Occupational therapy for MND

✓Supports this

“An occupational therapist's assessment is how you find out what your current home can realistically become.”

The occupational therapy guide for MND puts exactly this job with the occupational therapist: assessing access to and around the home against both current and future needs. It also shows the assessment deciding what is possible, saying that not every home can take a through-floor lift and that an assessment is what determines whether one is feasible.

An occupational therapist should assess access to and around the home, considering immediate and potential future needs.

Access, page 33

✓Supports this

“Planning around needs that may come, rather than only current ones, is what stops a solution having to be redone.”

Says plans have to be made against short, medium and long term ability, and gives a worked example of what happens otherwise: a stairlift, which is a common answer to stairs, usually only covers the short to medium term because transferring on and off the seat gets harder as MND advances.

For example, installing a stairlift is likely only to meet short to medium term needs.

Getting up and down the stairs, page 31

✓Supports this

“Building extra accessibility in early usually costs less and takes less time than redoing the work later.”

States the cost and the delay together as the price of not planning, in the section on long-term plans for reaching an upper floor. It also says these plans need to be made earlier than people expect.

Failure to plan ahead can lead to lengthy delays and costly consequences in making necessary adaptations.

Getting up and down the stairs, page 31

✓Supports this

“Being able to live, sleep, wash and use the toilet without stairs is often what lasts longest as needs change.”

Works through the options for reaching an upper floor and lands on this one. It says a stairlift usually only covers the short to medium term, that not every home can take a through-floor lift, and that ground-floor living with a wet room is often the better answer for the long term.

in many cases, ground-floor living with appropriate wet-room adaptations can be the preferred long-term option.

Getting up and down the stairs, page 31

✓Supports this

“Asking about funding early matters, because both the funding decision and the work itself take time.”

Says funding has to be thought about in advance rather than once the need has arrived, and shows why with the main UK home-adaptation grant: the work can take months to be approved and completed, by which time the change may no longer suit the person, so eligibility should be looked at as early as possible.

Consideration of funding options in advance is crucial for anticipating needs.

Funding for equipment and adaptations, page 65

✓Supports this

“The occupational therapist is the person who assesses the home itself alongside the person's needs.”

The occupational therapy guide for MND gives this to the occupational therapist directly. It says the therapist should assess access to and around the home against immediate and future needs, and should be working out ahead of time what will be needed to keep the person doing the things that matter to them.

OTs should proactively anticipate what equipment might be required to enable the person with MND to continue with valued occupations.

Accessible home, page 32

✓Supports this

“Thinking ahead about what may help next is what leaves enough time for equipment to be in place before it is needed.”

Gives exactly this as the reason for planning ahead in MND: anticipating future needs is what creates enough time for the support or equipment to actually be put in place.

To reduce delays, the occupational therapist should anticipate and plan for potential future needs, to allow enough time for support or equipment to be put in place.

Timing of interventions, page 15

✓Supports this

“An occupational therapist assesses how you manage everyday activities and recommends equipment matched to your own needs.”

An occupational therapy guide for MND endorsed by the Royal College of Occupational Therapists. It describes the point of the assessment as working out what a person can do and needs in daily activities, and lists timely provision of adaptive equipment as part of the therapist's job.

The goal of assessment is to analyse a person's strengths, skills, and needs in performing daily activities, considering how the environment influences them.

Assessment and outcome measures, page 12

!Qualifies this

“The right adaptive tool can let someone carry on doing everyday activities such as eating, dressing and washing for themselves.”

Agrees that equipment can maximise independence, but adds that as MND progresses a person is still likely to need help with personal care. So tools extend how long you can manage a task yourself rather than removing the need for support.

Equipment and adaptations can maximise independence but as the disease progresses, the person is likely to need support to manage their personal care.

Personal care, page 40