Make sure the path from your bedroom to the bathroom is well-lit and free of clutter Wear non-slip shoes or slippers If you feel dizzy or unsteady on your feet, talk to your family doctor The techniques listed below are recommended during early healing and are generally in place for six to eight weeks following your surgery.
Grab bars and non-slip mats should be installed where possible, to make getting in/out of the shower easier and safer. When bars cannot be installed and if space allows, you can use your walking aid (walker, crutches or cane) for more support.
Stand close to and face the shower door, and move your walker behind you. Then step into the shower stall with your operated leg, by using your walking aid and grab bars for support.
Then step down with your non-operated leg, using your walking aid and or grab bars for support. To watch a video clip on how to safely get in and out of a walk-in shower stall, please see below.
Note: These instructions for getting in and out of a standard bathtub are for patients who are allowed to weight bear as tolerated (WHAT) following surgery. If you have any concerns at all, you can sponge bath in the early days after your surgery.
Grab bars and non-slip mats should be in place where possible, to maker getting in/out of the bathtub easier and safer. If you do not have, or are unable to install, grab bars in your tub enclosure, it is strongly recommended that you get an add-on-tub rail.
To watch a video clip on how to safely get in and out of a standard bathtub, please see below. A bathtub transfer bench lets you sit while bathing for more safety and comfort.
If you have any concerns at all, you can sponge bath in the early days after your surgery. Grab bars and non-slip mats should be in place where possible, to make getting in/out of the bathtub easier and safer.
To safely get into a tub using a transfer bench, follow these steps : Place your hand on the back of the chair or use the add-on tub rail for support.
Instead, you should use a hand held shower hose, and have someone turn on/off the water. You can also use a long handled sponge and soap on a rope to avoid bending forward too much.
To safely get out of a tub using a transfer bench, follow these steps : To watch a video clip on how to safely get in and out of a bathtub using a transfer bench, please see below.
To watch a video clip on how to safely wash your hair at the sink, please see below. Maybe your aging parent or elderly loved one is using a wheelchair and is having difficulty transferring onto a bench or seat in the shower.
Remember to put the brakes on when transferring in/out of the chair and when showering. Occupational therapy evaluates how a person with ALS performs daily functional tasks that include personal care, mobility and work activities.
Assessment is made through interview and functional evaluation in the ALS Clinic. Recommendations for assistive devices, durable medical equipment (wheelchairs, hospital beds, bath chairs, etc), and home or outpatient therapies are made.
The therapist provides instruction in body mechanics for the patient and caregiver gives instruction in energy conservation techniques and provides exercise and range of motion guidelines. You can schedule an appointment for physical and occupational therapy through the Center for Rehabilitation Services.
Wrist and hand muscles may become weak affecting grasp for eating, dressing, grooming and work activities. You must purchase them on your own, but check with the occupational therapist about sources and prices, and whether these devices will help you or a waste of money.
They allow horizontal and vertical motion of the arms, so you can reach your plate and your mouth. There are many devices, braces and durable medical equipment available to assist you if you develop hip, knee or ankle weakness.
Proper evaluation of the extent of your weakness and endurance is necessary before any recommendations for equipment are made. You must check with your insurance company or Medicare regarding what they will cover and what preferred providers or vendors they use.
Forearm crutches act like two canes by giving two-sided support. A strong arm cane can also provide more support for weak hands.
Standard walker, lightweight, folding type can be transported in the car. Collator walker with wheels, brakes, seat and basket (swivel wheels are needed for easier turning) give a smooth, steady gait for persons with weakness and/or stiffness.
Ankle-foot arthrosis (AFO) used to be called a short leg brace. It fits inside your shoe, and usually should be custom molded to your leg.
Which brace is medically indicated must be evaluated by your physician, physical therapist, and orthotic. Gait should be evaluated by a physical therapist in an outpatient clinic to test stability and safety using the appropriate walking aide.
To obtain one, you need a prescription, and a supplier (accepted by your insurance). Considerations include: overall stability for your height (three-wheeled walkers are not as stable), adjustability of the height of the hand grips, hand brake system, ease of operation and stability, ease of turning the walker, folding feature for easy transport in the car, seat and basket options.
