MOBILITY CHALLENGES

Traveling This World with Mobility Challenges

Living with Mobility Challenges

     My husband has primary progressive multiple sclerosis (MS). Though he can move both arms and legs, he can move none of them well enough to accomplish tasks. Nerve damage from MS, along with muscle spasms, and weakness from lengthy hospital stays, contributed to his current state of powerchair dependency. He needs full assistance with all activities of daily living and has significant mobility challenges.

 

     At the time of his initial diagnosis in 2006, Lynn was very athletic and only showed occasional foot drop and other muscle weaknesses.  He ran, lifted weights, rode bikes, and could physically do whatever he needed without difficulty.  He was completely independent.

 

Walking Stick

     However, his physical decline and subsequent mobility challenge rapidly followed. As the fatigue increased, he started using a walking stick and progressed to a rollator walker within a year. The walking stick did not give him the full balance he needed to prevent him from falling. However, his stubborn will kept him going and he refused to give into the need for  using assistive devices.  In fact, as he was working on building us a new home at the time, he climbed a cinderblock  wall alone to lay block in spite of the need for help ignoring his balance issues. 

Though he would stumble and fall, he still climbed the cinder block wall to lay block all by himself.
 
Rollator

     Lynn was a proud person (stubborn actually) and did not like to rely on anyone. Therefore, he preferred the walls as his “support-of-choice” whenever he could use them.  Family and friends grew concerned as he continued to use a walking stick rather than a rollator.   Finally, a friend brought one to our home and dared him not to use it since it was a present. Pride lost, and gratitude won that battle, and the rollator became a part of his life.

 

Using Rollator as Wheelchair

     His ability to walk became progressively worse as his need to use the rollator to meet his mobility challenges instead of a walker happened regularly. He continued to refuse to consider the idea of using a wheelchair. Then, one day in 2009, his refusal to face reality all came to an end.

 

 

The Fall

     Lynn was home alone. He started to walk across the floor and felt his legs begin to go. Just before hitting the floor, Lynn reached over and grabbed his cell phone to call for help. Try as he might, he could not get up.  Lynn didn’t want to call 9-1-1 because he was headed to the shower and had no clothes. After calling me to come home, he waited three hours on the floor alone and afraid. When I arrived, he was dehydrated, overheated (he was lying next to a heating vent), and emotionally traumatized. Though tricky, I managed to get him back to bed and treated his condition.

The Beginning of Change

  • The next day I ordered emergency alert buttons for us to wear since either of us could be alone and need help. 
  • We talked frankly about his abilities and limitations and identified with greater accuracy his safety needs and what level of assistance he needed full time.   
  • We made an appointment with a mental health professional to discuss the difficulty he was having in adjusting to the realities of his illness.
  • We meet with a physical therapist to determine the correct mobility device he needed for his current level of mobility and the anticipated progressive nature of his condition.
Reality Sets In

     Though traumatic, the fall had brought reality home.  Lynn had no more delusions. It was a turning point that all people with chronic illness seem to face at some point.  Each person seems to have that moment of reality where it all becomes real for them. That fall was Lynn’s. He was just very fortunate that it turned out as well as it did.

 

Transportation Challenges

Mobility Challenges Increased

     As my husband’s mobility challenges became more substantial and his ability to move became less, my need for transportation assistance became a challenge. 

Safety Concerns Using a Sedan

     For many years, I transported Lynn using a four-door sedan.  I manually transferred him to and from the passenger seat from his powerchair using a lot of prayers and personal body strength. I came very close to dropping him a few times in the summer when his MS was particularly affected by the heat, and he was unable to help me with the transfer at all. After one very close call, we decided that the debt would have to be incurred and moved forward with the decision to purchase a conversion van. 

 

Conversion Vans Don’t Come Cheap

     As with all caregiving lessons, it was an eye-opener.  The cost of the van was extremely high compared to a typical van of that same model. Therefore, my bank refused the loan, saying the seller was asking too much.  I had to prove that the conversion kit makes the van more expensive. My simple purchase took two weeks for approval instead of the usual one.  

 

Learning Safety Equipment

     We finally got approved, and then I had to learn to use the equipment.  All those straps to secure the wheelchair! The first time I drove the van, the door wouldn’t close due to parking on uneven pavement. I’ve learned I have two batteries, and one runs down the other if I leave the radio on when I turn off the motor. There are all sorts of new and exciting discoveries with this van, but I wouldn’t trade it for the world.  It’s a lifesaver, and I would never be without one again as long as Lynn has a powerchair. Love it!!.

Child with muscular dystrophy swinging

Caregiver Marketplace Check out links to products recommended to help caregivers cope with the challenges of caregiving at home. Ideas are available on everything from positioning to self-help booksmobility devices, to skincare. 

Using Assistive Equipment - Make Sure It Fits

     Having the right equipment can make all the difference in how well you function. Have an experienced technician measure your family member to the equipment (as in this case– a wheelchair).

