Assistive devices and adaptative equipment to help with vision and eye symptoms:

• Audiobooks: Ease straining of eyes
• Large print books or tablets
• Botox injections: help to keep eyelids open (done by neurologist)
• Eye drops: GenTeal Tears Lubricant Eye Gel, Refresh Plus, Restasis and Systane Drops Moisturizing Eyes
• Hat with a bill or rim: help with light sensitivity
• Punctal plug: placed in the tear duct of each eye by an ophthalmologist to reduce tear drainage and keeps the eyes moist
• Prism glasses: Can help when a person is having difficulty looking down
• Dark glasses: Decreases glare to help with light sensitivity
• Warm washcloth: Comfort sore eyes
• Surgical tape: Keep eyelids open
• Smart speakers: For timers, weather reports or to call or text others
• Low vision apps on the phone to help make use easier
• Adding brighter light bulbs or more fixtures to help the person see
• Night lights to make it easier to see in the dark

Medical Lending Closets are donation sites that give or lend medical products, equipment and devices. Lending Closets provide an alternative to purchasing such supplies outright. In addition to loaning out products, Medical Lending Closets also readily accept contributions of used equipment.

Items that come from lending closets are clean and in good working condition. Supplies are distributed on a first-come, first-served basis. Please note that Lending Closet sites and what they have available can vary greatly by location.

Among the first places we recommend contacting are: your local Area Agency on Aging and senior center. Also, for those people who have an occupational therapist, you might ask if they have information on local lending closets.

Before ordering any medical supplies from a lending site, consult with your medical team – physician, physical therapist or occupational therapist – before selecting a specific kind of adaptive or mobility equipment. There are a wide variety of products on the market, and the healthcare team can help you find which one is right for you and your individual symptoms or needs.

The types of organizations that may lend medical supplies and assistive devices:

• Adult Day Centers
• Area Agencies on Aging
• Churches, Synagogues, and other faith/worship congregations
• Departments/Councils on Aging
• Disability Services
• Fire Departments
• Human Services Departments
• Lions’ Clubs
• Parishes
• Parkinson’s Disease Chapters
• Parkinson’s disease
• Exercise Classes
• Parkinson’s disease and PSP/MSA/CBD Support Groups
• Senior Centers
• Senior Services Departments of local townships
• Senior Volunteer Networks
• Township Offices
• Village Halls

Using an online search engine, patients and families may locate a local lending closet to access or borrow equipment listed above. Helpful keywords to include when doing a general computer search for lending closets are:

• Durable Medical Equipment
• Federal agencies, e.g. Disability Services: usa.gov; Social Security: ssa.gov; National Association of Area Agencies on Aging: www.n4a.org; Administration on Aging: acl.gov
• Health Equipment Loan Programs
• Medical Equipment Loan Closets/Town/State
• Medical Lending Organizations
• National, Not-for-Profit, Disease-specific Organizations, such as Muscular Dystrophy Association: mda.org; ALS
  

PSP, CBD and MSA can cause weakness and incoordination of throat muscles, making it more difficult to swallow. This issue increases the risk of food or liquids going into the lungs, which is called aspiration, and can lead to pneumonia. Your doctor may recommend regular examinations of your swallowing function to make sure food and liquid are going down the right way. Additionally, speech-language pathologists can help assess swallowing function as well as provide recommendations for diet and lifestyle modifications and exercises for the throat in order to make swallowing easier and safer.

Assistive devices and adaptative equipment to help with eating and drinking:

• Blender: To puree food
• Insulated dish: To keep food warm
• Large handle and weight utensils: Designed for easy grip
• Angled utensils: Helps with stiff wrists
• Liquid thickeners: Helps make swallowing easier
• Nosey cups: Have an opening for the nose allows drinking without lifting the head
• Pill splitter or crusher: Helps to swallow pills
• Pizza cutter or rocker knife: Use instead of a regular knife to help cut food with one hand
• Plastic bibs with pockets and/or disposable bibs: To catch food if it falls
• Plastic cup with handles, cup with screw on top or sippy cup: Prevents spills
• Rubber shelf liner or silicone placemat: Prevents plate from sliding at the table
• Scoop plates or plates with deep rims: Helps keep food on the plate
  

Due to the common issues with swallowing in PSP, CBD and MSA, buildup of phlegm and mucus can occur in PSP, CBD, or MSA. Speaking with a speech-language pathologists to evaluate swallowing can help alleviate this issue as well as these recommendations below.  

