Question

The case manager is contacted for discharge planning. E.B. will be discharged to an extended care facility for strength training. Once the patient receives his prosthesis, he will receive balance training. After that, he will be discharged to his daughter's home. A physical therapy and occupational therapy home evaluation should be ordered. You have provided several sessions of teaching to E.B. and his daughter about care of the residual limb.

What instructions should be given to E.B.'s daughter concerning safety around the home?

Answer 1

What instructions should be given to E.B.'s daughter concerning safety around the home?

Coming home from the hospital or rehab after amputation can be a very different experience and figuring out what needs to be modified can be a big decision and one that might change as time goes on.As our patient is lower limb amputee ,the safety in home plays a great role and the home arrangment needs to be changed to adapt a wheel chair initally and later with the prosthesis mobility.Here are some instructions proposed for Mr. E.B's home safety .

Entrance way/Living Area

• If you have stairs leading your house entrance,then make a ramp to enter into the house, you may not want this to be a permanent fixture,later it might be removed once the patient start adapted to prosthesis. •
• Adequate lighting to be provided outside the house to prevent falls
• • Need a hand rail or grab rail on the steps leading up to your entryway, this can be helpful for amputee till he get used to prosthesis
• . • You may also need to have doorways widened or offset hinges can be installed on doors for the easy passage of  wheelchair within the house.
• Floor and environment should be free of clutters
• • wedge cushions will be helpful in transfering from on chair to other or to wheel chair.

Kitchen :

• kitchen sink to be adapted to accomodate the wheel chair
• • Adding pull-down shelves to make contents reachable from a wheelchair. •
• Lowering the kitchen cabinets so that they are accessible from a wheelchair. I
• • Utilize the lower cabinets for the items that you need daily and keep items on the counter top.

Bedroom

• Rearrangment of bedroom to ensure adequate spacing for wheel chair mobility.
• Environment should be free of clutters.
• Adequate lighting in the room.
• There are many ways to transfer into your bed, tools can include transfer boards, grab poles and hoyer lifts
• keep the crutches ,wheel chair or prosthesis near in the night to use on urgent basis

Bathroom:

• Arrange for a shower bench /chair in the bathroom.
• Grab bar can be installed in bathroom for shower bench ,chair transfer.
• A non-slip mat for the floor of the shower can make showering standing up safer.
• Using liquid soaps, shampoos, etc. with a pump head can be an easier way to maintain balance while in the shower.
• Grab bars should be fixed for transfering to toilet seat.
• Adequate night lighting in bathroom should be provided.