Healthy Body, Healthy Mind

Transcription

1 Volume 3 Spring 2016 The Firelands S.P.O.T. Inside this issue: 2 Speech Therapy Corner REPORT 3 Physical Therapy Corner Your quarterly guide to new information, insights, and events from Speech, Physical, & Occupational Therapies at Firelands Regional Medical Center. 4 5 Occupational Therapy Corner Clinician Spotlight Melissa Gibboney, OTD, OTR/L, STAR/C Healthy Body, Healthy Mind The Weight Management and Nutrition Clinic at Firelands The Cognitive Clinic at Firelands Regional Regional Medical Center provides a safe environment to Medical Center offers an efficient and assist individuals in achieving a healthy weight and comprehensive process to assist individuals in maintaining any necessary lifestyle changes. A multidisciplinary team comprised of a physician, nurse Individuals with cognitive impairment may also identification and treatment of cognitive deficits. practitioner, pharmacist, registered dietitian, physical experience co-occurring physical deficits that therapist, and behavior management specialist will create can significantly impact independent individualized programs to meet the needs of each specific functioning and quality of life. The Cognitive patient to facilitate healthy and sustainable weight Clinic allows individuals to receive a thorough management. A referral from your physician is needed to evaluation from a neurologist, speech therapist, participate in the core program, which spans weeks. occupational therapist, and physical therapist. To read more about the weight management clinic, please To read more about the cognitive clinic, please see page three. For further information, please call see page two. For further information, please call

2 Contributed by Emily Muratori, PT, DPT THE FIRELANDS S.P.O.T. REPORT Volume 3 Spring 2016 Cognition Connection Contributed by Amber Klein, M.S., CCC-SLP The Cognitive Clinic is a new program that streamlines the process for identification of services needed for patients with deficits related to cognition. Firelands Regional Medical Center recognizes the importance of therapeutic intervention to improve and/or maintain a patient s current skills for the highest quality of life for both the patient and his/her caregivers. A neurologist, physical therapist, occupational therapist, and speech therapist assess each patient in a one-stop shop atmosphere. Typically, a patient would have to first see a neurologist and then be referred to the various therapies that might be needed. The patient would then have to schedule four separate appointments over a period of several weeks or months. With the Cognitive Clinic, the patient only needs to make one appointment and then is able to be assessed by four different medical professionals on the same day. The speech therapist will quickly evaluate several different areas of possible need to determine if and what further outpatient services are recommended. The speech therapist will evaluate: cognition (memory, orientation, attention, problem solving, reasoning, and executive function); speech and language; and swallowing. (Continued on p.6) Hand In Hand Cognition & Daily Mobility Under the direction of Steven Benedict, MD, the Cognitive Clinic was created as a multidisciplinary approach to streamline the diagnosis, treatment, and care management of patients with cognitive deficits. Cognitive deficits can co-occur with physical impairments including weakness, balance deficits, and mobility safety concerns. Physical therapy (PT) is a critical component of the Cognitive Clinic to address these concerns. Following completion of a thorough neurological questionnaire, patients are scheduled for an individually tailored PT evaluation. (Continued on p.5) 2

3 Contributed by Emily Muratori, PT, DPT THE FIRELANDS S.P.O.T. REPORT Volume 3 Spring 2016 MOVE MORE, WEIGH LESS Firelands Regional Medical Center offers a medically supervised program focused on weight management in a supportive environment to help individuals make lifestyle changes to reach and maintain a healthy goal weight. The weight management program commences with an initial appointment that consists of a medical review with a clinical nurse, a prescription medication review with a pharmacist, and a personalized consult with a registered dietician to review eating habits and to set nutrition goals. These program components are then coordinated with Luis Perez, D.O., a family medicine physician, and with physical therapy to manage weight loss. Physical therapy (PT) is a critical component of the weight management program and requires a physical therapy evaluation, which must be scheduled separately from the initial clinical appointment. A physical therapist will assess whole body range of motion, strength, and any acute and/or chronic pain concerns and their relation to overall functional mobility. Based on an individual s current level of function, he or she will complete a two-minute walk test, a six-minute walk test, or a one-mile walk test to assess endurance and gait and for comparison to age-related normative data. Individuals will also perform a fitness assessment based on guidelines established by the American College of Sports Medicine regarding muscular endurance and strength. During this test, individuals will perform strengthening exercises including, chest press, leg extension, lat pull down, bicep curl, triceps extension, and hip press at a near maximal resistance to compare against body weight and to compare repetitions to muscular endurance ratings. Upon completion of the physical therapy evaluation, the physical therapist will provide recommendations for a home exercise plan, will teach individuals about appropriate ways to exercise safely, and will identify any (Continued on p.4) 3

