Health & Wellness

People with MS are faced with numerous challenges that may affect the things they want and need to do. Often, limitations impede the ability to take care of basic needs at home, at work, and within the community. Simple everyday tasks can turn into daily frustration. One of the best approaches to help alleviate these challenges and minimize the frustration is through the intervention of occupational therapy (OT).

I was an occupational therapist for 20 years and I’ve had MS for 12 years. As my MS has progressed, incorporating my professional skills into my daily life has been essential. As a healthcare provider and a person with MS, I want to share with you the benefits of OT for the various daily challenges that can accompany this disease.

What Is Occupational Therapy?

Occupational therapy is a healthcare profession that focuses on an individual’s ability to perform the broad range of everyday life activities. OT promotes independence by improving the skills required to perform these activities and/or teaching alternative ways to accomplish them.

In order to receive OT, a physician’s referral is required. At your first appointment, the occupational therapist will complete a thorough evaluation of your needs, problems, and concerns. Then, the therapist will create a customized treatment plan designed to improve skills and maximize functional abilities based on your priorities and personal goals. The therapist will consider your physical, psychological, and social well-being, as well as environmental factors when developing your treatment plan.

What Types of Activities Will Be Addressed in OT?

The broad range of activities that may be addressed with your therapist are categorized as activities of daily living (ADLs), instrumental activities of daily living (IADL), education, work, play, leisure, and social participation. 

Activities associated with basic self-care needs are ADLs. They include eating, personal hygiene/grooming, dressing, bathing/showering, bladder management, toilet hygiene, functional mobility, personal care, sexual activity, and sleep/rest.

Activities that involve environmental, domestic or community interaction are IADLs. These include tasks like cooking, cleaning, doing laundry, driving, shopping, parenting, caring for other people or pets, use of communication devices, community mobility, financial management, and other domestic tasks.

Your therapy will include purposeful (or goal-directed) activities designed to create, restore, improve, and/or maintain your skills and abilities. Purposeful activities can enhance function in various areas including, but not limited to:

• Strength

• Proprioception (the sense of your body in space)

• Endurance

• Motor Planning

• Motor Skills

• Sensory Integration

• Coordination

• Cognition

• Sensation

• Visual Impairment / Low Vision

• Range of Motion

• Visual Perceptual Skills

• Balance

The Role of Assistive Devices

In order to reduce barriers and promote independence, you may be assessed for an assistive device. Assistive devices include dressing aids, bathroom equipment (such as grab bars or a shower chair), household helpers, adaptive eating utensils, transfer devices, seating/mobility, and more. Once the therapist determines which device or devices may be useful and appropriate, you will be instructed in the proper use of the device that will enable you to perform tasks as safely, easily, and independently as possible.

It is not advisable to purchase or use an assistive device for ambulation, such as a walker, electrical stimulation system, AFO, cane, crutches, or wheelchair without proper assessment by an occupational or physical therapist. The therapist will ensure that you choose the most appropriate device, make sure that it is sized properly, and provide training to ensure safe and optimal use. If you purchase an inappropriate device, use one that is ill-fitted, or use it improperly, you may be doing more harm than good.

Paying for Assistive Devices

Coverage for assistive devices varies depending on your insurance coverage. Your therapist or physician will first need to verify that there is a medical need for the item. Mobility devices (walkers, canes, wheelchairs, and some scooters), hospital beds, and bedside commodes are often covered with a physician’s prescription but may require a co-payment. If you do not have insurance or your insurance does not cover the equipment you need, there are organizations that may provide the item at no cost or provide financial assistance.

Home Evaluations

Home evaluations are often conducted so that the occupational therapist may observe you in your home environment. This allows the therapist to identify barriers and potential risks, make appropriate recommendations for modifications, adaptations and equipment, and to recommend supervision, if needed. Training and instruction for your caregiver or family member will also be provided, if needed.

Education and Awareness

Your therapist will offer strategies for fatigue management, energy conservation, work simplification, home safety, joint protection, proper body mechanics, and the management of time, stress, and pain. All of this can help to alleviate frustration and improve your quality of life.

The Use of Splints and Orthotics

Occupational therapists and their assistants make and modify splints and orthotics. These are used for positioning, support, stabilization, mobilization, range of motion, reduction of pain and spasticity, and contracture prevention. Sometimes, a splint or orthotic is all that is needed to enable you to carry out a certain task independently.

Ergonomics

If you or someone you know is in need of occupational therapy services, consider contacting any of the following organizations: a rehabilitation center,hospital, skilled nursing or assisted living facility, outpatient center, school, mental health clinic, or private practice. Services may also be obtained through home health agencies. If you are feeling frustrated and overwhelmed with daily challenges, maybe it’s time to see what occupational therapy can do for you.

Susan Dorne is a licensed Occupational Therapist with over 20 years experience.  Her professional career as a clinician and manager focused on the treatment of neurological and orthopedic patient care in a rehabilitation unit. In 1995, Susan was diagnosed with MS. Although she has retired, she continues to utilize her knowledge and experience to support and educate the MS community. She is actively involved with the NMSS as a Peer Support Volunteer and facilitator for a telephone support group for the newly diagnosed. She also volunteers for MSFriends, the first 24/7 telephone peer support hotline.

(Last reviewed 7/2009)