Request help with a patient please.

 

I evaluated a 52 yof veteran dx with MS approximately 12 years ago.  She has no UE movement (fine or gross), confined to a power wheelchair, and has reduced neck musculature strength (more so inability to raise head up when head; pt states she drops her head down to relieve nagging back pain throughout the day).  Communicatively, she presents with a mild-moderate dysarthria, reduced vocal intensity, and becomes fatigued from prolonged verbal comm.  Mild oropharyngeal dysphagia. 

 

Pt lives with a wonderfully dedicated husband.  They like to take their RV and travel frequently but when they are home he has to leave her to go complete grocery shopping and other necessities.  Per Audiology, pt has no useable hearing in the left ear and a mild low frequency loss in the right; using a Phonak mini BTE to supplement rt-sided loss.  Bilateral double-vision as well.

 

Pt’s primary issue/concern is related to emergency access.  Pt desires to have a stable means to call 911 in the event she is home alone and needs assistance or if something should happen to her husband while they are traveling.  Additionally, pt would like to talk to her mother and daughter who live in different states.

 

I discussed AAC options with them as her speech is dysarthric but she remains quite intelligible in known contexts when the utterance length is shortened.  Pt and husband stated they were overwhelmed with options and abilities of these “complex devices” and would prefer to focus on emergency access options.  Pt’s husband has researched options to some degree and feels that the Vocalize! Wheelchair Bluetooth cell  phone voice control system plus voice control digital media player would be the best option but they are certainly open to other suggestions.

 

 

 

Please share your experiences in working with pt’s who present with lack of UE movement, difficulty with head control, mild-moderate dysarthria yet intelligible with shorter words and phrases, emergency access (911) concerns, who travel often via RV. 

 

 

I anticipate making a decision within 4 days so please share your device recommendations with me in that time frame.

 

 

Thank you,

 

 

 

Kelli M. Johnson, M.S. CCC-SLP

Speech-Language Pathologist

James H. Quillen VAMC (126)

Mountain Home, TN 37684

Phone: (423) 979-2910

Fax:      (423) 979-3404

 

...to care for those who have borne the battle