Assistive devices and adaptative equipment to help with symptoms in the mouth, throat and nose:

• Flonase: Dries up post-nasal drip
• Flutter mucus clearance device: Helps move thin mucus from throat and nose
• Orajel: Ease pain of mouth sores
• Diflucan: Treats mouth ulcers
• Oral suction devices: Helps clear phlegm when they cannot produce enough force on coughing
• Mouth moisturizing spray: Helps with dry mouth
• MucoMyst: Thins and loosens mucus to make it easier to remove
• Nebulizer: Can turn certain medications into a mist that can be inhaled (speak with a pulmonologist)
• Portable suction machine: Helps remove mucus, saliva and other secretions from the airways

Maintaining good oral hygiene can prevent infection and pain. Assistive devices to help maintain good oral hygiene:

• Electric toothbrush: Reduces need for hand motion
• Non-fluoride toothpaste: Less risk when toothpaste is swallowed
• Open Wide mouth rest: Helps mouth stay open with brushing
• Toothpaste dispenser (pump or hands free)
• Suction toothbrush: A toothbrush attached to a suction device to remove fluids during brushing
• Oral swabs: Clear mouth of food Toothettes, Sage Foam Oral Swab, McKessin Oral Swabs with Dentifrice, or Monkcare Disposables Oral Swab Sticks Suction bulb or a portable oral suction device
• Water irrigating device or water flosser: Waterpik Cordless Profloss, Panasonic Dental Flosser, Sonicare Air Flosser or WaterPik Water Flosser
• Tongue scraper: Gum Dual Action Tongue Cleaner and Scraper or Brosite Tongue Cleaner Scrapers
• Dental Wipes: EZGO Deep Cleaning Teeth Wipes, Hisight Fresh Breath Deep Cleaning Teeth Finger Brush or Lurrose Disposable Finger Toothbrush
  

As these conditions progress, overall hygiene becomes more difficult due to balance and vision problems; stiffness and slowness of movement. All contribute to difficulty for the person diagnosed in maintaining their general hygiene. Seeing an occupational therapist can be helpful for maintaining independence or reducing  caregiver burden for basic self care.

Assistive devices and adaptive equipment to help maintain good hygiene:

• Electric face wash device: Help washing face
• Electric razor: Help shaving
• Gillette Trio: A razor that is safer and easier for care partner to use on patient
• Grab rails and bars: Safely move around in the shower, tub or bathroom
• Hand-held shower head: Allows for washing while seated
• Non-skid rubber bathmat: Reduce risk of slipping while bathing and showering
• Roll-in shower: For those using a wheelchair
• Tub transfer bench: To help get into the tub while seated
• Shower chair: To avoid falls in shower
• Swivel shower bench: Makes showering easier and safer
• Shower chair with wheels: Allows the person to roll-into the shower, but requires a roll-in shower
• Mild soap: Helps those with sensitive skin
  
• Waterproof shower accessible transport commode medical rolling chair: ease of showering safely
• Wheelchair accessible portable shower stall: separate shower stall to ease showering while in wheelchair
• Benzoin: Heps with pressure ulcers
• Sheepskin under pressure areas: Helps prevent pressure sores

Incontinence and constipation are fairly common as PSP, CBD and MSA progress. Often the person diagnosed has balance issues and is at risk for falling, especially overnight. Falls in the bathroom can be especially dangerous due to hard sharp surfaces in a bathroom.  Occupational therapy can hep with equipment recommendation and training to prevent bathroom falls.

Assistive devices and adaptive equipment to help with incontinence and toileting issues:

• A catheter to eliminate need to get up to urinate:
• Abena Abri-Form Premium M4 catheter
• Reusable Male Comfort Fit AdvantageMale (external catheter/condom catheter): alternative to indwelling catheters and easier to use and less invasive
• Adult diapers: Depends or Tranquility
• Bedside commode, urinal or bedpan: Prevent trips to the bathroom and nighttime falls
• Bidet or bidet attachment: self-cleaning toilet
• Toilet tongs: Helps to grab toilet paper
• Laxatives and/or stool softeners: Help with constipation
• Pads: To help keep those with incontinence dry
• Squatty Potty: Helps with bowel movements
• Toilet riser: Easier to sit on toilet
• Over toilet safety bars: Helps to prevent falls while sitting or standing
• Plastic-lined bed pads: Use under bed sheets in case of nighttime incontinence
• Portable, hand-held urinals, available for both men and women

As PSP/CBD/MSA progresses, individuals with these diseases and their care partners must cope with the changes in their mobility, especially to prevent dangerous falls. A Physical Therapist plays an important role in the management of one’s mobility changes that occur as the disease progresses. They also make recommendations and provide training for equipment and devices that can make mobility easier and safer.

