Managing ET with Occupational Therapy

Coping with Essential Tremor Articles

By Karen Mainzer, OTL, CHT

Occupational therapists help people with mental, physical, or social disabilities to ndependently and more confidently carry out everyday tasks or occupations. Their aim is to understand each person’s requirements and lifestyle so that they can create the best treatment plan for them. They may suggest changes to the person’s environment, whether that be at home, work, or school, and may introduce the use of equipment designed to help with some activities.

An occupational therapist (OT) who specializes in treating people who have neurological conditions can help a person with essential tremor not only learn how to do tasks differently, but to look at the world, and the way it works, in more positive ways, says Karen Mainzer, an OT in Bridgeton, Mo., a St. Louis suburb.

As Mainzer explains, OTs work with patients to consider the “whole picture, including the person, the task, and the environment in order to suggest necessary changes to maintain or achieve independence.”

“Society has a system of ways in which things are to be done, and we try to fit into that system,” she says. “Problems arise when we cannot do a task in the way the system says it is to be done. As an occupational therapist, I help a person to see that the system can be changed.”

Mainzer helps people analyze difficult tasks to determine what components of the tasks are problematic or prohibitive. Additionally, she teaches individuals to look at those components to see how they can be changed, or how the environment in which they operate can be changed.

“The person is not inadequate for a task,” she says. “The task is inadequate for the person.”

From the perspective of working with a person with ET, for example, she might analyze the task of clipping nails.“It’s not that the person with ET is not strong enough or smart enough to clip their nails,” Mainzer says. “It’s that the clippers are not steady enough to do the task. A person with ET cannot change the fact that their hand is too unsteady to work the clippers, but they can change how they do the task, how they use the clippers.” Mainzer suggests five basic principles that people with ET can keep in mind when determining how a task can be completed differently than in the normal way:

  • stabilizing the object involved in the task through the use of non-slick surfaces, mounting tools,
    suction cups, clipboard and pumps;
  • Reducing fine-motor demands through the use of weighted utensils, levers, hooks and pulls, and Velcro;
  • conserving energy by taking rest breaks, sitting instead of standing, and sliding objects instead of picking them up to move them;
  • reducing the potential for not being successful by using covered mugs and glasses, eating finger foods, and using plate guards;
  • using advances of technology such as electric mixers and can openers, electric toothbrushes, and adaptive keyboards for the computer.

Mainzer says negative attitudes become the greatest obstacles in learning new ways to do things. These include saying things like: “I am too old to change the way I do things,” or “I will look older than I am if I use certain devices” or “I am not smart enough to change.”

If you believe occupational therapy could teach you fresh approaches to tasks that are too difficult or impossible because of your tremor, please ask your primary-care physician or neurologist to write a prescription for an occupational-therapy evaluation. Then discuss your service options with a representative of your insurance company.

Be sure to request an OT who has experience working with people with neurological conditions.