What Do OT’s Do? A Motor Neurone Disease Case Study

Shir is commencing her second year of an MSc Occupational Therapy (Pre-Registration) course at Oxford Brookes University.

As healthcare workers, many have often had the experience of having to explain their roles to those they come in contact with. Many patients, family members, and the public are not exposed to a variety of healthcare professions and the varying tasks and roles fulfilled by healthcare professionals.

One healthcare profession that is often not well understood is that of occupational therapists. Many occupational therapists themselves have difficulty explaining their role due to the wide range of contributions, specialisations, settings, and populations that they work with. As one researcher at the Central Florida Institute stated: “occupational therapy is a relatively unknown and misunderstood allied health profession”.

The Royal College of Occupational Therapy (RCOT) describes occupational therapy as “help[ing] [people] live [their] best life at home, at work - and everywhere else” (RCOT, 2022). RCOT goes on to explain that occupational therapy is:

“about being able to do things you want and have to do. This could mean helping you overcome challenges learning at school, going to work, playing sports, or simply doing the dishes. Everything is focused on your wellbeing and your ability to participate in activities” (RCOT, 2022).  

Even from this definition, it is easy to understand why occupational therapy is such a misunderstood profession. Occupational therapists work with children and young people; people with physical disabilities and long term conditions; people with learning disabilities; people with mental health conditions; older people; and people at the end of life (RCOT, 2022). Occupational therapists also work in all kinds of settings as well, including hospitals, rehabilitation centres, community services, schools, and so many others as well.

One of the populations that occupational therapists work with are people with  Motor Neurone Disease (MND). MND is an uncommon condition that affects the brain and nerves. Over time, MND results in weakness that worsens (National Health Service, 2021). People with early symptoms of MND often experience a weakened grip, fragility at the shoulder, a foot drop, dragging of the leg and slurred speech (National Health Service, 2021). As the condition progresses, patients experience increased weakness and the condition becomes more debilitating with many patients experiencing difficulties with communicating, swallowing, and breathing (National Health Service, 2021).

 Motor neurone disease is a rare ailment that primarily affects persons in their 60s and 70s, however, it can also affect adults of all ages, (National Health Service, 2021). There are currently 5,000 people living with MND in the UK (National Health Service, 2021).

 While many practitioners are involved in the care of people with MND, occupational therapists play a very important and distinct role in supporting patients with MND. In the treatment of people with MND, occupational therapists play a critical part in optimising meaningful activities of daily living, helping people to continue to engage in social and leisure activities, modifying one’s home environment, providing equipment, raising awareness of safety, providing support with posture and positioning, as well as fatigue management (MND Association, 2021). Occupational therapists can also assist in the development of psychological strategies, help prevent undesired hospital admissions, and promote a positive approach to death (MND Association, 2021). Additionally, occupational therapists can provide support for carers and families in coping with their family’s emerging physical health condition (MND Association, 2021).

 In helping patients maintain their quality of life, occupational therapists help support the adoption of equipment and adaptations. Some adaptations may include changing one’s home environment to make the home more wheelchair accessible, make modifications to the home set up to support people with washing and dressing and other activities of everyday life. Occupational therapists may also promote the adoption of bedding and seating that is more suitable for those with MND.

 Occupational therapists may also provide mobility equipment such as walking aids, sticks, frames, and rollators as well as grab rails and other home adaptations. As the patient’s condition progresses, it is likely that they will require a wheelchair. Wheelchairs are valuable as they aid in energy conservation and may become an individual’s primary form of mobility. Occupational therapists may also provide specialist seating to accommodate for a patient’s unique physical changes and needs. Furthermore, occupational therapists can prescribe equipment to help prevent pressure sores.

Some patients with MND experience contractures as a result of muscle weakness and spasticity. As such, some patients with MND benefit from splinting of their joints to promote prolonged stretching and facilitate improved range of motion.

Occupational therapists may also support the prescription of equipment and identification of strategies to help patients to continue to transfer from their bed, chair, or other furniture in their environment.

Weakness in the respiratory and facial muscles may also make it more difficult for patients with MND to communicate verbally. These physical changes often result in slurred or quiet speech and may at times lead to speech loss. Occupational therapists work closely with speech and language therapists to assess and support a person’s communication needs.

Further, occupational therapists play a significant role in fatigue management for patients with MND. Occupational therapists can provide advice on energy conservation strategies and fatigue management approaches that may help patients cope with their changing physical health.

While these are only a few examples of how occupational therapists can contribute to the care of patients with MND, through working with multidisciplinary teams, occupational therapists can support patients to maintain their quality of life, wellbeing, and overall physical and mental health.

To find out more about the role of occupational therapists in the care and treatment of patients with a variety of clinical conditions, consider joining the next Future Frontline MDT webinar.

References

MND Association. (2021). Occupational therapy for motor neurone disease. MND Association. https://www.mndassociation.org/app/uploads/OT-for-MND.pdf

RCOT. (2022, 01 01). What is Occupational Therapy? OT Explained - RCOT. Royal College of Occupational Therapists. Retrieved October 7, 2022, from https://www.rcot.co.uk/about-occupational-therapy/what-is-occupational-therapy