April is Parkinson’s Awareness Month – #Take6forPD

According to the Parkinson’s Foundation, every six minutes someone is diagnosed with Parkinson’s Disease in the United States.

April is Parkinson’s Disease (PD) Awareness Month and along with the PD Community, we are encouraging everyone to take six minutes in an effort to raise awareness, advance the research, and become knowledgeable of the available treatments for this disease. With someone being diagnosed every six minutes, that totals 90,00 people per year in the United States alone.  Let’s be advocates.

Beyond awareness comes treatment. At Tx:Team, we have Physical, Occupational, and Speech Therapists who are trained and certified in treating patients with PD. One treatment program which has been proven beneficial is the LSVT BIG® and LOUD® Program.

How do the LSVT programs benefit Parkinson’s patients?

Parkinson’s can impact function in everything a person does at home, at work, and in their community recreational pursuits. The LSVT programs help patients to maintain movement and voice for normal function in everyday life beyond medication and repetitive, non-direct task training exercises utilizing principles of neuroplasticity backed by years of research. It takes all 16 visits (four times per week for four weeks) to achieve carry over so that by the end of one month, patients know how to move BIGGER and be LOUDER all the time.   

A unique feature of LSVT BIG® and LOUD® is that it recognizes there is an internal cuing proprioceptive issue in individuals with Parkinson’s such as softer voice and smaller movements, in people that are unable to recognize their deficits the majority of the time.   

What is the focus of LSVT BIG®?

  • Faster speed  
  • Greater arm swing   
  • Longer steps  
  • Overcoming difficulty getting through the doorway  
  • Longer distance  
  • Faster clothing donning  
  • Grasping materials during meal preparation  
  • Legible handwriting  
  • Amplitude of movement when showering  

What is the focus of LSVT LOUD®?

  • Louder voice that is not hoarse  
  • Improved facial expression   
  • Reduction of monotone speech  
  • Improved emotion  
  • Using more words  

Who would benefit from BIG® and LOUD®?  

Patients who have a decline in the amplitude of their movement, voice, posture, and balance in addition to reduced speech intelligibility are motivated to participate in all required sessions.  

Why are these programs so important to this patient population?  

LSVT BIG® and LOUD® assists this patient population in maintaining, enhancing, and slowing progression of Parkinson’s Disease, which in return facilitates their ability to maintain a level of independence with the following skill sets essential for daily living:   

  • Changes in cognitive function. People with PD can still learn, but it might take longer and require more repetition of practice. As a patient progresses, the therapist will work on dual tasking so you can keep moving bigger and being louder while doing something else at the same time. For example, getting dressed and talking, walking while carrying something, or tapping your leg while reading.
  • Changes in movement amplitude. Commonly, people with PD have difficulty with activities they didn’t before. As a patient progresses, utilizing larger movements helps patients return to these activities without cues and assistance. 
  • Changes in communication. People who have PD have soft speech and feel that they are talking WNL while others “need a hearing aid.” However, people may begin to feel embarrassed with social isolation. As a patient progresses with continuous use of a loud voice, they are able to participate in conversations without feeling excluded while maintaining their dignity.
  • Changes in emotional regulation, pacing, attention, cardiovascular health, sleep, and confidence can also be seen!  

If you have any more questions about the LSVT program for BIG® or LOUD®, find a certified therapist in your area or visit this website.


Nidhi, Alita, and Johanna are all experienced therapists in the Outpatient Clinic setting in Frederick, MD.  They work collaboratively together to support and treat patients with a variety of neurological diagnoses. Nidhi, Alita, and Johanna enjoy the relationships they foster with their patients, and they love to help them achieve their functional goals.

Nidhi Talpade, PT, DPT, BIG® Certified
Alita Borkar, MA, OTRL, BIG® Certified
Johanna Ebbs, MS, CCC-SLP, LOUD® Certified.

“Home is Where the Heart Is” and the Place Where My Patients Heal

“The magic thing about home is that it feels good to leave, and it feels even better to come back.” – Unknown
“Home is a shelter from storms – all sorts of storms.”-William J. Bennett

For many of us, our home is the place we most want to be, especially while we are recovering from surgery, a hospitalization, or experiencing a decline in our ability to care for ourselves. In-home rehabilitation services have been offered through home health agencies for years. Patients are being discharged from hospitals sooner and sicker, and more patients are declining rehab placements after discharge from the hospital. The home health team becomes an important step in the care continuum. As an Occupational Therapist in home health, I am an important player on that team.

How Does Occupational Therapy Work

As an Occupational Therapist, I work on all those things that occupy your time, from getting dressing, getting up and down from the toilet, taking a shower, making a meal, doing the laundry, driving, working, and enjoying your hobbies or leisure activities. After I assess someone’s abilities, I determine the areas that need to be improved and design a program that addresses those areas. The program could involve interventions in many different areas such as, therapeutic exercise, self-correcting balance training strategies or cognition/thinking skills.

