PowerPoint Presentation Template General - FR

1
(No Transcript)
2
Quality of Life is at the Heart of the
Rehabilitation of People Who Have MS

• Natacha Foidart, Occupational Therapist,
• Neurology Program,
• Constance-Lethbridge Rehabilitation Centre
• Michèle Quinn, Interim head,
• Progressive Diseases Program,
• Centre de réadaptation Lucie-Bruneau

3
Objectives

• Know the range of rehabilitation services
  available for people who have MS
• Based on the phases of the continuum of services
• Based on programs/services
• Understand the roles of the rehabilitation team
  members

4
Overview of the Presentation

• Continuum of services for people who have MS
• Phases 1, 2 and 3
• Services at the Physical Rehabilitation Centre
  (PRC)
• Specialized services
• Sub-specialized services
• Services at the CLSC
• Rehabilitation clinic team
• Services provided by community partner
  organizations

5
Continuum of Services for People Who Have MS

• Objective Minimize the impact of the disease on
  quality of life
• First phase
• Hospital and MS clinics
• Second phase
• Intensive Functional Rehabilitation (IFR) in the
  hospital and on an out-patient basis
• Third phase shared mandate
• Social integration-based rehabilitation (SIBR) in
  a physical rehabilitation centre
• CLSC home services

6
First Phase

• Hospital and MS Clinic
• Diagnosis and medical treatments to reduce
  symptoms
• Roles of the medical and rehabilitation team
• Ensure personal care safety (e.g. meals, hygiene,
  getting dressed, moving around)
• Ensure safe return home (after a hospitalization)
• Links to the CLSC, if necessary
• Referral to a rehab centre, according to needs

7
Second Phase

• Hospital or regional hospital centre
• (according to the region)
• Intensive functional rehabilitation
• Roles of the rehabilitation team
• Promote recovery and maintain health
• Optimize physical, cognitive, communicative and
  social functions
• Encourage the recovery and maintenance of
  personal and socio-residential autonomy
• Ensure the persons safe return home and obtain
  the required support
• Links to the CLSC, if necessary
• Referral to an RC, according to needs

8
Third Phase

• Third phase shared mandate
• Social integration-based rehabilitation (SIBR) in
  a physical rehabilitation centre
• CLSC home services

9
Services at the Physical Rehabilitation Centre

• SIBR (maintain roles and daily activities)
• Customized rehabilitation services that are
  specialized or subspecialized in
  adaptation-rehabilitation
• Interdisciplinary approach

10
Services at the Physical Rehabilitation Centre

• Encourage full social participation and maximize
  quality of life
• Social integration
• Integration support
• Assistance and support for significant others and
  family members
• Alternative residential resources

11
Services at the Physical Rehabilitation Centre

• Roles of the rehabilitation team
• Improve aptitudes (motor, language,
  perceptive-cognitive, psychological and social)
• Adapt the activity (technical aids, ways of doing
  things)
• Adapt the environment

12
Services at the Physical Rehabilitation Centre
(Cont.)

• Specialized services
• Offered as part of the neurology, progressive
  disease and physical deficiency programs
• Multidisciplinary team, which varies according to
  the Physical Rehabilitation Centre and needs
• Intervention plan which is carried out with the
  patient according to needs and priorities

13
Physical Rehabilitation Centre Services (Cont.)

• Subspecialty services
• Mobility and position aids
• Evaluation of driving and adaptation of vehicles
• Work-related evaluation, orientation and
  rehabilitation
• Access to technological aids
• Other subspecialty services available according
  to region (service dog, Parents Plus)

14
Technical Aids for Mobility and Positioning

• Allocation, manufacture, maintenance, repair,
  recovery and upgrading of equipment necessary for
  locomotion, walking, mobility and positioning
• Manual and motorized wheelchairs
• Positioning bases
• Technical aids for positioning and walking
• Orthotics
• Criteria for allocation defined by RAMQ

15
Technical Aids for Mobility and Positioning
(Cont.)

• Technical aids for walking
• Usually evaluated by a physiotherapist
• Gait analysis expert
• Regular cane, quadripode cane and walker or
  walking frame

