.  You’ll be surprised what you can find.  I often get questioned about shipping costs but the way I look at it, with the price of gas and the cost of my energy, it’s so much cheaper!  You may even find a code that covers the shipping cost as well.

 

Gifts can be as simple or as extravagant as you want. I’m finding that the simplest gift, one that someone can actually use, is the best.  I’ve always tried to avoid buying something for someone that would serve no purpose for them other than a great opportunity to re-gift it!  Homemade gifts are a great idea and can be given to anyone, especially during these challenging financial times. Some ideas are craft projects (don’t know any or enough, look online or at bookstore/library), baked goods, food baskets, even homemade holiday cards….. the ideas are endless and fun. You can get the kids involved too as they make special gifts for parents, grandparents and teachers.  Perhaps your family, friends, or co-workers will decide on gift exchanges to eliminate numerous gift giving. There are several types such as “Secret Santa”, “Yankee Swap” and “White Elephant”.

 

Entertaining?  Get help from children, friends, and family to decorate and prepare and keep it simple. Let people get involved with the food. Ask guests to bring something based on what your needs are, make it pot luck. Use paper and plastic so everything can be disposed of rather than washed. Hire help or have everyone pitch in.

 

Parties and Gatherings:  Determine what activities and traditions are most important to you.  Participate in the ones that are most meaningful, provide happiness and are less stressful.  Make sure there will be a place for you to rest.  Prioritize what you will do and know there may be times that you will have to decline or leave early, understand that it’s okay to do that.

 

Regardless of what you are going to do, plan ahead. Do a little at a time and the sooner you get started, the better.  Remember to work around your limits and do not overdo it as you may pay the consequence in the end. Let the holidays be a time that you can enjoy, being with people is healing.  Avoid unrealistic expectations and don’t be afraid of creating new traditions. Change locations, get people involved, do whatever it takes so that in the end you enjoy yourself and the significance of the holidays.

Be sure to post your ideas and feelings on our blog.

 

Wishing you a Happy and Healthy Holiday Season,

Susan

“Kneading” to Feel Better Through Massage Therapy

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Written: October 21, 2008 by Susan Dorne, OT

Oooh, Ahhhh……. No, this isn’t the start of a mattress commercial or any special phone call, they are expressions often uttered during and after a massage. As an occupational therapist I have provided massage as an integral part of treatment but there’s nothing like being the recipient of a full body massage. As an individual with MS, massage therapy is one of the best ways for me to help manage many of my MS symptoms including pain, spasticity, decreased flexibility and vertigo. Although there are several types of massage therapy available, I am only going to focus on Swedish Massage and Deep Tissue Massage.

There are several benefits to massage therapy. Massage therapy improves circulation of oxygen and other nutrients to body tissues and vital organs, relieves muscle tension and pain, reduces spasms and cramping, increases joint flexibility, improves range-of-motion, releases endorphins - the body's natural painkiller, and relaxes injured and overused muscles, just to name a few.

The most common kind of massage received in the U.S. is Swedish Massage Therapy. When I was scheduled for my first Swedish massage session, I was expecting a tall, blonde, blue eyed, tan man with a funny accent to come in and rub my back. Nope, that didn’t happen! Swedish massage is best known simply as massage therapy. The massage therapist provides gentle, relaxing smooth strokes, while kneading and making circular movements to the top layers of muscles. The intensity can be adjusted to your preference. This is good when you are getting massage for the first time.

Another massage technique is Deep Tissue Massage. This is intended to work on deeper layers of muscle and connective tissue. The massage therapist uses slower strokes or friction techniques across the muscle grain. This can be quite uncomfortable especially if you never had a massage before and/or if you are having symptoms from your MS including significant pain, severe spasticity, spasms or heightened sensory issues. In general, it is not uncommon for people to feel discomfort one to two days after a deep tissue massage so keep that in mind when considering this massage treatment.

Touch, in itself, is important to our health and well-being as the simplest touch from another can do wonders. Touch, like massage, can promote relaxation, improve sleep, and achieve some level of relief from what ails you.

A nice addition to your massage is aromatherapy. Aromatherapy can be added with oils and lotions. Essential oils (oils that come from the essence of plants) are inhaled and a chemical message is sent to the brain which elicits certain emotional responses. They have different healing properties including calming, uplifting, energizing, cleansing, and decongesting. Personally, I enjoy lavender oil for added relaxation! Be sure to share your experiences with us.

