Fay J. Tripp, MS, OTR/L, CDRS Department of Occupational Therapy and Physical Therapy Duke University Medical Center 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. Limit the amount of work you do Plan ahead Plan rest breaks Be an efficiency expert Organize your storage spaces Use assistive devices to increase independence and safety Stabilize your forearm or elbow Wear wrist support braces Use weighted utensils or weights Hold items with a “fist” grip Gently apply pressure to muscles Gently move wrist side to side When writing, print in large letters using lined paper with wrist brace With computer work,use a forearm support system 5 Bathing Tub seat or bench Bathing Grab bars Adaptive devices Bathroom Use and Hygiene higher commode seats grab bars care aids Dressing Seated position Adaptive devices 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 ▪ ▪ ▪ ▪ ▪ large handled, tubing weighted utensils rocker knives long straws no spill mugs Cooking and Kitchen Work Assistive devices ▪ ▪ ▪ ▪ utensils cutting boards jar openers can openers “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 17 Vision Changes Blurriness due to dry eyes Decreased eye blink rate Eye discomfort Progressive pattern Can impair motor functioning Blepharospasm 18 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 21 Questions?