16
Driving

• Evaluation and development of the physical and
  mental capacities necessary for driving
• Evaluation of the adaptations necessary for
  driving a road vehicle and developing the
  abilities required for their use
• Evaluation and recommendations related to the
  driver or the passengers access to the road
  vehicle (including children)
• Psychosocial follow-up to explore alternate means
  of transportation

17
Possible Adaptations for Driving
18
Work Evaluation, Orientation and Rehabilitation

• Overall evaluation of functional work capacities
• Development of functional work capacities
• Analysis and adaptation of workstation
• Vocational guidance
• Support for employment integration and maintenance

19
Work Evaluation, Orientation and Rehabilitation

• Teaching of strategies aimed at returning to work
  (postural hygiene, pain management, energy
  management and compensatory strategies)
• Development of work retraining programs (protocol
  for returning to work)

20
Access to Technological Aids

• Reduction of handicap situations by using
  technological aids
• Evaluation, recommendations, training and
  allocation of technical aids to facilitate
• Oral and unspoken communication
• Access to a computer
• Environmental control
• Telephone
• Training and equipment integration
• Grant applications

21
Access to Technological Aidsa Few Examples

• Adapted mouse
• Adapted keyboard
• Software
• Environmental control

22
Services at the CLSC

• Keep the person in his or her natural environment
• Evaluate possibility of staying at home and
  safety
• Adapt the bathroom
• Recommend technical aids to maintain autonomy of
  personal care (hygiene, getting dressed, meal
  preparation)
• Evaluate the Residential Adaptation Assistance
  Program (RAAP)

23
Services at the CLSC

• Home health care, according to needs
• Psychosocial support, according to needs
• References for services such as housekeeping
  assistance, respite care and personal care
  assistance
• Evaluation for use of three-wheel or four-wheel
  electric scooter
• Services (cost and quantity) differ from one
  CLSC to another, according to CLSC budgets and
  priorities

24
Services at the CLSC

• Three-wheel and four-wheel scooters
• Evaluation
• Occupational therapists in the CLSCs assess needs
  and capacities (physical and cognitive) to make
  sure the person can use a three-wheel or
  four-wheel scooter
• Application (RAMQ)
• The application to obtain a scooter can only be
  made by two establishments now the IRGLM
  (Montréal) and IRDPQ (Quebec City), depending on
  where the person lives

25
Clinical Rehabilitation Team

• Various health care professionals who you meet on
  your path
• Multidisciplinary team
• The membership varies depending on needs Family
  doctor (GP), medical specialist, occupational
  therapist, speech therapist, nutritionist,
  physiotherapist, kinesiologist, psychologist,
  neuropsychologist, social worker, special
  education teacher

26
Clinical Rehabilitation Team (Cont.)

• Each health care professional
• Assesses each person according to his or her
  competency and expertise
• Implements an intervention plan
• Helps the person with his or her daily habits
• Works together with other health care
  professionals involved

27
Clinical Rehabilitation Team (Cont.)

• Gives the person a medical evaluation
• Prescribes investigations or treatments, if
  applicable, including orthotics and protheses
• Refers to other specialists, if necessary
• Helps people to take some steps (Régie des
  rentes, RAMQ, SAAQ, private insurance companies)
  together with the team

28
Occupational Therapist

• Assesses physical, perceptual and cognitive
  abilities, and the impact on daily habits
• Helps the person to optimize or maintain his or
  her functional autonomy.Recommends adaptations,
  changes to the environment and technical aids
  assisting in the completion of daily habits
  (adapted utensils, writing aids, bath chair,
  wheelchair)
• Teaches compensatory strategies (agenda, dressing
  techniques) and preventive strategies
  (disabilities, falls and energy management)
• Adapts the activity according to the persons
  remaining abilities

29
Physiotherapist

• Aims at prevention, maintenance and maximum
  re-establishment of various physical capacities,
  thus favouring functional autonomy
• Evaluates walking and recommends the necessary
  technical aids (cane, walker, walking frame,
  etc.) and braces
• Uses various treatment methods according to
  needs electrotherapy, manual therapy, ice,
  exercise program, etc.
• Provides information on different themes
  prevention of falls, saving energy and pain
  management

