The term Acquired brain injury (ABI) is used to describe injury to the brain that occurs after birth. There are 2 types of ABI. Traumatic Brain Injury (TBI) and Non-Traumatic brain injury.

Traumatic brain injury (TBI)

An injury that results from trauma to the head, commonly caused by road traffic accidents, falls, accidents at home, in work or from an assault.

Non-traumatic brain injury

An injury to the brain that does not result from physical force. Examples of causes of non-traumatic brain injury are poisoning, tumors, oxygen starvation from a heart attack or stroke, infections such as meningitis, or degenerative diseases such as Parkinson’s or Alzheimer’s.

Some common physical and cognitive symptoms of Brain Injury:

• Short and long term memory issues

• Personality changes- issues with emotions, speech, planning, behavioral issues, thinking

• Mobility issues- issues with coordination, walking, moving, balance

• Fatigue

• Spasticity - stiff or weak arms/legs

• Bladder and bowel problems

• Seizures

Areas that an Occupational Therapist at MedikOT can help individuals with TBI improve include:

• Independent Living Skills (feeding, dressing, grooming, bathing, toileting, functional mobility, sexual activity)

• Home management (money and medication management, meal preparation, shopping, house work

• Recreation (access to shopping, cinema, gym etc)

• Social skills (non-verbal skills, letting other person finish what they are saying, beginning and end conversations, behavior management)

• Cognitive functioning (memory strategies, visual perception, planning skills etc)

• Community re-entry skills (shopping, returning to work or school, driving, etc.)

What is cerebral palsy?

Cerebral Palsy is considered a neurological disorder caused by a non-progressive brain injury or malformation that occurs while the child’s brain is under development. Cerebral Palsy primarily affects body movement and muscle coordination.

Signs and symptoms of Cerebral Palsy:

1. Improper muscle tone occurs when muscles do not coordinate together. When this happens, those muscles that work in pairs – biceps and triceps, for example – may both contract or relax at the same time, impeding movement and coordination. Trunk muscles might relax too much, making it difficult to maintain a tight core; this can result in impaired posture and an inability to sit or to move from a sitting to standing position.

2. Movement, control and coordination issues

3. Impaired gross motor functions – limited capability of accomplishing common physical skills such as walking, running, jumping, and maintaining balance.

4. Impaired fine motor functions - limited capability to hold objects, feed self, write and difficulty using both hands simultaneously 

Areas that an Occupational Therapist at MedikOT can help to improve the functional independence of the person with Cerebral Palsy:

• Improve the child’s skills by adapting tasks, teaching & training or advise on appropriate assistive technology to maximize independence and increase participation

• Facilitate safe access to school and home environments by providing advice on structural building changes and/or equipment

• Computers with pre-programmed language (if they are unable to speak)

• Equipment to navigate transfers from a laying to seated position

• Computerized environmental control systems

• Specialized chairs that help maintain proper position for eating, breathing, bathing and school work or play

• Specialized feeding equipment

What is Autism?

Autism is a complex, lifelong developmental condition that typically appears during early childhood and can impact a person’s social skills, communication, relationships, and self-regulation. The Autism experience is different for everyone. It is defined by a certain set of behaviors and is often referred to as a “spectrum condition” that affects people differently and to varying degrees. 

Signs and symptoms of Autism:

Social communication and interaction:

• Poor eye contact and lack of facial expressions

• Delayed speech or does not speak

• Does not understand questions and directions

• Gets aggressive or disruptive

• Does not respond to his or her name

• Repeats phrases or words

• Resists cuddling and holding

Patterns of behavior:

• Repetitive movements like hand shaking, spinning or rocking

• Difficulty in body movement coordination

• Sensitive to light, sound or touch

• Self - harming activities such as head-banging

• Specific food preferences or food pattern

Areas that an Occupational Therapist at MedikOT can assist to maintain the independence of the child/person with Autism:

• Focusing on sensory integration and sensory-based strategies.

• Emphasizing mental health and wellness.

• Implementing emotional development and self-regulation strategies and programs.

• Recommendation for resources for peer groups, social participation, and play activities.

• Strategies for self-care routines to help with daily activities such as bathing, feeding, and grooming.

• Working on motor development

• Equipment and home adaptation for sensory regulation and safety

What is Arthritis?

