Wheelchairs & Assistive Devices Annual Compulsory Education

Learning Objectives Increase your understanding of why wheelchairs are used & simple care of a wheelchair Be able to demonstrate the care of wheelchair cushions Increase your understanding of assistive devices Increase your understanding of walkers, the types available, safe use, & apply this to your work Increase your understanding of the purpose & procedure for the use of canes

Wheelchairs should NEVER be used by other residents Wheelchairs are used for residents who can no longer safely walk a certain distance with helping devices and/or another’s support or supervision Wheelchairs provide the resident with a means to get around either on their own or with help; with support to all parts of their body Resident owned wheelchairs have been carefully measured & fitted to the resident’s needs. Wheelchairs should NEVER be used by other residents

Wheelchair Cushions All wheelchairs must have a cushion on them The cushion is specific to the resident Foam cushions must be placed with the low part at the back and the pommel (bump) at the front between the legs

ROHO Cushions ROHO cushions have a special cover Stretchy on the topside & non-slip on the bottom

ROHO Cushions ROHO cushions must be placed with the yellow rope to the left front corner of wheelchair to make sure of proper placement ROHO cushions are NOT to be covered with layers of cloth or padding (If a resident is incontinent,one layer of incontinent pad is acceptable over ROHO cushions) ROHO cushions that have a low part are positioned at the back If unsure if inflation is correct; check with your supervisor so that a physiotherapist can be consulted DO NOT exchange cushions form one resident to another

Positioning a Resident in a Wheelchair Position resident in center of seat; resident’s lower back against back of chair with thighs supported to 3-4 fingers width from knee crease to cushion Feet must be supported on the foot pedals or floor if foot propelling If the knees are too high, there will be increased pressure on the “sit” & tail bones If the knees are too low, there will be increased pressure behind lower thigh & danger of resident sliding

Positioning a Resident in a Wheelchair Reposition resident at least every two hours Helping the resident to move the body forward and back or side to side will help change pressure on the buttocks Encourage them to move their legs, hips, knees and ankles and lean body from one side to the other Report signs of pressure areas/sores to nurse

Pushing a Wheelchair Walk to the back of chair & use handle/handgrips Tell resident to keep elbows in or place hands on lap so that elbows are protected Push gently on handles to move resident Stop wheelchair & apply brakes in front of the wheelchair near the wheels when you have reached your destination

Damage & Identification If any part of the wheelchair appears worn, torn or damaged report to supervisor who can then report to the Physiotherapy Department All wheelchairs should have an identification tag with resident’s name & serial number All ROHO cushions have identification tags If any of the tags are missing, please report this to the nurse so that the Physiotherapy Department can replace them

Be Sure to Check Is it the correct wheelchair and/or cushion for the resident? Check the cushion – is it positioned correctly? Is it the correct ROHO cushion? Check the resident’s position

Assistive Devices Assistive Devices Walking Assistive Devices Help make up for problems the resident may have walking Increase a resident’s balance Walking Assistive Devices Walkers, canes, & transfer belts The needs of the resident & the causes of the problem are important when selecting the type of device required

Transfer Belts Transfer Belt is placed around the resident’s waist Belt is snug but allows 2 fingers to fit between belt & body A safe & secure way to assist a resident with balance Caregiver can keep control of the resident’s movement Care staff are required to wear a transfer belt & use it for all 1 person transfer & assisting someone on the walking program

Preventing Injury During a Fall If a Resident Begins to Fall Hold resident firmly by transfer belt Direct resident against wall, bed, or wheelchair Make sure you have a wide staggered stance (good base of support) Ease the resident slowly down to floor/bed/wheelchair Do not try to stop the fall Remain with resident as you send or call for help Reassure resident until help arrives

Walkers Residents who have poor balance and/or are weaker often use a walker for safe walking Provide greater of stability & are generally easy to use Types of Walkers Standard no wheels walker- pick up & place forward with each step It provides very firm support; good for a partial weight bearing resident Usually are aluminum frames & most fold for storage/transport

Walkers 2 wheeled walker: Slide front wheels forward along floor. Usually has a braking device in back posts. May have mini skis on bottom of back posts for easier glide. Folds for storage. 4 wheeled walker: Has 4 wheels, hand brakes, a seat, & often a detachable basket, and they vary in weight & speed. Slow down attachments are available.

Assisting Residents with a Walker Make sure the resident is wearing good walking shoes Have resident hold the walker firmly, standing halfway inside the walker & standing as tall as possible Have the resident move the walker slightly forward Instruct the resident to use their weak leg first, to lean forward with their weight on the hand rests Have the resident move the strong leg next Have the resident stand as straight as possible looking ahead instead of their feet Support with transfer belt as needed Encourage the resident

Canes Canes can be straight pointed or a quad canes Canes provide some support Often used by residents with one weak side The cane assists balance by widening the base of support Canes can be straight pointed or a quad canes Both provide balance & confidence for a resident Preferred canes are adjustable for height & fitted for individual needs

Walking with a Cane Assisting Resident to Walk With a Cane: Check the bottom of the cane to make sure it is not dirty and that the rubber end tip is in place Make sure the resident is wearing good walking shoes Have the resident stand as straight as possible & look straight ahead - not at their feet Canes are held in the strong hand opposite the weak leg When the resident walks, the cane is moved forward with the weak leg for support Support with transfer belt as needed