Fay J. Tripp, MS, OTR/L, CDRSDepartment 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

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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

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

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Vision Changes

Double Vision (Diplopia) impaired movement control eye muscle fatigue decreased tracking together,

alignmentColor perception Contrast sensitivity

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Vision Changes

Blurriness due to dry eyesDecreased eye blink rateEye discomfortProgressive patternCan impair motor functioning Blepharospasm

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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

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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

Questions?