Fay J. Tripp, MS, OTR/L, CDRS
Department of Occupational Therapy and Physical Therapy
Duke University Medical Center
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Increase awareness of:
 ways to save your energy to put you in control of what you do.
 ways to reduce the effect of tremors during function.
 adaptive devices and techniques to increase self-care and
home responsibilities and safety.
 possible visual changes that may occur.
 driving safety issues related to movement and process delays.
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Limit the amount of work you do
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Plan ahead
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Plan rest breaks
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Be an efficiency expert
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Organize your storage spaces
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Use assistive devices to increase independence and
safety
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Stabilize your forearm or elbow
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Wear wrist support braces
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Use weighted utensils or weights
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Hold items with a “fist” grip
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Gently apply pressure to muscles
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Gently move wrist side to side
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When writing, print in large letters using
lined paper with wrist brace
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With computer work,use a forearm
support system
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
Bathing
 Tub seat or bench
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Bathing
 Grab bars
 Adaptive devices
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Bathroom Use and Hygiene
 higher commode seats
 grab bars
 care aids

Dressing
 Seated position
 Adaptive devices
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Grooming and Hygiene
 Tremor control
▪ Wrist brace
▪ Forearm support
 Adaptive devices
▪ large, long handled devices
▪ electric razor
▪ nail care

Eating
 Tremor reduction
▪ wrist brace
▪ forearm support
▪ fist grip
 Assistive devices
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▪
▪
▪
▪
large handled, tubing
weighted utensils
rocker knives
long straws
no spill mugs

Cooking and Kitchen
Work
 Assistive devices
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▪
▪
▪
utensils
cutting boards
jar openers
can openers
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“Personal domain” care
 Home care tasks
 Workshop needs

“Personal domain” care
 Outdoor maintenance

Leisure Skills
 Safety first
 Alternate interests

Writing and Computer Work
 Forearm stabilization
 Forearm support
 Micrographia
▪ Begin good habits early
▪ Used lined paper
▪ Print in large letters
▪ Incorporate strategies to reduce
tremor
Vision Changes

Double Vision (Diplopia)
 impaired movement control
 eye muscle fatigue
 decreased tracking together,
alignment
Color perception
 Contrast sensitivity

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Vision Changes
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Blurriness due to dry eyes
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Decreased eye blink rate
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Eye discomfort

Progressive pattern
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Can impair motor functioning

Blepharospasm
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
Possible changes that may affect safety
 Physical ability and reaction time
▪ Response rate
▪ Freezing
 Attention
 Multi-tasking ability
 Judgment

Possible changes that may affect safety
 Visual skills
▪ Acuity
▪ Depth perception
▪ Peripheral vision
▪ Perception

NC Department of Motor Vehicles
 Medical Review Group
▪ Physician Medical Form
▪ Optometric Evaluation
▪ Occupational Therapy Evaluation
▪ Clinical evaluation: physical, visual, cognitive skills
▪ Behind the wheel evaluation: licensed driver instructor
 Referral to DMV Medical Review Group
▪ At time of license renewal
▪ Physician based
▪ Motor vehicle incident occurrence
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Questions?