Ms. Sarah Solomon
Occupational Therapist, Calvary Healthcare, Bethlehem
Best practice models of care
Sarah Solomon is the senior Occupational Therapist (OT) at the State-wide Progressive Neurological Diseases Service (SPNDS) at Calvary Health care Bethlehem in Melbourne Australia. SPNDS is recognised for providing specialist care to people with MND. Services provided include neurological and palliative consultancy, symptom management, neuropalliative rehabilitation and end of life care. Sarah is also a consultant OT in the field of Electronic Assistive technology (EAT) for a technology supplier called Zyteq. www.zyteq.com.au.
Sarah graduated from Curtin University (Perth, WA) in 1995. She has worked in Perth, London and Melbourne in many fields. In 2007 she started working at SPNDS and realised how important quality of life interventions were for people living with progressive neurological conditions. She has a passion for ensuring people with MND can live their best life within the changes occurring. She has lectured at universities and presented at many conferences on OT and MND in a variety of topics.
In a strange twist – in 2012 Sarah’s mum was diagnosed with MND so Sarah went home to care for her until she died. This has given her a unique and special insight into the challenges of living with MND.
OT for people with MND: Adjusting and adapting to rapidly changing function
Occupational Therapy (OT) has an important role in helping individuals and their families ‘adjust and adapt’ to the impact of a progressive neurological disease. MND is a rare and rapidly moving disease which requires a flexible and responsive approach to intervention. We often encounter OTs in the community who report they lack confidence and/or skills to manage the needs of individuals with progressive neurological conditions especially Motor Neuron Disease. This can be a confronting and demanding area of practice.
We hope by sharing our experiences and knowledge in the area of neuropalliative rehabilitation we may assist our OT peers in understanding the specific care needs of this challenging population. The presentation will focus on a best practice model of providing care and intervention for people with Motor Neurone Disease. MND is an incurable condition and the subsequent resulting disability has a massive impact on all aspects of a person’s being and ability to participate in previously held life roles. Rate of disease progression can be rapid requiring a flexible and responsive approach. Working in this area of care provides many challenges including:
• Constant change in functional abilities.
• Accessing funding, carer demands and specialised equipment needs.
• Grief, loss and emotional adjustment to devastating diagnosis.
• The understanding of MND phenotypes to guide clinical reasoning
CONCLUSION / TAKE HOME MESSAGES
• Clients with MND require a flexible, responsive and ongoing OT input.
• The rapid progression of this disease results in significant functional decline.
• There may be limited time to adjust to change before next change occurs.
• Vast array of presenting deficits depending on phenotype and onset location.
• Individual reactions to diagnosis may differ greatly – introduction of aids and equipment may require gradual introduction, gentle discussion and negotiation.
• Large challenges for funding equipment and supports in a timely manner.
• Huge psychological adjustment to neuro- palliative diagnosis for the individual and their significant others.