I address Activities of Daily Living (ADLs) and mobility in the home, sometimes recommending adaptive devices to improve independence. Think of me as the “gadget girl.”  I especially enjoy seeing how the right piece of equipment can make all the difference with someone’s independence. Equipment recommendations include the trialing and training on the use of the equipment, which is an important part of the job in the home. No matter how good a simulation in a clinic is, it can never replicate their home. Trialing the equipment in the patient’s actual home ensures the appropriate piece of equipment is obtained.

The Role of Home Health Occupational Therapy

Home Health OT plays a huge role in the prevention of re-hospitalization. Home health clinicians wear many hats. I am an OT but at any given moment, I may have to function as a PT, Social Worker or RN. Some days it seems that I spend half of my time talking to physicians, other clinicians and family members trying to problem solve what will work best for my patient.

As with anything, there are aspects of my job that I love as well as the ongoing challenges that require creative resourcefulness to complete my job to the best of my abilities. I enjoy the intimacy that comes being in someone’s home, connections seem easier to establish. I enjoy seeing people’s family photographs, the things they collect, from stamps, vintage Pyrex, perfume bottles, or teapots. I enjoy being able to use things like pet or plant care in my treatment sessions. I am happy that my personal confidence with driving, navigation and parking has improved. The challenges of my days include scheduling, finding clean bathrooms, communication with coworkers who I rarely see, traffic woes, and caring for an increasingly sick population.

I feel that the rubber meets the road in home health. I see how people actually live, not just what they or their family report. When my primary care provider and I have talked shop during my visits, I have told her that if she could make home visits it would change the way she practices medicine. Seeing patients in their home, is that powerful, and for an OT, is completely natural and just makes sense.

“Home is where the heart is,” and it is where my patients heal.

Monica Laird is an Occupational Therapist in the Home Health setting in Frederick, MD.  In her 35 years as an OT, Monica has worked in a variety of settings including subacute rehab, outpatient rehabilitation, acute care, and now home health. She is married, has 2 adult sons, and a 14 year old carnival goldfish. When she isn’t on the road seeing her patients, she enjoys crafting, traveling, and going out to dinner with friends. She does not enjoy gardening or yard work and avoids those activities as much as possible.

Meet Scott Benedict

Tx:Team turns 40 in 2023!

Founded in 1983, Tx:Team will celebrate a big anniversary in May, 40 years in business. Because it is such a major milestone, we felt we should celebrate this achievement throughout the year.

Thank you to all Tx:Team associates throughout the decades for his or her part in our success.

Meet Scott Benedict, Chief Executive Officer, and hear his story of his time with Tx:Team:

O Comes Before P But Not Always in Therapy

Typically, most places will list departments in alphabetical order; however, not in the therapy world.

Though “O” alphabetically comes before “P,” you will rarely see Occupational Therapy before Physical Therapy. I believe this is because the majority of the public is more aware of what PT actually is. I have jokingly referred to OT as being the “other” therapy. I get so excited when I meet someone who actually understands what OT is and what I do.

I’m a bit jealous that my fellow PTs don’t have to constantly explain what they do or feel the need to justify the benefits of their services. The name itself, occupational therapy, really doesn’t give the average person a good idea of what OT encompasses. I have worked in the geriatric setting for over 25 years and have heard it all. “Oh, honey, I’m retired. I don’t need you.” Well, actually you do, and let me tell you why!

What is Occupational Therapy?

OT focuses on the whole person with the ultimate goal of maximizing a person’s independence. Trying to get someone to view their occupation of living, what does that entail? What physical aspects (mobility, vision, limited ROM, or neurological movements) are preventing someone from being more independent?  What cognitive aspects (STM deficits, dementia, perceptual deficits) are holding them back? Are there any environmental factors, such as a cluttered area, poor spacing, fall hazards, or ergonomics? There are so many things that we do on a daily basis that we automatically perform. However, when someone is sick or injured, that is when these “occupations” get challenged.

How Can Occupational Therapists Help?

As occupational therapists, it is our job to help identify the factors that limit our patients to perform their daily routines. Whether that includes simple ADLs, figuring out ways for the patient to continue employment, or problem solving ways to continue to pursue activities of interest. To be a part of someone’s success in improving their independence and quality of life is one of the reasons that I love being an OT.

Sometimes all it takes are adaptations to make life easier. Use of adapted equipment, modifying the environment, and compensatory strategies are all techniques specific to OTs. Having been in the assisted living/independent living setting for almost four years now, I have been able to grow relationships with my clients and have enjoyed watching them in their daily occupations. Even after discharge from OT, it is great to be able to engage with them and make sure they are succeeding. However, it is also great to be able to observe any regressions and to help them identify when therapy may be warranted again.

I love it when I receive referrals from my former clients regarding other residents. Not only did I help one person improve, that person is now more aware of what OT is and looks out for others. I feel like I am doing my best to let others know what OT is and how it can potentially improve someone’s independence and quality of life. Now, if only I can get the “O” to come before the “P.” Okay, okay….now that’s just crazy talk!

Kate Beaty, OTR, is an Occupational Therapist in the Senior Living setting for Tx:Team.  She has spent the majority of her career in the geriatric setting, whether in nursing homes, assisted livings or sub-acute rehabilitation.  She really enjoys the relationships that she fosters with her clients and loves to help them achieve their functional goals.