4 THE FIRELANDS S.P.O.T. REPORT Volume 3 Spring 2016 (Weight Management, continued from p.3) physical limitations or reasons necessitating a follow-up appointment with Dr. Perez. Every participating individual will receive an individualized weight management plan, with strategies varying from a home exercise program to regularly scheduled outpatient physical therapy visits dependent upon an individual s needs. For more information regarding the Cognitive Clinic and/or the Weight Management Program, please contact Firelands Regional Medical Center at KEY ASSESSMENT FOR QUALITY FUNCTION Contributed by Melissa Gibboney, OTD, OTR/L, STAR/C Occupational therapy (OT) is one of the three therapy services that assess individuals referred to the Cognitive Clinic. Individuals who are experiencing physical or mental changes may find activities of daily living have become more difficult. OT can help patients improve skills in the areas of strength, balance, range of motion, and task planning. Occupational therapists teach people how to modify activities so they can be completed safely and/or how to change the area or environment to decrease the risk of falls. During the clinic, OT will assess key areas that can be affected by cognitive impairment such as reasoning and judgment, awareness of time and place, behaviors, physical ability, and senses. Atypical functioning in any of these areas can directly impact an individual s ability to complete functional activities of daily living. Assessments that evaluate cognition related to activities of daily living (ADLs) may include but are not limited to the Modified Barthel Index, the Lawton Instrumental Activities of Daily Living Scale, the Short Blessed, and the AD8 Dementia Screening Tool. Individuals participating in the Cognitive Clinic will also receive a vision assessment, as visual deficits can greatly impact an individual s risk of falls and can lead to a decline in functional independence. Visual testing may include tasks of right/left discrimination, scanning, peripheral assessment, and acuity. Some individuals experiencing cognitive decline may notice numerous changes at once while others may present with changes in only one area at a time. A clientcentered multi-disciplinary approach is vital in identifying necessary needs at the specific time and stage of the clinic knowing that a change could occur again. Upon completion of the occupational therapy assessment, the therapist will give the results and individualized recommendations to Dr. Benedict. Recommendations may include referrals for outpatient OT or home health services for home modification, a community mobility assessment related to driving skills, or that an individual is not in need of further OT services at this time. 4

5 THE FIRELANDS S.P.O.T. REPORT Volume 3 Spring 2016 (Hand In Hand, continued from p.2) The physical therapy evaluation assesses current lower extremity range of motion and strength and how any deficits may affect daily mobility and safety. Specific functional assessments, including a 30 -second chair stand test and Timed Up and Go, assess a patient s fall risk. Patients may also perform more advanced balance testing including the Four Stage Balance Test, Mini BESTest and Tinetti, which look at balance during ambulation and other dynamic movements. Based on the test scores, the patient will be provided with an individualized treatment plan and recommendations will be sent to Dr. Benedict. An individual s treatment plan might include a variety of options. Patients may not have functional deficits requiring continued outpatient physical therapy services and may use the Cognitive Clinic as a baseline measurement. Other patients who have been identified with mildmoderate deficits can easily schedule continued PT services at any of Firelands outpatient physical therapy clinics. Those individuals with significant and taxable mobility deficits will be referred for a home evaluation though a home health therapy service. I am a licensed occupational therapist who has been providing therapy services at Firelands Regional Medical Center since January I received a Bachelors of Science in Recreational Therapy with a Minor in Psychology, a doctorate in Occupational Therapy, and a graduate certificate in Contemporary Gerontology Practice from the University of Toledo. I reside in Huron, OH with my husband, four-year-old son, and two-year old daughter. I primarily work as the Occupational Therapy Supervisor but I also assist in performing evaluations and treatment with adults in inpatient acute care, inpatient rehabilitation, and skilled nursing settings. I also assist with program development and community education. I recently presented at the Alzheimer s Support Group on Falls and Home Modifications for individuals with Alzheimer s Disease and at the Firelands BGSU ElderCollege on Balance as We Age: Fall Prevention. I am a STAR certified clinician. I am currently training to become a 1:1 CarFit Technician and I am working on my Adult Vision Screening Certification via Prevent Blindness. I have always enjoyed working with adults in the inpatient rehabilitation setting but I am skilled at providing service coverage in a variety of settings. No matter which setting I find myself, I am passionate about providing education to patients, families, and community members on modifications, techniques, and strategies to help individuals to function as safely and as independently as possible in any setting. I also ensure that I am focusing on the holistic aspect of a patient s care and what may or may not significantly impact an individual from reaching his or her highest quality of life. I plan to continue pursuing my interests in program development and community education by expanding our community offerings related to the STAR program and breast cancer rehabilitation, the Cognitive Clinic, fall prevention and education to incorporate home modifications for the elderly and those diagnosed with dementia, and a clinic to assist those diagnosed with multiple sclerosis. Clinician Spotlight Melissa Missy Gibboney, OTD, OTR/L, STAR/C 5

6 THE FIRELANDS S.P.O.T. REPORT Volume 3 Spring 2016 (Cognition, continued from p.2) Our outpatient speech therapy program has several progressive treatment methods to offer this patient population, including Vital Stim (a neuromuscular electrical stimulation treatment for patients with dysphagia) and LSVT (an intensive program for improving a patient s voice, overall speech intelligibility, and/or swallow function). Patients diagnosed with disorders like dementia and Parkinson s disease often experience difficulties in more than one area. By quickly assessing each area and then collaborating with physical therapy, occupational therapy, and the neurologist, the speech therapist can develop an individualized treatment plan that will best suit each patient s needs Hayes Avenue Sandusky, OH 44870