ArticleFND3 min read
FND: why rehabilitation at home matters
Improvements made in hospital or clinic can be hard to keep once you’re back home. That’s why the community is where FND rehabilitation often succeeds or stalls.
The gap after specialist treatment
Specialist FND rehabilitation programmes can lead to real improvements. But many people find that, once they’re home, it’s hard to keep progress going: routines slip, symptoms flare and there’s little ongoing support.
Research at UCL notes that FND affects approximately 100,000 adults in the UK, that improvements from rehabilitation can be difficult to sustain in the long term, and that patients often report receiving equipment only from community OT, rather than rehabilitation.1 Many community OTs also say they lack confidence supporting people with FND.2
Why home matters
- Real tasks, real places. Practising in your own kitchen, stairs and routines builds skills that transfer to daily life.
- Spotting what keeps symptoms going. At home we can see triggers, habits and pressures that don’t show up in a clinic.
- Involving the people around you. Family members can learn how to help without unintentionally reinforcing symptoms.
- Building independence. A plan for setbacks means you’re not starting from scratch each time.
What community OT for FND can include
- Building on what you learned in specialist treatment
- Graded practice of the activities that matter most to you
- Daily routines that balance activity and recovery
- A personal plan for flare-ups and setbacks
- Reviewing equipment and adaptations
- Support returning to work, study or social activities
How NexGen can help
We provide FND rehabilitation in people’s homes and communities, and can continue support after specialist inpatient or outpatient programmes. Virtual sessions can help with self-management between visits.
Questions
Can you see me after an FND programme has finished?
Yes. Continuing rehabilitation at home is one of the most useful things we do for people with FND.
Will my family be involved?
If you’d like them to be. Helping family understand FND, and how to support you, is often valuable.
Do you work virtually for FND?
Yes. Virtual sessions work well for education, planning and self-management, alongside home visits.
References
- UCL Centre for Behaviour Change. Improving engagement in community-based OT and self-management for people with FND (NIHR-funded doctoral research, C. Nicholson). Link
- Nicholson C, Francis J, Nielsen G, Lorencatto F. Barriers and enablers to providing community-based occupational therapy to people with functional neurological disorder: an interview study with occupational therapists in the United Kingdom. British Journal of Occupational Therapy 2022;85(4). Link
- Nicholson C, et al. Occupational therapy consensus recommendations for functional neurological disorder. J Neurol Neurosurg Psychiatry 2020;91:1037–1045.
This article is general information, not a substitute for individual clinical advice. If you have new or worsening symptoms, speak to your GP or NHS 111.
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