Other Health Professionals

ADDITIONAL HEALTH PROFESSIONALS

Care for patients with frontotemporal degeneration is typically coordinated by a medical doctor, however many of the treatments, therapies, and tests involved may be delivered by someone who is not an MD. Some of these professionals may also offer help to the caregiver as well as the patient. Here is a list of some additional health professionals you may encounter.

NURSE
Nurses assess, plan, provide and facilitate care for people with frontotemporal degeneration in a wide variety of settings. They can have as broad a range of education, certifications, and specialties as medical doctors, and the specific activities they perform vary accordingly.  Below is a listing of nursing titles in the United States in order of increasing length of educational requirements

LICENSED PRACTICAL NURSE/ LICENSED VOCATIONAL NURSE (LPN/LVN)
LPNs perform many of the basic duties related to health care. They monitor vital signs and medications, give injections or draw blood, dress wounds such as pressure sores, and assist with ADLs. LPNs will be on staff in residential facilities or hospitals. LPNs must complete a one year post high-school training program and pass a national licensure exam.

REGISTERED NURSE (RN)
RNs perform a vast array of duties including administrative or managerial positions. RNs may start, alter or suspend treatment plans in collaboration with a MD and supervise LPNs and aids. Depending on local or state training regulations, RNs may be able to perform some therapeutic or diagnostic procedures and prescribe medications. RNs often act as health educators officially or informally to the public, other healthcare providers, or families and patients. RNs must complete at least a 3-4 year post high-school education program and pass a national licensure exam. Many RNs pursue additional education and training in areas of specialization.

NURSE PRACTIONER / ADVANCED PRACTICE NURSE (APN)
An APN is a RN with a masters or doctoral degree in a specialized area of practice. APNs may hold executive level positions as clinic directors or act as a primary care provider for patients. APNs may also conduct and administer research programs either independently or in association with a MD. In some states APNs may prescribe medications but regulations governing that authority vary.

CERTIFIED GENETIC COUNSELOR (CGC)
CGCs provide information and support to individuals and families when there is a multi-generational history of dementia or an increased risk of an inheritable form of FTD. A CGC can review a family’s medical history and analyze inheritance patterns, offer advice on potential inheritable risk factors, and offer guidance on options for more information including the possibility of genetic testing. CGCs are often part of the teams at specialized clinical or research programs at hospitals or medical centers. Some counselors have private practices or will work as a consultant to doctors or hospitals. You can find a listing of certified genetic counselors through the website of the National Society of Genetic Counselors.

PHYSICAL THERAPIST (PT)
Physical therapists help individuals develop, maintain, or restore mobility and function with exercise regimens and other physical treatments. PTs will evaluate a person’s range of motion and muscle strength then design and implement an appropriate treatment or exercise program.  Within FTD, the most common goals are to improve mobility techniques and prevent falls, slow functional decline, and preserve independence as long as possible.  Physical therapists recommend changes to the home or facility environment and teach techniques to caregivers that support these goals.  Education about the benefits may be needed for a physician to prescribe PT for someone with FTD.  Physical rehabilitation centers will have PTs on staff, and they may be on staff at residential facilities or hospitals. A few PTs are in private practice and will see patients by prescription or referral.  The American Physical Therapy Association website will allow you to search for a PT.

OCCUPATIONAL THERAPIST REGISTERED (OTR)
An occupational therapist helps people with a mental or physical disability, illness, injury, or other health issue, learn or relearn how to do daily activities like dressing, bathing, grooming, and meal preparation, writing, and driving using physical and cognitive therapies and exercises. OTs can teach patients and caregivers how to adapts activities or provide training in assistive technology or orthotic equipment to help with ADLs.  Occupational therapists are most often on staff at medical centers, rehabilitation and residential facilities. Some may have a private practice and see patients by referral or prescription. To be registered an OT must pass a national certification exam but eligibility requirements vary from state to state.

SPEECH-LANGUAGE PATHOLOGIST (SLP)
Speech-language pathologists, usually called speech therapists, evaluate and treat people with communication or swallowing problems (dysphagia). They develop and implement treatment plans based on a presenting problem, and  can advise on strategies or tools to help compensate for speech impairments, or avoid risks associated with dysphagia such as choking.  They also provide therapies and exercises to maintain or improve communication abilities or delay invasive procedures such as the insertion of a feeding tube.  You can search for a SLP by location or specialty through the website of the American Speech-Language-Hearing Association.

PSYCHOLOGIST
Psychology is a large and diverse health profession. Almost all professional psychologists will have at least a masters’ degree and most have a doctoral degree (PhD, or PsyD). Psychologists may teach, design, or conduct research, and provide direct services to clients such as talk therapy or counseling and testing.  Any psychologist who offers services that involve any type of client contact must be licensed by the state in which they work.

NEUROPSYCHOLOGIST
A neuropsychologist has additional training and education in the neurological basis of behavior as well as an advanced degree in psychology. They are often part of the team which performs and interprets the results of the diagnostic tests involved in a comprehensive evaluation.

SOCIAL WORKERS AND COUNSELORS
The field of social work is very diverse. Most practitioners have at least a bachelor’s degree and many have master’s degrees. You may encounter someone with a social work degree in a managerial position such as a clinic coordinator, as a case manager helping patients and families coordinate and access medical and other services, or as a therapist or counselor for groups or individuals.

THERAPIST, LICENSED CLINICAL SOCIAL WORKER (LCSW/LISW)
Social workers who meet state requirements and pass a national exam may be licensed as therapists and perform group or individual therapy. They can provide the same services as a clinical psychologist including helping people process the grief of losing a loved one, or navigating the difficulties families face when caring for a family member. They cannot prescribe medications. The link below will take you to the National Association of Social Workers website with a variety of options for finding a therapist.

CASE MANAGER / GERIATRIC CASE MANAGER
Case manager is a generic title for anyone (usually a social worker) who helps caregivers and patients navigate the often confusing process of finding, accessing and paying for health care services or using and understanding insurance benefits. Social workers who pass a national exam are licensed and able to bill some services to insurance providers. Some case workers may specialize in particular populations or services. For example, a geriatric care manager specializes in heath care and other services for seniors such as finding an appropriate residential care facility. The National Association of Professional Geriatric Casemanagers website allows you to search for a care manager by location or specialty.

HOME HEALTH WORKERS & NURSES AIDES
Home health workers and nurses aides are referred to as direct care workers because they are often the ones who provide hands-on care on a routine basis. This includes assistance with activities of daily living (ADLs) such as bathing, eating, walking, and getting in and out of bed or a chair. Direct care providers usually need to have a high-school diploma and will receive additional training directly from their employer. Licensure and certification requirements vary from state to state and may depend on the type of facility or setting in which they work.

ART/MUSIC THERAPIST
Because of the cognitive impairments and/or language problems some FTD patients may benefit from the opportunity to express themselves emotionally through an external medium such as music or paint. With the direction of a trained therapist these therapies may provide a safe and structured environment for FTD patients to interact and express themselves.

MASSAGE THERAPIST
A good massage can make almost anyone feel better. Massage may also be part or combined with therapies developed by physical or occupational therapists to address specific physical difficulties or targeted muscle groups.

CLERGY
Many people look to their church for support. Some clergy members will be trained in providing talk therapy or counseling in a manner appropriate to a particular denomination’s religious beliefs.