Page 21 - Mobility Management, May/June 2021

see their spasticity is worse.”
Chesney believes in tracking spasticity throughout the client’s
life. “Do you feel that it’s stayed pretty stable? Do you feel like it’s decreased or increased recently? If it’s still significantly impacting daily living, if they’re having trouble performing activities or they’re in a lot of pain — that’s when you want to bring up ‘Have you checked in with your physician who manages your spas- ticity?’ Sometimes it’s been awhile since anyone’s revisited that. They just accept that it’s gotten worse.”
And her message for a client who’s thinking that: “I always remind them there should be ways that we can manage this. The goal is always to manage someone functionally and make sure they’re not in pain. So it does have to be revisited. You don’t just start one treatment and stay on it forever.”
“When people get older, their skin gets thinner,” Kiger said. “So as somebody ages, they may become more susceptible to skin breakdown. That can happen in somebody with dementia who’s still ambulatory and living in a long-term care facility. If they’re hitting these different decades, you need to add all that into your thinking when you do the eval.
“You’ve got to start thinking about early-onset dementia. Just because somebody has CP doesn’t mean they can’t develop dementia, too. If a client is non-verbal and CP impacts all four
extremities, maybe dementia is playing a part in why he used to be super compliant about doing pressure reliefs, yet now is suddenly not as compliant. Suddenly, they’re non compliant about doing weight shifts. Could it be dementia?”
The lengthy pandemic that forced people to stay home might also have impacted people with CP, Chesney said. “I feel for parents and caregivers: They’re juggling online school and children and working from home along with care needs. I just feel like a lot of visits became telehealth visits, which is fine and certainly has a place. But I think a lot of times, people are just trying to rush through: ‘Everything’s going fine.’ Nobody wanted to bring something up that was going to cause them to need to go in for [an in-person] visit.
“Maybe people haven’t been getting out as much, or they’ve been spending more time in bed. For sure, people need to check back in.”
Still, Chesney’s message for clients is a positive one. “Sometimes people just need to be re-educated on their options and that it’s okay for them to ask questions and be re-evaluated. How can we help you from an equipment standpoint? But also
for the caregiver — how can we help the caregiver out to make it easier for them? Let’s see what we can do. We just have to re-eval- uate and see what our options are.” m
MOBILITY MANAGEMENT | MAY-JUNE 2021 21 5/24/21 1:59 PM
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