1. Wheelchairs & Assistive Devices
Annual Compulsory Education

2. 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

3. 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

4. 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

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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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

15. 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

16. 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.

17. 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

18. 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

19. 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