Find the right therapist for you. Share as much information regarding your situation, symptoms, medications, and goals you want to achieve. Massages can be performed privately or in outpatient treatment settings.

As always, I will keep you informed on different topics and anything else you request on a “knead” to know basis!

Susan

Bathing Safety

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Written: October 15, 2008
by Susan Dorne, OT

Did you know that the highest incidents of falls occur at home in the bathroom? They account for thousands of injuries in the United States each year. Working in a rehabilitation unit, I treated many people who had fallen in the bathroom and sustained broken bones, broken hips and other injuries which at times were very serious including head injuries.


In addition to the basic safety risks that naturally occur, we are also dealing with MS which adds to increased safety needs and awareness. A nice warm shower can bring upon fatigue from heat, standing, and from using weak extremities to cleanse ourselves. It can also trigger off dizziness from medications we are taking or simply aggravate that symptom you are currently experiencing. Often you need to stand for a longer period of time than what you are capable of doing which may make you lean on anything that’s around just to maintain your balance.


The first thing I want to emphasize is that towel racks and soap dishes are not considered assistive devices should not be used to lean on! I wonder just how many people are guilty of this! It is important to know that they are often attached to the wall by grout which over time and will loosen due to moisture and mildew. They are not made nor installed to hold a person’s body weight, just a towel or bar of soap. People also lean on the sliding glass door which moves and again, are not made for people to lean on.


An occupational therapist (OT) can do a home assessment. They assess your needs and will make recommendations that would work within your limitations to reduce barriers, promote independence, and increase safety.
Since getting an OT can be difficult at times, I wanted to share some suggestions with you. There are several devices and techniques that can help increase mobility, work around limitations, conserve your energy, and make a safer environment for you.


To begin with, shower and tub floors are slippery when they get wet. The risk of slipping increases as residue from soaps, shampoos, and even cleaners accumulates on the floor. Using a non-skid mat or textured strips/appliqués will help with traction. You will also need to consider some type of mat for when you exit but do not use a mat or throw rug that can easily slide. I also suggest that you dry off as much as possible before getting out.


Grab bars help to enter/exit the tub or shower, maintain your balance, and assist from sit ? stand whether from a seat or inside the tub. They should be installed at the entrance as well as on the long wall at the least. They come in various lengths and angles. I encourage you to use someone or a company who is licensed and insured for proper installation. If it is not installed correctly, there is the possibility that it can pull out off the wall and cause significant injury to you, as well as damage to the wall. Suction safety rails can be used on the wall and the side of the tub as well as the shower walls. They are particularly helpful when you travel or if you are unable to install grab bars.


Shower chairs or tub benches should be used if you have standing, balance, and dizziness issues. They will also help conserve your energy as well. A tub bench is important to use if you have difficulty stepping over the tub side. Both are adjustable in height and you want to make sure the seat is adjusted to touch the back of your knees. The benches and chairs have a variety of options to them including whether or not you want a back support or need built in arm supports. Do not use a walker or aluminum commode inside a shower or tub as the water will rust the device, cause “muck” and will compromise the integrity of the device.
Replace shower doors with a curtain if you are going to use a tub bench. You will need the extra space for leg clearance.


When you are seated you will need some items to get to the hard-to-reach areas. A hand held shower hose and long handled sponge will help with that. Liquid soap is easier to use than bar soap especially if you have any difficulty using your hands due to tremors and weakness. Another important issue has to do with lack of or decreased sensation. You will want to set your water heater thermostat to 110 degrees or lower to prevent scalding.


I am often asked how to go about getting these things and if insurance will cover the cost. Unfortunately, most, if not all of these items are not covered by insurances. The best thing you can do is contact your insurance company. There are many stores such as Target, K-mart, Wal-Mart, Home Depot, local drug stores, durable medical equipment companies, and several opportunities online to purchase them. I encourage you to shop around to find what best suits your needs and the best price.


Let me know if you need some additional online suggestions. Feel free to add any ideas that you have found helpful for you as well.


Stay safe.

Susan


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Stress Management

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by: Susan Dorne, OT

With this crazy thing called life, everybody will feel stressed out at one time or another, and sometimes it can feel like forever! There are countless reasons that can cause stress starting from the time we wake up to the time we go to sleep. Some stressors are ongoing such as work/job, marriage/relationships, children, and finances; some may be sudden such as loss of job or death of family member; and some stressors can be positive, such as getting married or getting a promotion.

