Responding to the Changing Adaptive Equipment Needs of by jennyyingdi

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									                                                                                                                                                                                                                        11/16/2011




Responding to the Changing                                                                                                                 Brain Atrophy
Adaptive Equipment Needs
of Individuals with                                             “Myelin dissolves, nerves
Neurodegenerative Disorders                                     short out, muscle atrophies,
                                                                            brain,
                                                                but the old brain riddled now
                                                                with sclerotic patches, goes
 Don Fredette                                                   on wailing, ‘I can do it
 Adaptive Equipment Specialist
 The Boston Home
                                                                myself!’ ”
                                                                Nancy Mairs
                                                                                                                                        Reprinted with permission from Rudick RA et al. Neurology. 1999;53:1698-1704.




   Pathology of MS                                              Sources of Symptoms                                                        Common MS Symptoms
        An immune-mediated disease in genetically                    Symptoms vary widely in incidence and severity                            Fatigue
         susceptible individuals                                                                                                                Depression
                                                                                                                 Cognitive loss
        Demyelination leads to slower nerve conduction                                                                                         Focal muscle weakness
        Axonal injury and destruction are associated with                                                    Emotional disinhibition
                                                                                                                                                Visual changes
         permanent neurological dysfunction
        Lesions occur in optic nerves, periventricular white   Tremor,                                       Optic neuritis                    Bowel/bladder/sexual dysfunction
                                                                Ataxia                                                                          Gait problems/spasticity
         matter, cerebral cortex, brain stem, cerebellum, and                                                   Diplopia
                                                                                                                Vertigo
         spinal cord                                                                                            Dysarthria                      Paresthesias
                                                                Sensory symptoms,
                                                                                                                INO
                                                                Lhermitte’s
                                                                Pain
                                                                Proprioception                   Bladder dysfunction

Trapp BD et al. N Engl J Med. 1998;338:278-285.




   Less Common MS Symptoms                                      Rare MS Symptoms                                                           Implications of MS
        Dysarthria, scanning speech, dysphagia                     Decreased hearing
                                                                                                                                               Cognition
        Lhermitte’s phenomenon                                     Seizures
                                                                                                                                               Speech
        Neuritic pain                                              Tinnitus
                                                                                                                                               Fatigue
        Vertigo/ataxia                                             Mental disturbance
                                                                                                                                               Pressure wounds
        Cognitive dysfunction                                      Paralysis
                                                                                                                                               Vision
        Tremor/incoordination
                                                                                                                                               Impaired Memory
                                                                                                                                               Depression
                                                                                                                                               Spasticity
                                                                                                                                               Decreased Motor Function




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      Rehabilitation   Farzin   Early Days at TBH

Nursing

Social Services

Mental Health

Occupational Therapy

Physical Therapy

   Mobility




                                Drive Control Systems




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                                                                                                        Drink Aid




                                                                   Current Wheelchair Configuration



                                                                                                      Alternative Drive
                                                                                                      Control Devices
Access to Adapted Phone
Utilizes Head rest as mounting platform for Headphone/Mircophone




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          Single Switches   RIM System
                                                                          Sip’n Puff System




                 Single
                 Switch
                 Scanner




Hybrid System               Upper Extremity Support System   Creative Placement of Switches




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Wound Management
   Wound committee meets 2 to 4 times per
    month
   Address problems and possible solutions to
    assist in healing of wounds
                    g
   For seating issues - assess seat cushions,
    back cushions and foot support - common
    problem areas




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                                  Quality of Life




Nurse Call Access




                    Foam Switch




                                    Bed Controls




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                                                                                           Tash Mini Relax

                       “Bumps”

                                                                                          Allows six infrared
                                                                                          commands from any
                                                                                          remote to be controlled in
                        Hardwired to PC board                                             a scanning fashion by the
                                                                                          push of a button




                                                          Modified Hill-Rom Bed Control




                                                In-Voca

                                                                                                               In-Voca




Basic Implementation




                                                                                          Tray Mounted Communication
                                                                                          System
                                                Communication




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Voice Amplifier




                  Telephone Access




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 Phase I


                             Phase III




                  Phase II




Computer Access




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Desk Mounted Kindle




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                                           Quartet

                Environmental Control
                (ECU)

                Electronic Aids to Daily
                Living(EADL)

Kindle Reader




                                           Art at the Boston Home




                        Imperium




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MIT Collaborations
   “Hobby Shop”




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                                               Miscellaneous
                                               Projects




                                 Entertainme
Cell Phone Access
                                 nt




                    Proper Hydration




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