I disagree that we can offer more to client's with physical problems than cognitive. As a neuro OT I work primarily with cognitive and perceptual problems. As an OT working with Older people I worked with many parkinson's clients with a recent diagnosis who exhibited mild cognitive impairment. Perhaps in the USA it is different?
> -----Original Message----- > From: Mike [SMTP:[EMAIL PROTECTED] > Sent: Wednesday, 3 December 2003 13:33 > To: [EMAIL PROTECTED] > Subject: Re: [OTnow] Differences in Alzheimer's and Parkinson's > > In my experience, the differences are enormous (a necessary > generalisation). Cognition is an early and significant problem in > Alzheimer's while physical difficulties usually present later. People > with Parkinson's usually present to us fairly early with problems in > performing certain ADLs and we usually get to know them long before any > cognitive difficulties manifest themselves significantly. We mostly > treat difficulties resultant from physical disability rather than > cognitive disability. We have few PD clients with significant cognitive > difficulty or Lewy body dementia but that may be because our particular > OT role has less to offer those with dementia than it does those with > problems that are more physical in their origin, so that if cognitive > difficulties become the primary problem the client is more likely to be > helped by the social work (care management) team than by us. > > Having said that, I do often find that people with PD often don't use > complex pieces of equipment like mattress variators and bath lifts, > but, strangely, it seems that although they are able to show that they > know how to use them, they just don't -- it's not at all > straight-forward and can be difficult to get a handle on. > > I would like to think that we don't vary our treatment approach based > solely on the disease but on our understanding of the problems and > strengths of each individual -- though we do obviously have to consider > the likely impact of cognitive loss on the person's ability to use > equipment, adaptations or new techniques if it is a part of their > diagnosis. For instance, there would be a need for a thorough risk > assessment if considering the recommendation of a stair lift for > someone with either Alzheimer's or Lewy body dementia, even if it's in > its early stages. We would probably need to be sure that a carer will > always be on hand to assist with its safe use or ensure that the case > would be reviewed regularly to ensure the person remains able to use > the equipment. > > For what it's worth, it seems to me that in advanced cases of any > dementia it is difficult to disentangle the cognitive component of the > problem from the movement disorder aspect. Don't the two almost always > coexist? > > Bear in mind that the above comments come from a setting where we > mostly remediate occupational dysfunction using equipment, home > adaptations or task modification. People with Alzheimer's rarely > present to us until fairly late, when difficulties in transfers or > moving and handling issues emerge because whilst there's a role for OT, > there's not much of a role for OT as it manifests itself in my > particular service setting and this is largely due to the fact that our > treatment modalities require the person to be able to understand their > use and learn new techniques, though adaptations like stair rails and > toilet frames present themselves fairly intuitively to people with > cognitive dysfunction. > > Cheers, > Mike (London, UK) > > On Tuesday, Dec 2, 2003, at 11:59 Europe/London, Ron Carson wrote: > > > Hello: > > > > What differences if any do you all see in the way that Alzheimer's > > versus > > Parkinson's diseases manifest themselves in your clients? > > > > Are your treatment approaches different based solely on the disease? > > > > Thanks, > > > > Ron > > > > > > _______________________________________________ > > To unsubscribe, visit: > > http://otnow.com/mailman/listinfo/otlist_otnow.com > > > > The OTnow Mail Archive: > > www.mail-archive.com/[EMAIL PROTECTED] > > =============================================== > > > > > _______________________________________________ > To unsubscribe, visit: http://otnow.com/mailman/listinfo/otlist_otnow.com > > The OTnow Mail Archive: > www.mail-archive.com/[EMAIL PROTECTED] > =============================================== _______________________________________________ To unsubscribe, visit: http://otnow.com/mailman/listinfo/otlist_otnow.com The OTnow Mail Archive: www.mail-archive.com/[EMAIL PROTECTED] ===============================================