 

     One size does NOT fit all.  The chair must fit the body perfectly to prevent skin breakdown and other injuries. The body, torso, leg, and arm length must all be accurate.  If it’s not, harm may occur to your family member’s body due to friction or undue stress.

 

     If you get a chair and it’s not right when you take it home, call them to come work on it. Keep calling until it’s right.  The chair is part of their body when they are in it and must function correctly the same as their heart and lungs. Keep the vital signs healthy, just like those of the body.

 Width and Depth Measurement
  • Seat Width: measure person’s hips from side to side. Add two inches.
  • Seat Depth: Measure from back of hip to back of knee while person is seated. Subtract one inch.
Arm Type and Height
  • Full-length wheelchair arms: best for those who are going to use them to stand-up and do pivot transfers. The full-length arm provides support to help push up to stand.  It gets in the way if you need to roll under desks to work or come in close to objects often.
  • Desk-length wheelchair arms: Recommended for people who want to be comfortable working at a desk or table. The shorter arms allow them to get closer to the table’s edge.
  • Arm Height: Height varies. Measure from the elbow to the seat of the chair while the person is holding their arm up with their elbows bent at a 90-degree angle. Height-adjustable arms are recommended if your moble can accommodate them. 
Footrest Style
  • Elevating Leg Rests: People who suffer from edema, swelling, or injury and are ordered by their doctor to elevate their legs should get leg rests which have the ability to be raised, lowered, and locked in place at different levels. 
  • To determine the length of the footrest, measure the distance from the back of the knee to the heel of the foot.
  • Articulating Leg Rests: (Useful for taller people) The leg rests extend longer while the elevating piece of the leg rest rises.
Back Height
  • While seated in wheelchair, measure from collarbone down to seat.
  • If additional back support is needed, there are options for higher back rests and  reclining back rests.
Wheelchair Seat Height
  • If the person needs to use their feet to propel themselves in the chair, measure the distance from the back of the knee to the heel of the foot. The seat height should allow for the person to reach the floor with their heels.
Weight Considerations
  • Wheelchairs have weight limits. Know the person’s weight and the wheelchair’s limits to know they are compatable.
  • Some people fold their own chairs to travel. Consider  upper body strength in those situations in regard to lifting the chair into the car in selecting a wheelchair. Weaker people needed lighter chairs. 

Resource:

How To Determine Proper Fit In a Wheelchair by Brian Carmody, www.verywellhealth.com

Helpful Safety Video Tips Using Mobility Assistive Devices

YouTube Video Resources for Reference:
Wheelchair Safety and Adjustments 
Wheelchair Mobility Over Curbs 
How to go Down Stairs In a Wheelchair with the Assistance of One Person  
How to go Downstairs in a Wheelchair with the Assistance of Two Persons  
 

TRANSFERRING FROM A WHEELCHAIR INTO A CAR

 
  
In each of these videos, it’s important to note that the mobility assistive device is sized to the individual and safety precautions are always used. It’s easy to forget an immobilized person’s limitations.  However, you must keep that in mind always. Stay alert to potential risks of injury Maintain awareness at all times of what may lie in front, back and to the sides; even above and below the individual that may cause harm if the person cannot fend off that harm. Make it a habit to assess the environment for potential risks each time you stop and settle in a new location for an extended period. 

YouTube Video Resources Demonstrating Proper Use of Mobility Assistive Devices

How to Use A Walker    

This video explains how to correctly use a walker to maintain balance in walking.  Walkers can be purchased at drug stores and many general merchandise stores. If you plan to get one, it needs to be the right height and easy to manage when getting in and out of a vehicle so you know it will be used. 

How to Use a Rollator Walker 

This video explains when is the best time to use a rollator walker, how to use one and what precautions to take when using one.

How to Use a Cane
A cane can be used to help maintain balance. Like a walker, it needs to be the correct size to achieve the desired result.  If it’s too short or long it will not be effective and may cause the user to lose their balance. 
 
How to Use a Walking Stick to Climb Steps
 

Going up: Step up with unaffected leg first, place the walking stick on the step, step up with the affected leg. Coming down: place the walking stick on the step below first, hold the rail, bring affected leg down, then unaffected leg down. 

How to Use Crutches 

This video explains the proper use of crutches. Crutches should be sized so that two fingers can fit between the top of the rest area and the shoulder rest for the animal. This cushion is needed to prevent injury to the nerves under the armpit.

How to Use Forearm Crutches 

This video demonstrates the use of forearm crutches 

Using a Convaid Stoller for a Wheelchair 

This video provides an example of how the tilt function of a wheelchair can be used to provide benefits to some individuals in wheelchairs that cannot be provided by standard models. 

Forearm Support Frames

Physiotherapist demonstrating with a client the safe use of a Forearm Support Frame, how to adjust the frame to the correct patient height, safety check, and safe mobilization techniques.

Top 10 Best Electric Wheelchairs Available Now 

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