Stress management simply refers to the variety of techniques used to control and reduce tension that can occur in potentially challenging, frustrating, and threatening situations. The fact is too much stress can be harmful, regardless if you have MS or not.

There is no solid scientific evidence that stress either causes MS or makes it worse. But stress can make people feel badly and make symptoms worse. For example, you may be under stress because of tension at work and you’re unable to sleep well or at all. You are already dealing with fatigue as a result of your MS and now you’re tired from interrupted or lack of sleep. As a result, your fatigue feels like it is getting worse.

Just like MS is different for each individual, how someone reacts to the same stress condition can be quite different. There are several techniques, approaches, and skills that can be used to manage stress. Current research suggests that managing stress well is important in managing MS well.

Realistically, eliminating stress out of your life is just not possible. However, you can learn how to cope in healthy ways. Do not try to make changes in your life because you think that it may cause stress and may make your MS worse. Make changes in your attitude and your emotional control so that you can approach stressful situations in a more positive way, with less of an emotional and physical response. Many people do not realize that stress is often created by what we think rather than by what has actually happened. It is believed that a significant amount of stress symptoms can be avoided or provoked by changing the way we relate to stressors.

Here are some tips to help manage stress:

Identify the sources of your stress (What do you worry about most? Is something constantly on your mind?),

Set realistic goals and expectations,

Recognize what you can change and work on accepting what cannot be changed,

Stay active mentally and physically,

Reduce the intensity of your emotional reactions,

Balance the various aspects of your life—work, relationships and leisure

Conserve you energy and utilize your time better,

Simplify and prioritize your lifestyle,

Learn to say “No”! Rely on others and delegate when needed,

Learn relaxation/meditation exercises,

Get help with hard-to-solve problems,

Share your stress- talk to others, join support groups,

Get enough rest and eat well,

Exercise- releases endorphins which enhance the immune system and provides fewer negative effects of stress,

And don’t forget to make time for yourself, have fun and maintain a sense of humor.


Experts say “Fat is bad for you, Sugar is bad for you, Caffeine is bad for you, but Don’t Worry, because that is bad for you too”!

To Ask a question to Susan or to leave a comment, please post it on our ms blog by clicking here

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How Can Occupational Therapy Help You?

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Many people are confused by the word “occupation” when it comes to occupational therapy (OT). When OT is offered as a treatment option, people often respond by saying “I don’t need to find a job”!

Actually, the word “occupation” refers to ‘everyday life activity’. Occupational Therapy (OT) is a healthcare profession that focuses on the performance of the broad range of occupations that make up a person’s life. OT promotes independence by improving skills and teaching alternative ways to help people stay active and enable them to perform the things they what and need to do.

Treatment is focused on helping people return the highest level of function in basic self-care needs which are referred to as Activities of Daily Living (ADL’s). ADL’s include eating, hygiene/grooming, dressing, bathing/showering, bladder management, toilet hygiene, functional mobility, personal device care, sexual activity, and sleep/rest. Additional intervention focuses on interacting within the environment by increasing skills and abilities for household and community activities. Some examples include cooking, cleaning, laundry, driving, shopping, child rearing, community mobility, financial management, and other homemaking tasks.

Purposeful activities are provided to create, restore, improve, and maintain skills and abilities to meet individual, family, and therapy goals. These activities will focus on improving several areas including (but not limited to) strength, endurance, range of motion, motor and sensory skills, balance, cognition, and visual deficits.

An occupational therapist can also determine the need for assistive devices. Assistive devices reduce barriers and promote independence. Assistive devices include dressing aids, bathroom equipment, household helpers, adaptive eating utensils, transfer devices, seating/mobility, and more. Training is provided for proper use and to ensure tasks are performed safely, easily, and as independently as possible.

Sometimes people are told by their physician that they need a splint or orthotic but many people don’t understand why. They are used for positioning, support, stabilization, mobilization, range of motion, reduction of pain and spasticity, contracture prevention, and independence in activities of daily living. Occupational therapists are often used to custom make or modify splints and orthotics.

A physician’s referral is required to receive occupational therapy. You will be evaluated by an occupational therapist and a treatment plan will be made. Your care will continue with an occupational therapist or occupational therapy assistant.

 

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