Arthritis is a collection of conditions affecting joints and other tissues. It causes pain, restricts mobility and diminishes quality of life. 

Rheumatoid arthritis (RA) can affect people of any age including the very young. It is a condition where the immune system which usually protects us from infection starts to attack the joints. The most common joints to be affected are the small joints of the fingers and toes, wrists, elbows, knees as well and the neck and jaw.

Osteoarthritis (OA) is where the surfaces of the joints become damaged and do not move freely causing symptoms such as pain, swelling and reduced strength. Knees, hips and small joints of the hands are the most commonly affected by the condition.

Gout is a form of arthritis where small crystals form inside and around the joints. It can cause episodes of severe pain and swelling.

Symptoms of Arthritis:

Common arthritis symptoms are joint pain and swelling, reduced joint movement, weakness in joints and visible joint changes. These symptoms range in severity and can vary depending on the time of day. 

How can an Occupational Therapist at MedikOT assist in helping a person with Arthritis to maintain their functional independence?

• Meal preparation - including lifting pots and pans, using kitchen equipment such as knives and graters, opening jars and bottles, turning buttons for the oven, carrying plates or hot drinks

• Washing - including grooming items such as toothbrushes and razors, squeezing tubes and bottles or turning on faucets and showers

• Dressing and undressing - involving zips, buttons and fastenings, or putting on socks or tights

• Moving around the home - including managing the stairs, holding onto stair rails, getting on and off the toilet or up and down from other furniture such as chairs and beds

• Turning keys in locks

• Recommendations on splints to support the joints while working or resting

• Recommendations on and equipment and home modification too help increase functional independence in the home 

• Advice on planning and balancing daily activities with rest to reduce tiredness 

• Help, advice and resources on driving and mobility problems

• Relaxation techniques

What is Motor Neuron Disease?

The motor neuron diseases (MNDs) are a group of progressive neurological disorders that destroy motor neurons, the cells that control skeletal muscle activity such as walking, breathing, speaking, and swallowing. This group includes diseases such as amyotrophic lateral sclerosis, progressive bulbar palsy, primary lateral sclerosis, progressive muscular atrophy, spinal muscular atrophy, Kennedy’s disease, and post-polio syndrome. Normally, messages or signals from nerve cells in the brain (upper motor neurons) are transmitted to nerve cells in the brain stem and spinal cord (lower motor neurons) and from them to muscles in the body. When the muscles cannot receive signals from the lower motor neurons, they begin to weaken and shrink in size (muscle atrophy or wasting).  When the lower motor neurons cannot receive signals from the upper motor neurons, it can cause muscle stiffness (spasticity) and overactive reflexes. This can make voluntary movements slow and difficult. Over time, individuals with MNDs may lose the ability to walk or control other movements. 

Symptom of Motor Neuron Disease:

• Difficulty moving in and around the home arising as mobility deteriorates. Particularly getting up and down the stairs, using the bath or shower and getting on and off chairs, beds or the toilet.

• The legs and arms become stiff, clumsy, slow, and weak, making it difficult to perform tasks requiring fine hand coordination (grooming, feeding, cooking, writing etc.) and/or difficultly balancing and walking, increasing the risk of falls.  

• Challenges completing previous work roles as the condition and symptoms progress.

How can Occupational Therapists at MedikOT assist in helping the person with Motor Neuron Disease maintain functional independence?

• Providing advice on new techniques to continue to complete everyday activities such as dressing and meal preparation for as long as possible as the condition advances.

• Recommend appropriate durable medical equipment to help with difficulties such as getting in and out of bed, chair, tub, shower and toilet. 

• Recommend assistive devices to maintain functional independence and communication with others such as such as buttoning aid, enlarged handle for keys, adaptive utensils, transfer boards, manual Hoyer lifts for transfer to sophisticated devices such as mobility-assistive device (motorized wheelchairs), augmentative and alternative communication aids, computer access aids, automatic self-feeding device, and  environment control systems such as opening curtains, turning on lights or adjusting music or TV settings to be controlled from the wheelchair, armchair or bed.

• Making recommendations on home modification to ensure the home environment will meet both current and future needs and removing environmental obstacles to facilitate use of wheelchairs. These include adaptations such as resizing bathroom doors, installing an outdoor ramp, installing a wet room, installing a ceiling Hoyer lift and possibly a residential elevator as necessary.