Assistive devices and adaptive equipment to help with mobility and movement:

• Walkers - 
• 4-wheeled walker: Helps with walking and moving around
• Drive NitroRollator: A 4-wheeled walker that folds up easily for transportation
• U-step walker: A weighted walker with braking system
• Car mobility - 
• BraunAbility Turny Evo: A car seat swivel that makes it easier to get in and out of a car
• Portable exercise bike pedals: used to strengthen legs while sitting in a chair
• Wheelchairs -
• Broda Tilt Chair: Wheelchair with a back that can be positioned as needed
• GOLDEN Literider Envy Power Chair Motorized wheelchair
• Wheelchair Footrest Leg Restraint Strap: Keeps legs on footrest so they don’t drag on the floor
• Karma Ergo Lite 2
• Medline Ultralight Transport Chair Lightweight wheelchair
• Motion Composites Ultralight wheelchair
• Peramobil m3 Motorized Chair
• Wheelchair seatbelt restraint: to prevent falling out of wheelchair
• Wheelchair tray: keep items close and wheelchair surface clean
• RohoAirLite chair cushion: for comfort and to prevent bed sores
• Non-slip skid pads for chair/tables: Helps to prevent a patient from sliding out of a chair
• Ramps: Helps wheelchair users get in and out of the house or buildings. An ADA specialized company should install or recommend one to ensure the angle is ADA compliant
  

The proper lift or assistive device makes a significant difference in the care partner’s ability to lift and transfer their loved one. For example, transferring their loved one from a wheelchair to a toilet, or lifting them to help get out of bed.  

Assistive devices and adaptive equipment to help transport the person:

• Electric lift chair: stationary reclining and lift living room chair
• Gait belt: Helps with transfers and provides stability
• Patient Lift Stair Slide Board: Helps to transfer person from wheelchair to bed, car or another chair (two people required)
• SARA lift (Stand and Raise Assist) -
• Invacare lift
• Lumex Stand Assistive Device
• Sabina lift
• Bestcare Bestmove Stand Assist
• Hoyer Life: A sling seat
• Transfer disc or a pivot disc: Helps with transfers
• Swivel seat cushion: Helps with transfers
• Car assist handle/car cane: Helps people to get in and out of a car

Assistive devices and adaptive equipment to help with speech and communication.

These fall into 2 general categories: 

1) devices and techniques to strengthen and amplify one’s voice and

2) devices when speech abilities no longer meet communication needs.  Speech Therapists are familiar with both categories, and they should be consulted before purchasing a device because there are many ones from which to choose, and new devices are being developed regularly.  Be mindful that some devices require good dexterity and often loss of dexterity occurs at the same time as does loss of voice.

Category 1:

• EMST Expiratory Muscle Strength Trainer: Helps strengthen voice and swallowing muscles
• LSVT Global (LOUD): Program to help increase voice loudness
• Voice amplifiers -
• Chattervox
• Spokeman
• Telephone amplifier

Category 2:

• Control Bionics: An eye-controlled computer mouse
• Eyegaze Edge: An eye-controlled speech generating device
• Grid for iPad: An Augmentative and Alternative Communication (AAC) tool with content for everyone and innovated for all ages and levels of literacy
• Head Mouse (Smylemouse): Hands free, facial recognition computer controller
• Picture cards: Can point to cards to communicate
• Letmetalk: Place finger on images and device speaks the words in a sentence
• SGD Lingraphica: Place finger on images and device speaks the words in a sentence
• Talk to me technology: Device to use eyes to communicate on computer screen. There is an option to record one’s voice and then playback
• Tobii Dynavox: eye-controlled speech generating device
• Word Tray: Alternative communication device with pictures one can point to
• Text-to-Speech Applications -
• Lingraphica, Dragon Diction App, TTS Reader
• Delayed Auditory Receptors - DAF Professional 
• Artificial Intelligence (AI) and Voice banking options -
• Eleven Labs
• MOV Acapela
• Speak Unique
• VocalID: CereVoice Me from Cereproc
• Voice Keeper
• Talk to Me Technologies

People with PSP, CBD or MSA develop a symptom known as impulsivity. To prevent unnecessary falls, care partners have found using one or more of the devices listed below has provided an alert for the care partner and has protected the patient from unnecessary falls. 

