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Dr. Andrew Rynne

Family Physician

Exp 50 years

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I recently took on the care of my wheelchair bound,

Answered by
Dr. Arnab Banerjee

Critical Care Specialist

Practicing since :2012

Answered : 1254 Questions

Posted on Fri, 21 Dec 2018 in Accident and Emergency
Question: I recently took on the care of my wheelchair bound, obese mother. Can you help me with good body mechanics and safe transfers?
Answered by Dr. Arnab Banerjee 45 minutes later
Brief Answer:
need some further details regarding...

Detailed Answer:
Hello and Welcome to 'Ask A Doctor' service...
I've gone through your query...
I can understand your concern for your mother...

Could you kindly let me know a bit more about her health concerns so that I can guide you specifically...

Why is she wheelchair bound? Is it because of some injury/paralysis of any body part/age-related problems or something else?

Can she able to stand up on her own/get up from bed on herself or need assistance there also?

Does she able to pass urine/motion on her own or is there any assisting device (eg. Catheter, motion assisting device attached)?

Is there any bed-sore (pressure sore on any pressure points of the body, eg. pelvic girdle, shoulder blade, tailbone, knee joint sides etc.)...

Any concern with respiratory secretions/any concern related to a cough?

Does she have any other assisted devices (any specific tubings, IV lines, Oxygen canula etc)?

When you say safe transfers, do you mean roadways/air transfer, long-travel/short duration, please clarify this too...

Any other concerns that you'd like to mention regarding this?

It'll be a pleasure to assist you further, just kindly let me know this necessary details first...

Take Care
Kind Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee
Follow up: Dr. Arnab Banerjee 38 minutes later
She needs assistance to stand from bed to portable potty and wheelchair. She weighs 320 lbs, I weigh 120 lbs. She sleeps in a hospital bed so we can crank it all the way up for transfers. I then transfer her to a lazy boy. She uses the wheelchair to come to the dining room for meals.
She had a stroke that has weakened her right side-she bears weight on the right side, for a stand pivot transfer as the nurse's said and taught me. She can sense when she has to use the portable potty-that's another transfer.
She has no bedsores or respiratory problems.
She went to an in-patient rehabilitation center and they brought her a long way.
We had a wheelchair ramp installed, so we transfer her to the front passanger side of the car for doctor visits, for lab work and the occasional restaurant.

I am worried about hurting her, that she could fall and also hurting myself as I am alone with her most of the day. I nees good transfer techniques and body mechanics for all of these transfers.
Answered by Dr. Arnab Banerjee 1 hour later
Brief Answer:
I'd explain as follows...

Detailed Answer:
Welcome back,

Thanks for the details...

Well, mobilization and ambulating are extremely important in this scenario...

Good to know she can sense when to use the portable potty, I'd encourage to do it this way only as not only it'll prevent and unwanted skin abrasion but also helps in maintaining good hygiene which is important on the long run...

Better to avoid any climbing stairs, just ensure everything gets managed on the same floor (preferably ground floor only)...Yes, just keep using the ramp while transferring to the car as you're already doing...

Now, the most important part of a good transfer technique is adequate manpower and equal weight distribution...So, do ensure to call up another help while you're there with her or at least transferring her from one place to another...Ideally, there should be three persons while transferring (one holding the upper and lower legs and the other two holding her upper body part by the shoulders and back)...

You can additionally install CCTV's around some main areas where she stays (like the bedroom, main exit and entrance) and put them in a central monitoring to keep an eye even when you're not immediately with her...The central monitor can even be connected to your tablet/mobile also...

Apart from that, you seem to be doing fine, good that you've already learned the stand pivot transfer technique...

Physical therapy should be stressed upon...Regular active and passive limb physiotherapy under the supervision of a physiotherapist will be immensely helpful as it'll help to regain strength to the right side to some extent...

Now, regarding the bed, well the only option, in this case, would be to buy/rent one of those portable hospital beds cause otherwise, at home, keeping the head-end up would not be possible...Recliners and lazy-boys would be helpful to mobilize from bed thereafter (but again, with the help of two persons at least)...

Daily three times mobilization from bed to recliners would be enough...apart from that just encourage her ambulating in the bed itself, during regular physiotherapy sessions and of course while in the wheelchair...

Let me know if I can assist you further...

Take Care
Kind Regards

Above answer was peer-reviewed by : Dr. Arnab Banerjee

The User accepted the expert's answer

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