• Advising on energy conservation and fatigue management techniques whether it is help managing work roles, parenting or day to day living tasks. 

• Recommendation of the use of day/night hand splints, prone stander desks for children to prevent knee and hip contractures and facilitate better positioning. An adapted seating system is also useful for the prevention and management for spinal deformities, which in turn help preserve a better cardiopulmonary function. In addition to proper seating adaptation, various seating cushions or mattresses  can also provide comfort, pressure relief and improve function.

What is Multiple Sclerosis (MS)?

Multiple sclerosis is a disease that impacts the brain and spinal cord which make up the central nervous system and controls everything we do. The exact cause of MS is unknown, but we do know that something triggers the immune system to attack the brain and spinal cord and disrupts communication signals to and from the brain causing symptoms such as numbness, tingling, mood changes, memory problems, pain, fatigue, and/or paralysis. Some people with severe MS may lose the ability to walk independently or at all, while others may experience long periods of remission without any new symptoms. 

Other symptoms of MS include:

• Tremor, lack of coordination or unsteady gait thus difficulty with mobility and getting in and out of the house

• Numbness or weakness in one or more limbs that typically occurs on one side of the body at a time, or legs and trunk making it difficult to walk and/or attend to personal care

• Vision problems are also common, including partial or complete loss of vision, usually in one eye at a time, often with pain during eye movement, double or blurry vision.

• Slurred speech

• Problems with sexual, bowel and bladder function

• Cognitive difficulties. Multitasking, concentrating, and learning may become harder. Remembering things or making proper judgments may also be difficult.

How can an Occupational Therapist at MedikOT help a person with MS maintain functional independence in their home?

There are many options for those dealing with symptoms that interfere with daily activities. Some modifications include:

• An anti-glare filter on a computer or maximizing contrast and font size on a smartphone can help with vision problems. Increase background contrast. Use black on white. Or apply bright colors (e.g., markers, tape). Increase illumination. Using different types of light sources, color temperature, softness, and reduce background pattern. 

• Everyday tasks such as dressing or brushing teeth may need to be re-learned. Teaching new ways of performing dressing, washing, grooming and hygiene.

• To prevent fall risks, recommendations for making the home safer by rearranging furniture or adding lighting to a dark staircase and removing clutter or rugs. 

• Making recommendations on home modification to ensure the home environment will meet both current and future needs and removing environmental obstacles to facilitate use of wheelchairs. These include adaptations such as resizing bathroom doors, installing an outdoor ramp, installing a wet room, installing a ceiling Hoyer lift and possibly a residential elevator as necessary.

• Advising on energy conservation and fatigue management techniques whether it is help managing work roles, parenting or day to day living tasks. 

• Ensuring the correct seating and wheelchair are provided to maximize function and independence

• Recommend assistive devices to maintain functional independence and communication with others such as such as buttoning aid, enlarged handle for keys, adaptive utensils, transfer boards, manual Hoyer lifts for transfer to sophisticated devices such as mobility-assistive device (motorized wheelchairs), augmentative and alternative communication aids, computer access aids, automatic self-feeding device, and  environment control systems such as opening curtains, turning on lights or adjusting music or TV settings to be controlled from the wheelchair, armchair or bed.

What is Parkinson's Disease?

Parkinson's disease is a progressive nervous system disorder that affects movement. Symptoms start gradually, sometimes starting with a barely noticeable tremor in just one hand. Tremors are common, but the disorder also commonly causes stiffness or slowing of movement. In the early stages of Parkinson's disease, the face may show little or no expression. The arms may not swing with walking. Speech may become soft or slurred. Parkinson's disease symptoms worsen as the condition progresses over time.

Symptoms of Parkinson's Disease:

There are four primary motor symptoms of Parkinson’s disease:

• Tremor - tremors in the hands may make it difficult to eat, holding utensils, brush teeth and hair, write and type, put on make up, dress or wash self, manipulate buttons and zippers, open lids, turn keys, drive or cook and attend to household activities. 

• Rigidity - making it difficult to move arms and legs due to increased stiffness of the muscles. 

