OT Shout out

Hey All,

I saw this clip and thought it was good recognition for our profession!! Just Copy and paste in your browser :)

Happy Holidays,

 Kailie


http://www.today.com/video/pay-it-forward-al-roker-honors-his-sons-therapist-587533379612

Toileting/transfer training for staff & caregivers

Below is a handout that I created for the Senior Care staff as an inservice that I provided to them.  It covers a variety of scenarios that can be more easily absorbed in a written format than the time it could take to review this info verbally.  If you had a caregiver that needed a handout/training like this, it should be modified/individualized for their specific family member.

Toileting training for Senior Care staff

·      Assisting patients with toileting is about balancing safety needs and the importance of privacy

o   Provide your patients with as much privacy to go to the bathroom as possible, but yours and their safety always comes first

·      Reduce a patient’s likelihood of rushing to prevent an accident by encouraging individuals to go to the bathroom more regularly

·      Explain what you’re doing before you start moving so your older adult knows what to expect – “I’m going to help you stand up now.”  “I am going to pull your pants up now.”

·      Your safety

o   Always protect your back by bending your knees instead of from your waist.

o   Ask the individual to use the wheelchair arms or toilet seat arms for support rather than holding on to your shoulders.

§  Once they have released their grasp of the wheelchair/toilet arms they should hold onto your forearms

·      Patient safety when sitting down and standing up from toilet

o   When performing transfers from a wheelchair to the toilet

§  Place wheelchair at a 90 degree angle to the toilet

§  Always lock wheels once in position

§  Do not hold onto a patient’s belt loops on their waist as a means of holding onto the patient as they can easily tear and result in a patient falling

§  Use a gait belt when necessary

·      Such as when certain individual’s clothing may be too loose for you to hold onto to provide extra leverage

·      Gait belt goes snuggly above the hips

§  If their legs are not strong, place your knees in front of theirs (called blocking) while they stand to prevent their feet from slipping out in front of them.

§  Undo belt and button/zipper on pants before having individual stand up to decrease their standing time (as long as their pants are not too loose that they will immediately fall down)

§  Tell the patient to start sitting down only when they feel the chair on the back on their legs and/or when you say it is time

o   Hold on to their trunk and hips to keep them stable. Don’t pull their arms or legs, it could injure fragile extremities or throw them off-balance.

o   If one side is weaker than the other, stand on the patient’s weaker side for extra steadiness and support

o   If you see that a patient uses the arm rests in a regular chair to help themselves stand up/sit down safely then they also rely on arm rests for safely sitting on a toilet

§  Individuals who “plop” into a seat quickly typically would be safer using a toilet with arm rests

·      In a bathroom with only a grab bar on the wall be cautious as certain patients may not be strong enough on their one side to fully support their weight when sitting down.

o   In these cases have them only use toilets with two arms or allow them to hold your forearm with their 2^nd hand for assistance

o   Don’t let them hold on to the walker as they sit and stand because it could tip over and cause a fall.

·      Patient safety when patient is removing/putting on clothing & providing hygiene assistance after toileting

o   Consider how much physical assistance the individual needs to put on/remove their clothing when toileting

§  Some individuals might surprise you and can do more than you expect without your physical assistance

·      Consider giving someone just a little bit of extra time to do it themselves

·      Consider giving verbal instructions on what steps they need to take next

·      For example, when safe, if a person cannot bend over safely to pull their pants up, consider pulling it up part of their leg, but then letting them finish the rest

o   Have the clothing pulled up their legs as high as possible before standing to decrease the need for them or you to bend over

o   Encourage the patient to hold onto the grab bar or walker with one hand while pulling up their clothing with the other

o   If the person can support their own weight standing still, have them hold onto the grab bar or walker while you provide physical assistance to clean or clothe them

o   If the person cannot stand without you holding him/her up then the patient should have a gait belt on, hold the gait belt with one hand and provide physical assistance to clean or clothe them with the other

o   If the patient needs your assistance for wiping, be aware of how long the person has been standing.  Some patients may need a sitting rest break on the toilet before you can finish cleaning them and putting their clothes back on.

§  Wiping can be done sitting or standing depending on the patient’s needs/abilities, but having them sit during hygiene tasks is always safer