30
Kinesiologist(Physical Education Instructor)

• Assesses physical fitness, develops an exercise
  program and follows it up
• Determines new ways of doing physical activity
  that take into account capacities and interests
• Helps the person to understand and apply specific
  training principles which adapted to people who
  have MS
• Offers in different types of physical activity
  (gym, pool, group activities and adapted sports)
• Promotes physical activity to improve physical
  and psychological well-being

31
Speech Therapist

• Assesses and handles communication disorders
  (speech, language or cognitive communicative
  disorder) and difficulty swallowing (dysphagia)
• Assesses and recommends using a technological aid
  appropriate communication
• Applies to the departmental program
• Trains the person on using technological aids
• Works in a complementarity manner with the
  nutritionist regarding swallowing problems

32
Nutritionist

• Assesses, informs, develops and monitors an
  eating plan promoting better health
• Prevents or corrects health problems which can be
  resolved by changing eating habit
• Specifically, a suitable diet for people with MS
  can
• Reduce health problems associated with the
  disease (gastrointestinal problems, urinary
  problems, sleep problems, osteoporosis,
  dysphagia)
• Reduce the duration and severity of relapses.
• Aims to correct nutritional deficiencies and
  reduce medication

33
Psychologist

• Assesses the persons psychological state in
  terms of cognitive, affective, behavioural and
  relational dimensions
• Evaluates symptoms of anxiety disorder and mood
  disorder
• Provides a psychotherapeutic follow-up to
  facilitate the adaptation process and use the
  appropriate intervention strategies
• Supports the team regarding behavioural
  strategies

34
Neuropsychologist

• Evaluates neurobehavioural changes (cognition,
  emotions and behaviours) following a cerebral
  impairment and its evolution
• Makes recommendations to the team based on the
  neuropsychological profile, in order to
• Facilitate recovery
• Facilitate compensation for the difficulties
  identified
• Optimize the clients adaptation to his or her
  situation
• Helps patients, their significant others and
  health care professionals to implement
  recommendations (tools, strategies)

35
Social Worker

• Assesses the persons marital, family, social and
  economic status (a progressive disease may create
  an imbalance in the family dynamic)
• Evaluates the risk of burnout in significant
  others
• Helps the person and his or her significant
  others to adjust better to the new situation of
  the couple or family (changing roles, task
  sharing, communication, seeking help in the
  community)
• Gives the person and his or her significant
  others relevant information on the impact of the
  disease, social legislation and resources
  available by providing relevant documentation

36
Special-Education Teacher

• Helps the person to implement the relevant
  strategies and maintain gains
• Accompanies, assists and supports the person who
  requires special supervision in the
  rehabilitation process
• Participates in the identification of community
  resources related to the needs of the person and
  the attendant, when necessary, resources for
  fostering integration
• Applies educational techniques to the development
  of the persons daily habits and develops
  clinical tools for this purpose

37
How to Make a Referral to the Physical
Rehabilitation Centre?

• Contact the admissions service in the Physical
  Rehabilitation Centre in your region
• Referral from your MD, neurologist or another
  health professional
• Self-referral accepted in some centres

38
Services of Partner Organizations in the Community

• Volunteer attendant
• Adapted physical activity
• Recreation centres
• Large range of services provided by the MS
  Society
• scleroseenplaques.ca/qc
• Other
• May vary from region to region

39
To find out the establishments and services in
your region

• MSSS website www.msss.gouv.qc.ca
• Agence de santé et services sociaux website in
  your region
• MS Society, Quebec Division website
• List of MS clinics by region
• WikiGuideSP

40
Legend of Abbreviations

• H Hospital
• CHSLD Residential and Long-Term Care Centre
• CHU University health centre
• RC Rehabilitation centre
• PRC Physical Rehabilitation Centre
• CSSS Centre de santé et de services sociaux
• IRDPQ Institut de rehabilitation en déficience
  physique de Québec Physical rehabilitation
  institute
• IRGLM Institut de rehabilitation
  Gingras-Lindsay-de-Montréal Gingras-Lindsay
  rehabilitation institute
• MSSS Ministère de la santé et des services
  sociaux
• IFR Intensive Functional Rehabilitation
• SIBR Social Integration-Based Rehabilitation
  (SIBR)
• RAMQ Régie de lassurance maladie du Québec

41

• QUESTIONS?

42
Thank you!