• Slow movement - movement may slow down making simple tasks difficult and time-consuming. Steps when walking may become shorter and feet may start dragging and shuffling causing increased risks of falls and injuries. It may be difficult to get out of a chair, bed, tub, shower, or on/off the toilet, walk, getting in and out of a car, walk on the stairs or perform work and hobbies. 

• Balance difficulties/postural instability - More pronounced in the later stages, postural instability includes the inability to maintain a steady, upright posture or to prevent a fall. Such balance problems in Parkinson’s Disease are associated with a tendency to lean forward (list) or fall backward (retropulsion).

• Speech changes - You may speak softly, or it may start off strong and then fade away, may become slurred or hesitate before talking. 

How can an Occupational Therapist at MedikOT maximize a person's functional independence with Parkinson's Disease? 

• Teaching new ways of performing dressing, washing, grooming and hygiene.

• Recommend appropriate durable medical equipment to help with difficulties such as getting in and out of bed, chair, tub, shower and toilet. These may including chair risers or riser recliner armchairs, tub bench or battery operated bath lifts, raised toilet seats or bidets and grab bars. 

• Making recommendations on home modification to ensure the home environment will meet both current and future needs and removing environmental obstacles to facilitate use of wheelchairs. These include adaptations such as resizing bathroom doors, installing an outdoor ramp, installing a wet room, installing a ceiling Hoyer lift and possibly a residential elevator as necessary.

• Recommend communication devices such as low-tech options, can include an alphabet board that people use to spell out the words that they want to say, or a whiteboard, notebook, or index cards to write the words.  High-tech options can include specific apps on an iPad or the text-to-speech features on a smart phone.  

• Domestic skills: Meal preparations, housework, and shopping may be affected due to loss of coordination and balance, and a reduced ability to multitask. Small items of equipment may be introduced to help promote domestic skills, such as non-slip latex for easier jar opening, lever taps to reduce effort when using taps, and a wire mesh to help drain pans or vegetables. Extra assistance for housework such as ironing, maintenance tasks, and management of paperwork may be required.

• Making recommendations to access local resources/support groups to reduce loneliness and isolation and improve cognitive and mental health, improve mood and also exercise groups to maintain endurance, muscle strength, coordination and balance. 

What is Alzheimer's/Dementia?

Dementia is a general term for a decline in mental ability severe enough to interfere with daily life. Alzheimer’s is the most common cause of dementia. 

Alzheimer's - Alzheimer’s is a degenerative brain disease that is caused by complex brain changes following cell damage. It leads to dementia symptoms that gradually worsen over time. As Alzheimer’s advances, symptoms get more severe and include disorientation, confusion and behavior changes. Eventually, speaking, swallowing and walking become difficult. 

Dementia - Dementia is not a normal part of aging. It is caused by damage to brain cells that affects their ability to communicate, which can affect thinking, behavior and feelings. Dementia describes a group of symptoms associated with a decline in memory, reasoning or other thinking skills. 

Symptoms of Alzheimer's and Dementia:

• Having less energy to do things

• Less interest in work and social activities and spending more time just sitting, watching TV, or sleeping

• Personality changes

• Memory issues

• Language problems, like trouble putting thoughts into words or understanding others

• Mild coordination problems, such as trouble writing or using familiar objects, issues with sequencing, planning and organizing

• A hard time with everyday tasks, such as following a recipe or balancing a checkbook

• Mood swings that involve depression 

• Trouble with driving, like getting lost on familiar routes and wandering

• Problems with judging distance for example on the stairs

How can an Occupational Therapist at MedikOT help a person with Alzheimer's and Dementia to promote independence?

• Fatigue management, as extreme tiredness is a common problem with Dementia

• Remediation–While Occupational Therapists will not be able to restore cognitive abilities, they can use physical and cognitive exercises to help improve the daily lives and design memory strategies with routines. Memory strategies such as to help manage short term memory loss and to help with daily structure, such as medication reminders, routine planners, bed alarms and wandering alarms and orientation strategies 

• Reminiscence work to help manage long term memory loss

• Routine planning, to help structure the day and provide stability

• Home modification to create a safe home environment, such as using assistive technology like door alarms, labeling doors, maintaining a familiar environment, adaptations to the home for safety with mobility, personal care and to reduce falls or other injuries such as forgetting to leave the gas on and recommending mobility equipment.

• Ensuring that the wellbeing of the caregiver is being met, offering information about societies and networks available.