Progressive Neurological Disorder
Authored by Michelle Eliason, MS, OTR/L, CKTS, C.D.S.
What is a Progressive Neurological Disorder?
Progressive Neurological Disorders (PNDs) is any type of diagnosis that causes the deterioration of function due to how the process of disease is effecting the brain and/or nervous system. There are many types of diagnoses and the prognosis (the approximate amount of time someone will live with this deterioration or resulting outcome) various from diagnosis to diagnosis. The time frame of symptoms may last anywhere between decades and years to months or weeks. But in any case, PNDs are to be taken seriously and a neurological rehabilitation occupational therapist should be designated at the time of diagnosis to provide non-pharmaceutical interventions to preserve function by leveraging cognitive reserve and neural plasticity as well as maximizing functional performance (continuing to do activities for yourself) throughout the progression of the disease.
There are many implications to consider when living with a PND including cognitive implications, executive function deficits, visual perceptual deficits, neuromuscular communication barriers, generalized weakness, increased atypical tone through arms and legs, coordination and balance, agility, walking, going up and down stairs, getting in and out of a car, inability to perform activities most meaningful to you, and more. A neurological occupational therapy practitioner is specialized in addressing all of the above challenges and more.
Some of the PNDs treated by Neurological Occupational Therapy
- Parkinson’s Disease (PD)
- Multiple Sclerosis (MS)
- Lew Body Dementia (LBD)
- Alzheimer’s Disease (AD)
- Myositis
- Corticobasal Degeneration (CBD)
- Amyotrophic lateral sclerosis (ALS)
- Myasthenia Gravis (MG)
- Huntington’s Disease (HD)
Meaningful activities [occupations] affected by progressive neurological disorders
- Eventually, every activity held meaningful will be impacted. Things once considered ‘easy’ will become challenging. It is important to note that, with the right support and interventions, changing abilities do not mean inability. Because of the nature of a progressive neurological disorder, many body structures, functions, and performance skills are impact, but compensetory strategies or adaptive approaches at the right time throughout the progression of your disease will allow you to protect all current abilities and maximize your functional potential through every stage of your diagnosis.
How can occupational therapy help Progressive Neurological Disorders?
- Your ability to move (upper and lower body mobility)
- Range of motion including effects of a joint contracture, spasticity, or flaccidity
- Upper body and lower body physical function
- Mobility (walking and getting up from a chair)
- Teach you exercises that are most appropriate if you have a neurological based ailment in order to maximize cognitive reserve and amplify neural plasticity
- Ensure you maximize you independence (performance of an activity without assistance) for as long as possible throughout the progression of disease.
- Home assessment and home accessibility throughout the progression of disease
- Activity of daily living (ADL) and Instrumental activity of daily living (IADL) training and re-training
- Addressing personal concerns, worries, and psychosocial barriers that may be preventing rehabilitation progress
- Coordination of care – Occupational Therapy Practitioners are trained in discharge planning and coordination of care to ensure you have a structured plan to follow when living with your diagnoses in the community.
- Remember that an occupational therapy practitioner is the only allied health professional that can follow you from the time you are diagnosed throughout the progression of your diagnoses and treat mobility, cognition, and functional symptoms! Imagine having a close relationship with your therapist who can help you every step of the way!
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Helpful Page Definititions
Instrumental Activities of Daily Living (IADLs)
Instrumental Activities of Daily Living (IADLs) are essential for independence in life roles and required for aging in place. There are 8 activities core activities for independence including cooking, cleaning, communication, taking and managing medication, handling your personal finances, transportation and community mobility, shopping
Cooking - The ability to follow a recipe and having the stamina to prepare a meal for yourself and/or your family
Cleaning - The ability to perform light housekeeping including making your bed, doing your laundry, washing the dishes, taking out the trash, vacuuming, sweeping, cleaning your bathroom, etc.
Communication - The ability to use the telephone, the computer, have conversations with people (familiar and strangers), communicate your needs clearly.
Taking medication - The ability to sort and organize your medication or determine a compensatory method to do so as well as taking the appropriate dosage at the appropriate time.
Personal Finances - The ability to establish an organization method to understand financial responsibilities and pay your bills on time.
Transportation - Whether you are driving, calling for a driving service like a taxi or Uber, or taking public education. You must have a defined action plan for community mobility and transportation.
Shopping - The ability to plan transportation, plan a grocery/clothing list of needs for yourself and your home, have the stamina to collect your items at the store, and be able to get them into your house.
Activities of Daily Living
Occupational therapists are trained in occupations and activity analysis. An occupation is an activity that you believe is important to your life. There are many levels of occupations, but activities of daily living (ADLs) are the most personal activities and are usually the ones people find most important if they were to lose the ability to complete them.
ADLs include:
- Bathing and showering
- Getting dressed
- Going to the bathroom
- Walking and getting up and down from a chair or car
- Eating and swallowing
- Feeding
- Sexual activity
- Personal hygiene and grooming
- Being able to use personal care devices like adaptive equipment and durable medical equipment