Assistive devices and adaptive equipment to help prevent unnecessary falls:

• Apple watch: Monitors falls and sends alerts
• Bed monitor: Alerts if patient moves off surface
• Baby monitor: To view and hear activity in another room
• Chair alarm: Starts to chime if patient moves off surface
• Floor mat alarms: Alert after fall
• Cordless doorbell: Can alert care partner if they are needed
• Emergency alert systems and devices: Extra safety precautions and will provide video alerts of movement and auditory alarms with opening doors or windows
• Hand bells: To alert care partner if they are needed
• Video monitors in home connected to phone: Care partner can be in another room and still monitor loved one

For the purpose of comfort and ease of dressing or undressing, our care partners and patients have found the following list of clothing, shoes, etc. very helpful. As an example, sometimes when it’s necessary for the care partner to assist the patient with toileting, easily removable pants makes the job much easier for both involved. Seeing an occupational therapist can be helpful for maintaining independence or reducing  caregiver burden for basic self care.

Assistive devices and adaptive equipment to make getting dressed easier:

• Adaptive Clothing Showroom: Website to purchase adaptive clothing
• Adult ‘onesie’: Has snaps that attach in the crotch area, which keeps shirts down and secured
• Clothing with Velcro: Instead of buttons and zippers, easier for people with fine motor issues
• Elastic waist pants: Easier to put pants on
• Helmet: To protect head during potential falls
• Lightweight and supportive shoes: Prevents falls
• Velcro closures or elastic shoelaces: Won’t have to tie shoes
• Oversized outdoor jackets: Easier to put on
• Padded pants: Keeps safe in case of a fall; can be football pants, ski, snowboarding pants
• Slip on shoes: Easier to put shoes on
• Dressing Hook: Gets rid of the need to bend or reach while getting dressed
• Reacher or Grabber: Reaches and grabs that are far or high away
• Sock aides: A tool that helps put socks on without having to bend over
• Adaptive shoes: Designed to slide feet into shoe easily

Assistive devices and adaptive techniques to make taking medication easier:

• Take 1 pill at a time and swallow with liquid
• Use the chin tuck technique
• Take pills with thicker liquids to make swallowing them easier
• Create habits and routines around taking your medications, like when you brush your teeth or eat breakfast. Keep the medications in a visible spot that lines up with the routine.
• Use a pill box to organize and track your medication. Get one custom to your schedule. Some even self-dispense pills or have built-in alarms.
• Have a plan for when you are not at home to take medications. Have something to carry them in and a way to remind yourself to take them.
• Use pen and paper, or a health and medication app to check off when medications are taken.
• Use the alarm on your phone to remind you when to take medications - 
• If you have one, smart speakers like Alexa or Google Home can also remind you.
• Take the medication(s) as soon as the alarm goes off in order to reduce the chance of forgetting if you get distracted by a task
• Ask your pharmacist to fill your medication in bottles with “arthritis-friendly” bottle caps for easier opening.
• Some in-store and online pharmacies can offer individual packaging or in bubble packs -
• These can help with tracking but can be difficult to open if you have trouble with fine motor tasks. 
  

The following list are recommendations from many of our care partners and are used for various purposes. You can google many of these devices. 

Other assistive devices and adaptive equipment that people with the disease and care partners recommend:

• AMAneo (Assistive Mouse Adapter): To help control a computer mouse
• Motion-activated or remote-controlled lights, curtains, fans and doors
• Alternating pressure mattress or “egg-carton” pad for comfort in bed 
• Doughnut cushions: Round cushions with a hole in the center to relive pressure while sitting
• Buttons to turn on/off lights: Makes turning the lights on and off easier than cranking a lamp wheel
• Continuous Positive Airway Pressure (CPAP) Machine: A device commonly prescribed for treating sleep apnea, which is a condition where a person stops breathing in their sleep. A CPAP machine pushes air through the nose to keep the person breathing during sleep.
• Adjustable Height Home Bed Assist Handle: Helps to get in and out of bed (Drive Medical is a common brand).
• Emesis basin: Used for vomiting.
• Foam corners for tables: Prevents serious injury when falls occur
• Hospital bed that elevates (to 40%) or flexible frame: Some patients sleep better when they are elevated
• Magnifying glass with light: Assists with reading, ideal if the magnifying glass can clamp to the table.
• Seatbelt extender: Helps care partner strap on seatbelt.
• Widen doorways: Doorways should be wide enough for a walker or wheelchair to fit. You can consult with an OT or PT if needed.
• Wrist Strength Recovery Massage Ball Palm Grip: This can strengthen the wrist and hand muscles. It can also be used to keep the hand from closing shut if that is a symptom that affects you.
• Robotic vacuum cleaners
• Automatic plant-watering
• Automatic pet-feeding device