What is Multidisciplinary Team?
A multidisciplinary team is a group of specialised individuals from different disciplines who come together to provide the necessary expert treatment for multifaceted conditions such as Progressive Supranuclear Palsy and Corticobasal Degeneration.
The team usually consist of:
- a neurologist- specialist in neurological conditions
- a physiotherapist – advice on how to improve co-ordination, mobility, flexibility.
- a speech and language therapist- advice on voice, speech and swallowing
- dietician – advice on nutrition
- an occupational therapist- advice on how best to approach difficulties with daily tasks
- a psychologist – emotional support and coping strategies
- a social worker/health nurse- advice on what supports and services are available locally
- an ophthalmologist/orthoptist- advice on eye problems
- a clinical nurse specialist- a nurse with special interest in neurological conditions.
It may be necessary for a palliative care specialist to join the team depending on how the disease progresses.
The Neurologist will help to diagnose your condition through a series of tests and observations. He will review how you are progressing and discuss your progress with the consultant.
The Physiotherapist will advise you about your mobility and how to make the most of your abilities. An exercise plan will be discussed. Regular exercise strengthens muscles, aids flexibility and improves posture and balance. Sometime you may not feel like doing them but they do help and with regular practice and some music they are easier. Breathing exercises can help with eating and swallowing issues. Advice on walking aids such as sticks, walking frames, appropriate shoes etc. will be given when necessary.
Speech and Language Therapist
A Speech and Language Therapist will help you with voice, speech and swallowing problems. You will receive a series of exercises to help develop your voice and strengthen the muscles of the mouth, tongue and face. The Lee Silverman Technique is an effective technique to improve the voice if practised frequently. As the voice weakens the SLT will advise on other form of communication such as simple gestures, letter/ picture boards, assistive technology or ipad.
The SLT can provide instruction on exercises that stimulate the swallowing reflex and strengthen the muscles used when eating and swallowing.
A Dietician may be called in if you are losing weight and to advise on specific foods that might be useful with symptoms such as constipation, dehydration and malnutrition. As the severity of the speech and swallow difficulties (dysphagia) increase you may be referred to a Dietician who will advise on changes to your diet. This may mean using foods and drinks that are easier to swallow or preparing food in a different way such as mashing, or pureeing, making smoothies etc. The dietician will provide information on how best to get a balanced diet with the nutrients you require.
In severe cases feeding tubes such as a nasogastric tube or a percutaneous endoscopic gastrostomy (PEG) may be required. The use of these needs to be a decision based on discussion with the family and the care team taking into account the pros and cons of their use.
The Occupational Therapist will provide advice on what items you may need at home in your day to day activities to make life easier for you. The OT will visit your home to have a look at what changes might need to be made e.g. removing mats and clutter to prevent falls, putting handrails in place along stairs, support bars in the bathroom, putting in a shower room etc.
A psychologist can provide a listening ear and help with emotional issues, coming to terms with the disease and dealing with depression.
Social Worker/ Health Nurse
They will visit you at home and discuss your needs and what services you will be entitled to. They will be able to let you know what help or activities are in your local area and will help you to access any help you need. The Health Nurse will provide advice for the patient and the carer and forms a very good link between you and your medical team and the provision of services.
Ophthalmologist and Orthoptist
Ophthalmologist is a specialist in medical and surgical eye procedures. The orthoptist works with the ophthalmologist in the diagnosis, assessment and management of eye disorders and vision. When problems arise such as increased blinking and involuntary closing of the eye (Blepharospasm) Botox may be administered with some success to ease symptoms. The effect is temporary and further injections will be required.
Clinical Nurse Specialist
A Clinical Nurse Specialist has specialist interest in neurological disorders and practical expertise in many aspects of PSP and CBD. They are highly trained and a great source of information and advice on these conditions. They are there to help so don’t be afraid to ask.