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and limb elevation, VNA of Ohio's certi- fied lymphedema therapists initially visit patients three times a week. "Education increases patient compliance, which in turn improves outcomes," Fishman points out. These therapists use a number of thera- pies, including compression garments and short stretch wraps for affected areas. They may also choose to use manual lymph drainage — a technique of pushing lymphatic fluid back to the lymph nodes, where it drains into the venous system and is excreted by the kidneys. In addition, a lymphatic pump may be used to drain excess fluid. Occupational Therapy VNA of Ohio occupational therapists make life easier for patients with mobility deficits caused by rheumatoid arthritis, brain injury, multiple sclerosis or other issues. These patients often need assis- tance with activities of daily living, such as bathing, dressing, eating, grooming and toileting. Home modifications and special adaptive equipment, such as a long- handled shoehorn or a raised toilet seat, are simple solutions to assist with mobility for those with physical needs. Patients with a behavioral health diagnosis, such as depression or schizophrenia, present different challenges. "VNA of Ohio occupational therapists create plans to reduce anxiety that many of our behavioral health patients face," Fishman says. "Sometimes these patients focus on their anxiety, and by helping them focus on something else — in most cases, structured daily activities and routines — we can significantly improve their lives." No matter the diagnosis, VNA of Ohio occupational therapists offer solu- tions to help patients return to their maximum independence. Speech and Swallowing Therapy While physical and occupational thera- pists focus on returning patients to a higher level of independence, speech therapists work to improve patients' interactions and communications with their loved ones. Certain conditions ma ke speech unintelligible due to stutter, speed or raspiness. VNA of Ohio speech therapists use a number of techniques to improve speech clarity and vocal quality, helping patients to express themselves. Many patients suffer from neurological conditions affecting their cognitive abilities to focus, understand and retain informa- tion. Speech therapists use techniques, such as memory cues, books or communi- cation systems to improve the way patients absorb and convey information. Patients with neurological conditions may also need help with motor controls associated with the mouth and throat. Problems with swallowing or drooling can lead to complications such as pneumonia. Various diet modifications, including thickened liquids and pureed solids, can help alleviate choking risks and the associated problems. To facilitate safe swallowing, three VNA of Ohio speech therapists are also certified to offer VitalStim therapy. "VitalStim is an electrical stimulation unit that delivers low-dose stimulation to the muscles of the throat," Fishman explains. "Stimulation improves muscle contraction and swallowing function." Fishman emphasizes that all of VNA of Ohio's rehabilitation therapies are individu- alized according to each patient's needs. "We build treatment around each patient," she says, "and we work with primary care physicians to facilitate optimal outcomes." For more information about VNA of Ohio or to make a referral, visit www.vnaohio.org or call 216-931-1400. ■ Wendy Fishman, PT, MS, Director of Rehabilitation Services at VNA of Ohio VNA of Ohio occupational therapists make life easier for patients with mobility deficits who need assistance with act- ivities of daily living, such as dressing. Shown here is Carol Van Duyne, OT, instructing a patient in the use of a sock-aid. 2 0 1 4 J U LY/AU G U S T ■ M D N E W S . CO M ■ MD NEWS Cleveland/Akron/Canton | 2 3