Transverse MyelitisAdapting to Change
Joy Sinclair
Professional Background
Post Graduate Certificate in Spinal Injuries at Stoke Mandeville
Marketing – large international pharmaceutical company- animal health division
Primary Health Care
Private Health Care
People living with TM experience the same later life issues as the general population but are also susceptible to a variety of health issues specific
to their condition
Physical changes
• Wear and tear on shoulders, wrists, hands- use right walking aids, splints, crutches - physio for exercises to stay flexible and avoid stiffness
• Change in bowel function- avoid constipation
- eat high fibre diet
• Change in bladder- Continence support; Continence Specialist Nurse- Bladder and Bowel Foundation Helpline: 0845 345 0165- Urodynamic tests e.g. bladder emptying- Urinary Tract Infections
Physical changes
• Fatigue- What is the underlying cause- Exercise – the right type and quantity e.g. Yoga, Pilates
• Pain- Pain management clinics- Conventional medicine- Alternative therapies
- NB always check for compatibility when using alternative therapies - Other options such as transendental meditation, acupuncture
Physical changes
• Spasms- Physio, exercises, night splints
- Passive movements- Medication; Baclofen
• Skin management- Prevention of pressure ulcers- Pressure relieving equipment, mattress, cushions- Tissue Viability Nurse
Psychological changes
• Mood changes - hormonal changes• Depression – family support, obtain appropriate treatment
Other factors• Disturbed sleep patterns
- establish cause• Intolerance to medications - long term use of analgesics• Memory loss
Wellness in late life
• The length of time a person has spent since onset of TM has a impact on increasing care needs for daily tasks
• Managing relapses, recurrence / fluctuations of old symptoms e.g. infections, temperature control, heightened sensitivity
• Maintaining friendships, hobbies, trying new activities
• Having the right equipment to ease daily activities
Wellness in later life
• Important to focus on nutritional needs and exercise both active and passive
• Annual MOT at a specialist centre / Spinal Cord Injury Centre
Social changes
• Difficulty with transferring• Maintaining independence • Managing adjustment to later life• Difficulty accessing SCI services• Failing health of partner / carer• Loss of a parent • Loss of partner / main carer• Abandonment
Mobility• Examine what methods of mobility have been used and consider how these can be adapted to changing functionality
• An Occupational Therapist could carry out an assessment and advise on any equipment changes
• Try aids for transferring – sliding boards, hoists, swivel seats
• If a wheelchair user, wear good quality gloves for propelling, to protect skin and help prevent carpal tunnel syndrome
• Explore add-on power pack for wheelchair propulsion
• Adaptations to your vehicle e.g. minor or major
Social Changes
Accessing care for the first timeDo you know who to contact when assistance is needed?
Professionals who can help:- Social Services, GPs, District Nurses, Occupational Therapist
Accessing increased levels of care
• Adult Care – Social Services• Needs assessment• May need ‘critical’ or ‘substantial’ need in a crisis• Benefits – carer’s allowance
Social Impacts
Adapting to Change
General Health
Weight
Later Life
Existing Co-Morbidities
Psychological Status
Upper LimbFunction
Length of time injured
Any Questions