Practical Guidance for Care Partners Ruben Pagkatipunan Jr.,

Practical Guidance for Care Partners Ruben Pagkatipunan Jr.,

Practical Guidance for Care Partners Ruben Pagkatipunan Jr., PT, DPT, OCS Department of Rehabilitation, Johns Hopkins Bayview Medical Center Baltimore, Maryland, USA Malin Regardt PhD, OT Karolinska University Hospital Stockholm, Sweden Disclaimer

The health information provided in this presentation is provided for general informational and educational purposes only, and is not a substitute for professional health advice. Consult your physicians, physical therapists, and occupational therapists regarding your individual needs with regards to mobility. We do not endorse or recommend any particular products mentioned in this presentation. We do not have any financial interest in any of the products or with any of the vendors. Outline

How to be a healthy caregiver Proper body mechanics Safe Transfer and Mobility Techniques Mobility equipment Be a Healthy Caregiver Be strong and stay fit Eat well Keep up your emotional energy

Take care of your back Be strong Have your own muscle strengthening program Easy to do at home Specific muscles (abdominals, gluteals, thigh, shoulder/upper arm) Start with low-intensity, high-reps with gradual progression Regularly Don't forget to stretch!

Focus on the core muscle group Stay fit Aerobic training program Fun, enjoyable How long? At least 30 minutes Several times a week How hard? Moderate Use "Talk test to monitor

exercise intensity Physical Strain on Caregivers ? Studies have shown caregivers are at increased risk of musculoskeletal symptoms and injury Prevalence of LBP was significantly higher among caregivers (58%) compared with age- and BMI-matched controls (27.6%) (Bardak, Erhan, & Gunduz, Journal of Rehabilitation Medicine, 2012)

? Transfers, lifts, and patient repositioning are associated with musculoskeletal injury (Daragh et al., Journal of Applied Gerontology, 2015) ? Most common causes of back injury Lifting a heavy object incorrectly Twisting the spine while lifting Sudden, jerky movements while lifting

Poor posture or body mechanics over time Practice Good Body Mechanics Good body mechanics is the correct positioning of the body to maintain the natural spinal curves (neutral spine) during lifting, bending, moving and performing activities of daily living Maintain neutral spine position

Why learn correct body mechanics? Ensure safety of caregiver and patient Reduce stress and strain to the muscles, joints, and soft tissues, preventing injury Conserve energy Principles of Good Lifting Technique Maintain a wide base of support

Keep good posture (neutral spine), bend with knees, not with your back Use the stronger leg muscles to do the lifting Keep the load close to your body Avoid twisting and turning Clear the pathway

Plan the sequence of events Can you manage by yourself? Know your capabilities Safe Transfer and Mobility Techniques Bed mobility Transfers Wheelchair repositioning

Getting up from the floor Disclaimer: The transfer/mobility techniques shown may need to be modified for specific patient diagnoses To get higher up in bed To turnaround in bed

From lying to sitting From lying to sitting, with help Transfer techniques Before you transfer the person... Prepare the environment Get equipment ready Plan the movement

Prepare the patient Transfer techniques Stand pivot transfer Squat pivot transfer Sliding board transfer Stand Pivot Transfer

Squat Pivot Transfer 1-person assist 2-person assist Sliding board Transfer Repositioning a Person in the Chair and

Wheelchair Option 1: With the help of a person Repositioning a Person in the Chair and Wheelchair Option 2: With help of one person Repositioning a Person in the Chair and Wheelchair

Option 3: With the help of two people Getting Up From the Floor If the person is unconscious or injured, call 911 for emergency medical assistance Only attempt to help the person if you feel that both of you are able to safely work together If patient is not hurt and is able to move, you may assist with getting up from the floor

Forward method using knees Backward method using arms Hip Hike Forward Method Using Knees Forward method with caregiver assistance Backward method Using Arms

Hip hike Transfer and Mobility Equipment Chair booster Hoyer lift

Step ladder Extra-thick seat cushion Lifting seat

Beasy board Transfer and Mobility Equipment GentleBoost Uplift Assist Commode and Shower Chair Mangar ELK Emergency Lifting Cushion 30

Transfer and Mobility Equipment Rifton TRAM Thank you! 32

Reference Bardak, A., Erhan, B., & Gndz, B. (2012). Low back pain among caregivers of spinal cord injured patients. Journal of Rehabilitation Medicine, 44(10), 858-861. doi:10.2340/16501977-1043 Lockette, K. F. (2Lockette, K. F. (2011). A caregivers complete guide for safe mobility and independence in the home. Minneapolis, MN: Two Harbors Press.011). A caregivers complete guide for safe mobility and independence in the home SolutionsBenefits. (n.d.). November 09 Monthly Safety Spotlight November 09 Safety Discussion Topics, horizontal format Get to Know Your Back Lifting Safety Checklist

Maintaining. - ppt download. Retrieved from https://slideplayer.com/slide/4920136/ Reference List for Images/Videos

Slide 6 (people exercising with elastic bands): https://thecaregiverspace.org/how-to-encourage-the-elderly-to-exercise/

