zissieg@walla.com
Introduction to Interior Decorating 101
My pediatrician had a good sense of humor, and his tip regarding how to care for teething babies was unique. In fact, this tip was useful under a variety of circumstances. He told me that if the baby cries for a long period of time due to pain from teething, this is what I should do: fill a shot-glass full of bourbon or rye or scotch and dip my finger into the liquor; then rub the liquor on the baby’s sore gums. The alcohol will almost always relieve the pain. If the baby continues to cry after this procedure, however, I should then proceed to drink the remainder of the liquor in the shot-glass. I told you he had a good sense of humor. Well, as we all know, this is not a very practical tip for handling that problem or any other problem. But I have learned a lot of tips both from my experience and the experience of others that can make the home and environs more user-friendly for people with mobility problems. I’d like to share some of these tips with you.
THERE IS NO SUBSTITUTE FOR A PROFESSIONAL THERAPIST’S ASSESSMENT AND INSTRUCTION BASED ON THE NEEDS OF EACH INDIVIDUAL PATIENT
Before I share these tips, I should caution you that in any event you should have a qualified occupational or physical therapist from the patient’s kupat cholim evaluate the situation and recommend the necessary equipment and environmental alterations needed for the patient’s particular case. This is no substitute for professional medical advice. Any links to specific sites for sale of such equipment are for demonstration purposes only, not an endorsement of any particular company.
How to Achieve a Standing OvationProbably the most important item we introduced into the home was a sturdy office-chair with arms. Some patients may be able to push themselves up by simply placing the palms of their hands on their thighs and pressing on their thighs to gain the strength to stand. Post-stroke patients who have lost use of one side of their body have great difficulty in standing up. Placing their hands on the chair arms helps them boost themselves to an upright position. Likewise, raising the height of the chair seat, either by placing a firm cushion on it, or by purchasing specially made cones that fit under the chair legs, makes it easier for the patient to rise to an upright position.
The same holds true for the height of the patient’s bed. Getting in and out of bed can be very difficult with no support on the sides to hold onto. A raised mattress somewhat alleviates the situation. There are also bars (similar to but smaller than the types of bars used to keep children from falling out of bed) that can be inserted under the mattress and act as a support for pushing up from a sitting position at the edge of the mattress.
While we’re on the topic of the edge of the mattress, it is important that the patient learn how to scoot forward to the edge of the chair or bed before attempting to stand up. An occupational therapist can instruct the patient in all the steps necessary to properly stand up from a sitting position. If the patient still has difficulty achieving this on his/her own, you can assist the patient by placing your hand on the small of the patient’s back and applying gentle pressure to give him/her that extra nudge forward to be able to rise. Unless you really enjoy the experience of back pain, try to refrain from pulling the patient up by yourself.
Cars present a special challenge. The car seat’s proximity to the ground coupled with the need to maneuver the body until the feet are in the proper position for either sitting or standing pose difficulties for the patient. Bars are available for installation into cars to enable the patient to grasp onto something while either attempting to sit in or rise from a car seat. I personally have never used these bars, so cannot vouch for their effectiveness. There are also swivel discs (like a turntable) that can be placed on the car seat to help the patient maneuver in the seat and position his/her feet correctly.
Then there are toilet seats to deal with—can’t do without them, can we? Booster seats are available for toilets. Some have a hole and plug in the plastic where you can fill the seat with water, the weight of which helps stabilize the seat on the toilet. I came up with a Velcro solution to keep the seat I bought stabilized, gluing a piece of Velcro to the toilet bowl in several strategic spots, and matching strips of Velcro on the booster seat. I then cut a third piece of Velcro for each of these strategic spots and joined the booster seat to the toilet bowl that way. This kept it from sliding around. Necessity is the mother of invention, they say. Another important item near the toilet is a bar attached to the wall. Utilizing the bar the patient can more easily pull him/herself up from the toilet seat. There are also other bathroom solutions available, such as a U-shaped bar that can be placed surrounding the back and sides of the toilet to act as arms for the patient to use to help him/herself stand up, or a commode on wheels (similar to a wheelchair) that can be pushed to the toilet without the patient even having to stand up. These commodes also come with removable bed-pans. OK, that’s enough about the toilets. I think I’m going to lose my audience if I dwell on this subject any longer.
As long as we’re in the bathroom mode, let’s talk about showers. Many patients will need to be seated during a shower. The commode mentioned above can double as a shower chair, or you can use a regular plastic garden arm chair with holes drilled into the seat to prevent a buildup of water while showering the patient. Next to the area where the patient is seated or standing there should be a bar on the wall. A slip-free floor surface is also recommended. It is difficult to shower the patient with a stationary shower-head, so if your bath is not already equipped with a hose type shower-head that can be directed to different areas of the patient’s body, you’ll want to invest in one of these.
TOSS THOSE CARPETS!
Just a-Walkin’ Through the House
Now that we have the patient clean and standing, let’s discuss how he/she is going to walk around. First of all, carpets and throw-rugs are a “no-no”. Not only is it harder to push a walker on a carpeted surface, it’s just too easy for a patient to stumble over the edge of one. So roll them up and get rid of them. Some patients may need no assistance in walking. Others may manage with the assistance of a simple cane (make sure to purchase a cane that is the correct height for the patient). A cute device that can be added to the tip of the cane is a rubber contraption that
allows the cane to remain upright. It’s called a tripod. A cane equipped with this makes life easier for the patient: he/she no longer has to find a wall against which to lean the cane, or a chair on which to hang it, and, should the cane topple over, the patient need only press on the side of the rubber tripod with his/her toe to bring the cane back up to a vertical standing position. Brings back memories of those bop-bags we used to punch down and watch pop right back up.If the patient requires a walker, be sure to adjust the height of the walker to suit the patient’s needs. There are both folding and non-folding walkers, the latter being more sturdy, the former more easily transported in cars. Tennis balls placed on the back legs of the walker (you have to work hard at slitting and prying them open to fit them onto the tips of the walker) make for a smoother glide across the floor. Replace the tennis balls periodically, as they get worn. You can purchase accessorized walkers that come with seats, and baskets are available for the patient to tote things along with the walker. The patient will tend to want to use the walker as support for standing up from being seated. Some physical therapists will say this is the proper way to stand with one hand on the walker and the other pushing up from the seat, and others will discourage it. Follow the advice you receive from your own physical therapist.
I think now would be a good time to take a break from discussing all this equipment. It’s time for a breather. Look for my post next week with the remainder of the tips I have accumulated from my experience—I know the suspense is mounting, but hang in there: there will be more help and advice on the way.
Guide to Services for the Aged and Disabled in Israel
© Copyright-2008
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