During your admission you may work with various therapists. These therapists work as part of the multidisciplinary team (MDT) and have experience in both neurosurgery and neuro-oncology. Specialist neurological therapists have knowledge of how the brain and spinal cord work, and the specific problems that people with central nervous system tumours may encounter.
Dietitians are specialists in clinical nutrition. Nutrition plays an important role in maintaining the best possible state of health during your admission. We assess your nutritional needs and provide dietary advice and support for various conditions. We can help you control your symptoms – such as poor appetite, sore or dry mouth, taste changes, weight loss, nausea and vomiting, fatigue, changes in bowel habits and difficulty swallowing –by providing dietary recommendations to help you maintain your strength during treatment. We can also advise on use of nutritional supplements.
We may also take a number of different measurements to assess your current nutritional status, such as taking your weight, measuring your height, and/or mid upper arm circumference. This helps us to to provide you with tailored advice that meets your specific nutritional needs and social circumstances.
We work closely with the speech and language therapists to provide support to manage swallowing difficulties. By working together, we can assist with suggestions for texture modified meals, suitable snacks and food fortification. Some patients may have a feeding tube placed to help support them during times when they are unable to eat and/or drink enough.
Physiotherapists help patients with issues that affect their movement and mobility. This involves assessing a number of areas such as strength, sensation, coordination, muscle tightness, balance and fitness. Treatments are individualised depending on your needs and often involve exercise, practising specific movements, or helping you to move if you are unable to do it yourself. Sometimes this might involve using equipment or aids to enhance function. Physiotherapists are also involved with respiratory care, helping to keep the chest clear of secretions and the lungs working properly for those who have developed difficulties with their breathing. Physiotherapists can provide advice and education to patients, family and carers about how to manage and maintain movement and participation in functional activities.
Occupational therapists will work with you to assess and optimise your independence in activities of daily living. These activities may include eating, washing and dressing, preparing a meal, shopping, using your phone or working.
Assessment is focused on your physical, cognitive, sensory and perceptual abilities that may impact your function in day to day activities.
Occupational therapy is individualised and may include education, task practice and/or modification, teaching compensatory strategies, provision of aids or equipment. Intervention may also include carer training and providing advice to family or friends to optimise your independence.
Speech and language therapists (SLTs) may help you with problems that affect your communication and swallowing. This involves assessing a number of different areas.
For communication, we look at your ability to understand conversation, to read, write and express yourself, as well as evaluating how clear your speech is.
For swallow, specialist assessment is carried out to evaluate sensation, strength and coordination of relevant muscles and advice is given on liquids and food textures, as well as any strategies to enable you to eat and drink safely.
SLTs work closely with physiotherapists, for example, on improving posture for eating and speaking, and occupational therapists, for example, on communicating every day needs or advice and strategies and to help with self-feeding.
SLTs work with patients, families and carers to give information to help understand and manage any effects that a tumour is having on communication and swallowing.
The facial rehabilitation clinic is an outpatient service at the National Hospital for Neurology and Neurosurgery (NHNN) staffed jointly by a physiotherapist and speech and language therapist.
The service provides care for those that have developed facial weakness or dysfunction as a result of their tumour or after an operation. This may also include looking at functional activities such as eating and drinking, and communication such as speech and facial expressions.
The vocational rehabilitation team is comprised of a consultant, an occupational therapist and a psychologist. They can help to support patients in maintaining and/or returning to work or study.
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vocational rehabilitation team
Occupational therapy, physiotherapy and speech and language therapy all have outpatient services that specialise in supporting those with brain tumours and other neurological conditions.
Rehabilitation assistants work with patients to implement a rehabilitation plan as recommended by a therapist. They may work on any aspect of rehabilitation, such as physiotherapy, occupational therapy or speech and language therapy.
You may need on-going rehabilitation after your surgery or because of the impact of the tumour. This can occur in several different ways depending on your needs and what is provided in your local area:
- As an inpatient at a local or specialised rehabilitation unit
- On one of the wards at your local hospital
- In your own home with a community team
- As an outpatient at your local hospital or at NHNN
All referrals will be discussed with you and/or your family before they are made.
Patients having planned surgery that have complex needs, in terms of co-existing health problems or needing increased support at home, are often contacted prior to coming in to hospital by an occupational therapist. The aim of this clinic is to identify the need for services or equipment and begin to organise this.