The Clinical Team
|Prof. Orla Hardiman, B.Sc, MD, FRCPI, FAAN
|The neurologist is the person who makes the diagnosis, and who directs the medical management of the patient. Although discussions with patients and their families may overlap with other Health and Social Care Professionals, repetition by different team members usually helps patients and families to more fully understand their condition, not only because they hear the information again, but because each team member will have his or her own individual educational perspective.
Bernie Corr MSc., RGN, SCRN, cANP
Aisling O’ Reilly CNS,
Olivia Grogan CNS
Triona Bannerman MND/SMA, CNS
Katie Kinsella CNS
The nursing service comprises: one Candidate Advanced Nurse Practitioner and four Clinical Nurse Specialists.
The role of the nurse is:
We provide an efficient high quality National Outreach Service that is accessible and responsive to the needs of patients with MND, their families and carers, The Irish Motor Neurone Disease Association and members of multidisciplinary teams in Hospitals, Hospice, Nursing Homes and Primary Care Teams.
|Dr. Deirdre Murray
The Physiotherapist works as part of the MND team, with a focus on physical functioning. This includes assessment and management of muscle strength and stiffness, walking, arm function and problems with pain. The Physiotherapist also assesses breathing function with a focus on coughing and managing secretions.
Based on assessment, individualised advice on exercise and prescription of appropriate exercise are provided. For weakness in the legs and walking problems, mobility aids and devices are often prescribed to make walking easier and safer. Muscle stiffness can sometimes be treated with medications and injections, as well as exercise and the Physiotherapist works with the doctors on making a treatment plan. Shoulder pain is very common in MND and the Physiotherapist arranges consultation with orthopaedic colleagues to address this.
For problems with coughing there are a number of exercises and devices that can help.
A key focus is communication with the community and/or palliative care based physiotherapists to ensure that as much care as possible can be provided close to home, with support from the expert centre as needed.
|The Clinical Psychologist
|Dr Annette Lloyd; Prof Niall Pender
|The clinical psychologist works as part of the MND team to provide psychological support, assessment and advice to patients and families. An important role of the psychologist is working therapeutically with patients to support adjustment to diagnosis, development of coping strategies and continued engagement in valued activities. Some of the difficulties that psychology provide intervention for include anxiety, emotional changes, depression, grief and loss. As a significant minority of MND patients develop cognitive impairment and/or behavioural changes, utilisation of neuropsychological assessment and formulation is also a key role. The psychologist can work with families and caregivers to better understand these changes and support adaptation.
|The Medical Social Worker
|Ms Sarah Murran
Receiving a diagnosis of Motor Neurone Disease can result in life adjustments for both the person who receives the diagnosis and those close to them. In these circumstances a Medical Social Worker can assist with identifying solutions to help navigate through the diagnosis and any challenges that may arise as a result.
The Medical Social Worker can assist with the following: Emotional support to the person and their family member/support network, advocacy and information with regards to social welfare entitlements, assistance with care planning and availing of local supports in your community and support with speaking to children about the diagnosis.
The Dietitian can assess, diagnose and advise on treatment options for dietary and nutritional issues. Good nutrition is important in MND – it plays a role in maximising energy levels, helps fight off infections and also supports the muscle and respiratory systems.
The issues around nutrition in MND can vary but may include swallowing difficulties, reduced appetite, constipation, feeling full very quickly and difficulty preparing meals or self-feeding. Any combination of these can have an impact on the amount of food and fluids taken and, in turn, increase the risk of poor nutritional status and weight loss. The Dietitian can give individualised advice on diet and nutrition and help devise a plan to help ensure nutritional needs are met. This will include identification of foods and techniques to incorporate extra goodness into meals and snacks. Oral nutritional supplements are often considered. These are available through pharmacies and can be recommended by the Dietitian in addition to meals and snacks to help meet nutritional needs.
People who find it difficult to meet their nutritional needs through eating and drinking, sometimes consider the option of a feeding tube. The MND team, including the Dietitian, can help advise about the best time to consider this option. For those who decide to get a feeding tube inserted, the Dietitian provides the training on the use and care of the tube and devises an appropriate feeding plan.
|The Occupational Therapist
|The aim of Occupational Therapy (OT) is to maximise your independence and engagement in your everyday activities. The OT will look at the strength in your arms and legs and how that impacts on participating in your daily activities such as dressing and feeding. They will advise on adaptive equipment or strategies you can use to participate in these activities more successfully. This may include advice on fatigue management. They will link you with your local Community Occupational Therapist to arrange an assessment of your home environment and provision of equipment. They can advise on potential home modifications to maximise your independence. The OT will also look at your seating needs and recommendations regarding using a wheelchair if required. They can refer you on to a specialist service if adaptive or environmental controls are required. The OT in the MND clinic may also look at the provision of a neck collar if you experience neck weakness and have difficulty holding your head up.
|The Speech and Language Therapist
The Speech and Language Therapist (SLT) provides advice about communication and swallow changes.
Speech: The SLT can show you strategies to maximise your speech clarity. Some people with significant changes to their speech consider communication devices as a backup or replacement for spoken communication. The SLT can suggest appropriate devices or, if needed, organise an onward referral to a specialised service for advice about communication technology.
Voice recordings: When speech is clear and easy to understand, we encourage everyone to consider message and/or voice banking as a way to preserve your unique speech pattern. The SLT can give you information about the various options available and help you decide what option is right for you if you would like to make recordings.
Swallow: If you notice changes to your eating, drinking and swallowing, the SLT can advise you about techniques and changes to food and drink textures that can increase your comfort and safety when taking your food and drink.
|The Voluntary Organisation: The Irish Motor Neurone Disease Association (IMNDA)
The Irish Motor Neurone Disease Association (IMNDA) is the support organisation for people living with Motor Neurone Disease (MND), their carers, families and friends. The MND clinic has a long standing relationship with the organisation. A patient service representative from IMNDA attends the clinic on a weekly basis to act as a liaison between the clinic and the patient. The representative advises on the services available to patients and healthcare professionals. The key services of the voluntary organisation include:
Home visiting by four MND outreach nurses
Assistance towards home care
Providing specialist medical equipment free of charge to patients
Assistance towards counselling
Supporting research into the causes and treatments of MND
Freefone support line for patients and families
Educational information about MND and the services provided
Charity Number: CHY 17822
Registered Charity Number: 20067076
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