1. Restorative/Rehabilitative Care ADL & MOBILITY NEEDS 4.02Nursing Fundamentals 72431 Adaptive Devices For Assisting With Activities of Daily Living (ADL)

2. 2 Special utensils available to help with eating Special utensils available to help with eating Electric toothbrushes for brushing teeth Electric toothbrushes for brushing teeth Long-handled brushes and combs for hair care Long-handled brushes and combs for hair care 4.02 ADAPTIVE DEVICES FOR ASSISTING ADL Nursing Fundamentals 7243

3. 3 Supportive devices to assist with walking – canes, crutches, walkers Supportive devices to assist with walking – canes, crutches, walkers Wheelchairs and motorized chairs to provide movement from place to place Wheelchairs and motorized chairs to provide movement from place to place 4.02Nursing Fundamentals 7243

4. 4 Prosthesis to replace missing body parts Successful use of adaptive devices depends on the resident’s: – attitude – acceptance of limitations – motivation – support from others 4.02Nursing Fundamentals 7243

5. 5 Walker… four-point aid with rubber tips Resident stands erect when moving walker forward Resident stands erect when moving walker forward Walker adjusted to height of hip joint Walker adjusted to height of hip joint Elbows at 15-30 degree angle Elbows at 15-30 degree angle Walker picked up and put down, not slid Walker picked up and put down, not slid 4.02Nursing Fundamentals 7243 AMBULATION AND TRANSFER AIDS

6. 6 Walker… Back legs of walker even with toes so resident walks into walker Back legs of walker even with toes so resident walks into walker Resident steps toward center of walker Resident steps toward center of walker Leads with weaker leg Leads with weaker leg 4.02Nursing Fundamentals 7243

7. 7 Canes…Types: single-tipped single-tipped tripod - 3 legs tripod - 3 legs quad - four point quad - four point 4.02Nursing Fundamentals 7243

8. 8 Canes… Used when weakness on one side of body and resident has use of at least one arm Used when weakness on one side of body and resident has use of at least one arm – Provides balance and support 4.02Nursing Fundamentals 7243

9. 9 Canes… – Should be fitted properly: cane handle level with femur (greater trochanter) cane handle level with femur (greater trochanter) elbow flexed at 15 to 30 degree angle elbow flexed at 15 to 30 degree angle shoulders level shoulders level 4.02Nursing Fundamentals 7243

10. 10 Canes… Gaits ordered by physician or physical therapist: Gaits ordered by physician or physical therapist: – move cane and affected leg together – move cane, then affected leg Used on side of body where leg is strongest (side opposite the injury) Used on side of body where leg is strongest (side opposite the injury) 4.02Nursing Fundamentals 7243

11. 11 Crutches… – Provide support and stability through use of hands and arms. – Used when one or both legs are weak. 4.02Nursing Fundamentals 7243

12. 12 Crutches… – Measured to fit properly by physical therapist. height correct if two fingers fit between armrest and axilla height correct if two fingers fit between armrest and axilla hand grip adjusted to allow 20- 30 degrees flexion of elbows hand grip adjusted to allow 20- 30 degrees flexion of elbows 4.02Nursing Fundamentals 7243

13. 13 Crutches…Gaits four-point gait three-point gait two-point gait swing-to gait swing-thru gait 4.02Nursing Fundamentals 7243

14. 14 Crutches… Weight supported on hand bar, not axilla 4.02Nursing Fundamentals 7243

15. 15 Wheelchairs… Available in different sizes and models to allow for proper fit and usage Available in different sizes and models to allow for proper fit and usage Cleaned with mild detergent and water, rinsed with water and dried Cleaned with mild detergent and water, rinsed with water and dried 4.02Nursing Fundamentals 7243

16. 16 Wheelchairs… Periodic maintenance needed with 3 in 1 oil Periodic maintenance needed with 3 in 1 oil Arm rests adjusted to appropriate height Arm rests adjusted to appropriate height Feet rest flat on floor when chair is not moving Feet rest flat on floor when chair is not moving 4.02Nursing Fundamentals 7243

17. 17 Wheelchairs… Seat should not sag toward center of chair Seat should not sag toward center of chair Seat should not reach back of resident’s bent knees Seat should not reach back of resident’s bent knees Brakes locked when chair not moving Brakes locked when chair not moving 4.02Nursing Fundamentals 7243

18. 18 Wheelchairs… Wheelchair guided backwards when going downhill Wheelchair guided backwards when going downhill Wheelchair pulled backwards over indented or raised areas (i.e., entrance to elevators) Wheelchair pulled backwards over indented or raised areas (i.e., entrance to elevators) 4.02Nursing Fundamentals 7243

19. 19 Wheelchairs… Feet placed on footrests for transport Feet placed on footrests for transport 4.02Nursing Fundamentals 7243

20. 20 Gurneys/Stretchers/Litters Wheels locked when transferring residents on or off Wheels locked when transferring residents on or off Safety belts secured prior to transfer Safety belts secured prior to transfer Both side rails raised prior to transfer Both side rails raised prior to transfer 4.02Nursing Fundamentals 7243

21. 21 Gurneys/Stretchers/Litters Residents never left alone on stretcher Residents never left alone on stretcher Backed head first into elevators Backed head first into elevators 4.02Nursing Fundamentals 7243

22. 22 Gurneys/Stretchers/Litters Always used with assistance when transferring resident on or off Always used with assistance when transferring resident on or off Pushed feet first during transport Pushed feet first during transport 4.02Nursing Fundamentals 7243

23. 23 Guided backwards when going downhill Guided backwards when going downhill Cleaned with mild detergent and water, rinsed with water and dried Cleaned with mild detergent and water, rinsed with water and dried Gurneys/Stretchers/Litters 4.02Nursing Fundamentals 7243

24. 24 Gait belt (safety belt, transfer belt) – Used for residents unsteady on feet – Protects resident who loses balance or faints – Held at back 4.02Nursing Fundamentals 7243

25. 25 Must be tight enough to provide support but loose enough to be comfortable Must be tight enough to provide support but loose enough to be comfortable Used to safely transfer resident Used to safely transfer resident Gait belt (safety belt, transfer belt) 4.02Nursing Fundamentals 7243

26. 26 Correct aids must be used because they are individually fitted Correct aids must be used because they are individually fitted Resident observed closely to be sure aids are being used as ordered Resident observed closely to be sure aids are being used as ordered Faulty equipment reported and not used until repaired Faulty equipment reported and not used until repaired 4.02Nursing Fundamentals 7243

27. 27 Shoes must fit and be in good condition Shoes must fit and be in good condition Skin breakdown reported Skin breakdown reported Rubber tips on aids in good condition. Rubber tips on aids in good condition. 4.02Nursing Fundamentals 7243 SAFETY – AMBULATORY DEVICES