spasticity

Helping Him Get Comfortable in Bed

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One of the most difficult aspects of caring for someone who has limited movement is getting them comfortable in bed; at least it is for me.  When I lie down at night, I know it takes a few moves here and there just to find that right position of comfort that allows me to settle in to sleep—that sweet spot.  However, when you are responsible for helping someone else find their “sweet spot,” you don’t have the benefit of “feeling” for just that right point of pressure and relaxation; so how do you help them get comfortable?  Here are some things I do to help Lynn be as comfortable as possible in bed.

I use lots and lots of pillows to help me position him. He has gastric reflux so I have a wedge pillow under the top of his mattress to elevate his head. Unfortunately, that can cause his head to be slightly pushed into his chest so I have a pillow to put under his head that is designed to give more neck support and it allows his head to fall back over a slightly elevated fold. By lying back over the fold, it raises his chin off his chest allowing him to get a better airway and creating less pressure on his neck muscles.

I also use pillows under his knees. I actually use two thin pillows under his knees and position then so that they support both his thighs and his knees. That helps to reduce the pressure under his lower back which seems to help if he is lying on his back for very long.

If I need to roll him over, I bend the leg that is closest to the side of the direction in which I’m moving him, reach to the shoulder that needs to end up “on top,” and roll his body either toward me or away from me to achieve the desired direction. I have a wedge pillow to put under his side that allows him to roll back slightly and rest on the wedge or I double over a pillow and use it like a wedge. Then I keep bent both the top and lower leg slightly and put a pillow between the legs so that the bones aren’t resting on each other (one between the ankles may also be necessary). When on his side, a pillow to support his upper arm sometimes helps as well. The biggest challenge to resting him on his side is the lower arm. Sometimes it helps to have him slightly leaning back on the pillows and I use a towel under his hips to move the hips slightly forward so he’s not completely lying on that side. Positioning on his side takes a lot of communication between us to determine how to best support those body parts hanging in the air and how to keep the pressure off all those bones taking all the weight in that position.

Since Lynn has so much spasticity in his arms and legs, one of the most important devices I use for his comfort is a “boot” for his foot.

continue reading at: http://multiplesclerosis.net/caregiver/helping-get-comfortable-bed/

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What’s a Ratchet?

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When I took on being a full time caregiver, I knew I was taking on full responsibility for skin care, elimination, nutrition, hygiene, assistance with activities of daily living and even physical therapy.  What I hadn’t counted on was taking on my husband’s role of maintenance mechanic for our home. Having a medical background, I’m comfortable with the caregiver duties; not so much with the mechanic ones.  In fact, they intimidate me to the point of panic when Lynn says something like he did last night, “Go get a ratchet.”

His electronic peddler (that he had been using almost non-stop for spasticity release for the past three years) recently bit the dust.  We had taped it up with duct tape, oiled all visible parts, and my solution, jiggled it unmercifully, with no success.  Resuscitation attempts of the old one was “called” and we had to pull out our backup peddler.  Unfortunately, when we turned on the backup, this terrible grinding noise could be heard with every rotation.  Since the grinding seemed to be coming from the motor, Lynn’s recommendation was to order a new one and return the noisy one when it came in.  So I did.  Well, the new one isn’t noisy but it has a hitch in its giddy-up.  Every rotation now is accompanied with a shimmy jump that can be felt in the base of Lynn’s foot and all the way up the leg. Upon watching the action for a period of time, he made the pronouncement, “I don’t think the arm is tight enough.  You need to tighten up the bolt. Go get the ratchet.”
Hearing the, “Go get…” was like a Pavlovian response for me.  My skin became clammy; I developed tunnel vision; and the muscles in my head and neck tightened.  It happened to be raining yesterday so my arthritic hands were already screaming with every use. “Wait a minute.  I can’t tighten anything today,” I responded. “My hands hurt, too, much.”
“It will be okay. The ratchet will do all the work.”
To myself, I’m mumbling, sure, that’s what you always say but outwardly, I’m saying, “okay, I’ll give it a try.”  So, off I go in search of a ratchet.
Lynn has not been in the garage in at least five years.  During that time, many of his friends, our kids, and I have gone into the garage to use his tools.  He remembers the tools being right where he last saw them. That’s not exactly true anymore so the first thing I have to do is search for and locate this item that I don’t know what is.  He describes it as a long silver tool with a thing like a bolt sticking out the side at the end of it.  I start looking under things, opening all the drawers in the tool box, moving things around and piling them into new heaps (that will again cause confusion in the future because they have again been moved), until finally, I find three silver things that match the description.  “Is this it?” I ask my mentor.
“Yes,” he responds, “but you also need the sockets.”
“Okay, what are those and why didn’t you mention that before?”
“Those are small silver round things that you put on the bolt and which inserts into the racket.  There is a metal strip out there that has what you need on it.”
He doesn’t answer my question on why he didn’t tell me this the first time and I proceed to look for sockets.  I find a metal strip with silver things that match his description.  At least half of the slots are empty so I look through drawers again finding similar items and again return to Lynn.
“Where’s all the sockets that belong on the strip?”
“Who knows?  I told you things have been moved around. This is all I can find. Okay.  What now?”
Lynn proceeds to tell me how to remove the protective cap covering the bolt on the arm of the peddler. Then we go through how to select the correct size.  I try to figure out how to attach the socket to the racket finally being successful after multiple attempts to push it into place. I put it on the bolt wrong, feeling totally inferior as a mechanic.  It doesn’t work so I try it the other way and it works!  After multiple, painful, tightening attempts, the arm of the peddler seems tighter and the squeak that was accompanying the giddy-up hop goes away. Triumph!
Finish reading this post at: http://multiplesclerosis.net/living-with-ms/whats-ratchet/

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