Gait belt is used around the person's waist to give assist to stand or sit. Call for a demonstration to make sure you are comfortable in it and your caregiver can operate it.
TED hose are used to reduce mild swelling in feet, ankles, and legs; to promote circulation; to reduce risk of blood clots (available by prescription at your pharmacy). Hospital Beds All require a prescription and a letter of medical necessity from your physician.
Full electric frame power switch for adjusting the bed frame height to transfer from the wheelchair or stand at bedside, as well as, adjusting head and foot positions. Alternating pressure mattress is used under the sheet, works with an electric compressor to raise and lower pockets of air under the body areas (needs a prescription and letter of medical -necessity).
Hand-held shower hose can be attached to a shower head or faucet to allow water spray from proper height. Grab bars securely fastened in the shower wall at the appropriate height can provide a “shelf” for weak arms to rest on while washing your hair, shaving, washing your face.
We suggest that patients be evaluated at the Center for Assistive Technology (CAT) in order to get a wheelchair best suited to their needs. Therefore, if you need a power wheelchair, you should purchase a manual chair on your own.
Hall widths and turning space into bedroom or bathroom. Lightweight manual wheelchair used for transportation to and from car, should not be used for sitting in a wheelchair for a long period of time, must have a pressure-relief cushion, detachable armrests, swing-away footrests; some have four small wheels, some have quick release large back wheels, both are easier to place in car.
Electronic environmental control devices, used to turn on lights, access TV, VCR, stereo/CD, computer and telephone. The Center for Assistive Technology evaluates patients for appropriate wheelchairs.
A platform area for the wheelchair is needed for safety and stability inside and outside the entrance doorway. Remember who is pushing up on down the ramp and the strength that is needed to control the wheelchair.
A “Z”-shaped ramp is necessary when short front- or backyards do not provide length for a safe, long incline. A five-foot area at the bottom of the ramp is recommended for stopping and turning the wheelchair.
Platforms or decks outside the front and back or inside garage doors must meet the threshold. This will give you approximately 1.5 to 2 inches increased clearance depending on the width of the door itself.
It can be used over the toilet or in the shower and is usually 21-22" wide; it goes through most bathroom doors easily. Remodeling is very expensive, but a tiled floor with a recessed drain allows a shower commode easy access for patient and caregiver.
An oblong shower stall can be modified with a wood deck and removable ramp; glass doors must be removed and replaced with an expandable curtain rod and shower curtain. Stair lifts are an alternative for those unable or unwilling to move.
A decision to move the person with ALS to the most accessible level of the home with changes for toileting and bathing needs may be the most feasible solution in the long run. Check with companies that use ADA (American Disability Act) guidelines that modify homes in your area.
Your occupational therapist will choose the appropriate splint depending on how much muscle weakness or stiffness is present. It does not place the thumb and index finger in pinch position, and it does not make the hand stronger.
Ambulatory, moderate weakness in select muscle groups, use of assistive device(s). Maintain as many activities as possible, take breaks, and avoid excessive fatigue.
Maintain activities as able, take breaks, and avoid excessive fatigue. Dependent, severe weakness all muscles, maximal assistance needed.
Consider short bouts of therapy; possibly two to three visits, three or four times per year. Adapted or support equipment may be necessary because of weakness and poor balance.
Encourage rest breaks as needed; energy conservation. Because of the progressive nature of ALS, some persons may have little motivation to exercise.
Activity improves digestion and gastric motility, quality of sleep, joint stiffness, and psychological state. The change also depends on how easy it is to accomplish the task when performing the new method.
When you climb a mountain, you also have to have enough energy to return to base camp. Examples: walkers with wheels, wheelchairs for distance (shopping), handicapped parking cards.
Eat high-energy foods in small amounts every two to three hours since muscles become fatigued more readily. Purchase “gadgets” or other energy-saving devices after recommendation from someone who is knowledgeable about their actual success rates.