Slide 6 (seniors exercising with a ball and a kettle ball): https://www.verywellfit.com/chair-exercises-for-seniors-4161267 Slide 6 (people on gym ball exercising with weights): https://www.aarp.org/auto/driver-safety/info-2013/exercise-for-safety.html Slide 6(people doing plank): https://blog.cheapism.com/exercises-for-seniors/ Slide 7 (pool exercises for seniors): https://www.upliftingmobility.com/pool-exercises/ Slide 7 (people walking together): https://www.verywellhealth.com/the-benefits-of-walking-for-people-with-copd-914997 Slide 7 (people in aerobic class): https://www.tribuneindia.com/news/health/aerobic-exercise-may-ward-off-memory-decline-in-elderly/314148.html Slide 7 (people in spinning class): https://www.freepik.com/premium-photo/people-working-out-spinning-class-while-gesturing-thumbs-up_1833569.h Slide 8 (risk of injury picture): http://www.springvillechiropractic.com/our-services/lower-back-pain Slide 9 (picture of spine ligament and a person bending over): https://www.spineuniverse.com/wellness/ergonomics/body-mechanics-your-spine-tipsSlide 9 (picture of the spine): https://en.wikipedia.org/wiki/Neutral_spine

Slide 9 (person lifting box): https://myhealth.alberta.ca/Health/pages/conditions.aspx?hwid=hw206944 Slide 9 (person lifting neutral spine position and non-neutral spine): https://www.reddit.com/r/Fitness/comments/3ky5fg/my_road_to_elite_level_powerlifter_from_235lbs_to

Slide Slide

Slide Slide Slide Slide Slide Slide Slide Slide Slide

10 (proper lifting techniques): https://www.braceability.com/blogs/articles/7-proper-heavy-lifting-techniques 10 ( transfer logo): https://safepatienthandling.us/manual-patient-transfers/ 18 (stand pivot transfer): https://www.drugs.com/cg/how-to-transfer-a-person-safely-ambulatory-care.html 19: (squat pivot transfer 1-person assist and 2-person assist) https://www.mrswivel.com/patient-transfers/squat-pivot-transfer/ 20 (sliding board transfer): http://www.spinalcordessentials.ca/handouts/lateral-transfer/ 21-23 (wheelchair and chair repositioning): https://www.vardhandboken.se/arbetssatt-och-ansvar/arbetsteknik-och-forflyttningskunskap/oversik 25(getting up from floor using knees): https://www.stayonyourfeet.com.au/over60/what-if-i-do-fall/get-up-off-the-floor/ 26(Helping Someone Up after a Fall): https://www.youtube.com/watch?v=10jR0zjl19Y

27 (a person getting from floor using ResQUp fall recovery aid): https://www.activeforever.com/resqup-floor-recovery-mobility-aid 27(getting up from floor using arms): https://www.stayonyourfeet.com.au/over60/what-if-i-do-fall/get-up-off-the-floor/ 28(how to get up from the floor macgyver style, from youtube): https://www.youtube.com/watch?v=4ETgQD8QhZs Reference List for Images/Videos Slide 29 (seat cushion): https:// www.allegromedical.com/cushions-covers-backs-c544/deluxe-seat-lift-cushion-p555966.html?CS_003 =9164468&CS_010=ff808181178387c301179dcff8be031a&gclid=Cj0KCQjwkK_qBRD8ARIsAOteukAz Vou-wF6PGOs_AUp325xXLljdY3kmqPa1Uc8OUZb-0PDp_GoIZIEaAjC9EALw_wcB#1179-DCFF8F8

Slide 29 (hoyer lift): https://www.amicamedicalsupply.com/blog/top-5-hoyer-lifts-for-home-use/ Slide 29 (seat assist): https://www.medical-supplies-equipment-company.com/homehealth/product/lifting-cushion_14209.ht ml Slide 29 (beasy board): https://www.amazon.com/Beasy-Board-Transfer-System-BeasyTrans/dp/ B01BL43XKW Slide 29 (chair booster): https://www.target.com/p/kaboost-portable-chair-booster-natural/-/A-52783155/ Slide 30 (Mangar ELK Emergency Lifting Cushion) : https://

www.lightningmobility.com.au/products/patient-handling/mangar-elk-floor-lift Slide 30(GentleBoost Uplift Assist Commode and Shower Chair): https://www.amazon.com/GentleBoost-Self-Powered-Freestanding-Platinum-Healthcare/dp/ B01LXM50T1 Slide 31(Rifton Tram picture): https://www.adaptivemall.com/riftontram.html? gclid=EAIaIQobChMI4fHLzMa94wIVDxgMCh0--A9EEAQYASABEgLDdfD_BwE Slide 31(patient being transferred out of chair using rifton tram): https://www.rifton.com/adaptivemobility-blog/blog-posts/2017/october/workers-compensation-patient-transfers-tram Slide 31 (patient walking with rifton tram with healthcare professional): https://www.rifton.com/adaptive-mobility-blog/blog-posts/2014/september/stand-pivot-transfer-tram

Slide 31(patient being transferred out of w/c using Rifton TRAM): https://www.dailycareinc.com/shop/product/rifton-tram-lift-gait-trainer-sit-to-stand-lift-rental

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