Help for bedbound pts - Geri chair?

[kaliRN]

I thought this the best place to ask this question. I wonder what you may have seen that worked well for clients in the home as an alternative to a hospital bed - to aid in giving the client some time out of bed - without putting them at increased risk for skin breakdown. Specifically, a client who is bedbound and max assist (read unable to move anything but upper extremities independently). Pressure relief is in full effect, turn q2 on a pressure reduction mattress and Rojo cushion for limited time in a wheelchair, decubitis ulcers are a huge concern.

Are "geri chairs" a LTC strategy only? Ever seen these work well in the home, they seem ideal because of the multiple positions, especially for lateral transfers.

Any help or insight would be appreciated. Could really use a suggestion and if there is a possibility of reimbursement that would be a plus, but is not a deal breaker. Thanks in advance!

[KateRN1]

I've never seen Geri-chairs used in the home, but have seen reclining wheelchairs and recliners used with some success with a Hoyer lift. I don't think Medicare pays for anything beyond a regular wheelchair, though.

[kaliRN]

Thanks so much for your reply. We have a reclining wheelchair (and it is covered by Medicaid for its rental - which has similar if not more stringent guidelines to Medicare in our state). No hoyer lift here, just 3 able-bodied adults and plenty of good body mechanics. The wheelchair isn't supportive enough for extended periods ... but maybe a good recliner would be enough. I was hoping someone had seen it done, there are several recliners I've seen that I think may work ...

Since we don't have a lift, I would really love to be able to transfer laterally, it would be a 2-person transfer that way. We'd love to have him up more in the day, without being "committed" to waiting for all 3 of us to be there to make the transfer.

Again, I so appreciate the insight.

[erroridiot]

The Barton Chair is the best home care chair available. It makes 1 person transfer easy. I don't know about the insurance coverage for it. I did have one caregiver tell me that there was partial reimbursement from Medicare. Purchase and rentals are available. The chairs also come in different sizes and can accommodate up to 700 lbs for bariatric patients.

http://www.hill-rom.com/usa/PDF/155817.pdf

[kaliRN]

That Barton chair is incredible, way out of our budget, but will definitely start searching for rentals. Thank you so much! I believe I saw it when I was doing research for our options, but could never find it again.

[jm_emt]

The Barton chair costs about $6000 for the least expensive model. It has a HCPCS code (E1035) for Medicare reimbursement and is described as a "Multi-positional Patient Transfer System with integrated seat operated by the caregiver". To be eligible for reimbursement, the patient must need a patient lift but also require "supine transfer" for some medical reason (which makes them unable to use a lift).

Because of its high cost, it may be a challenge to get reimbursement but it apparently can be done for the home environment. Its size may also limit its use in some homes since it requires additional room space during transfer as compared to a patient lift.

The chair can usually be rented for about $470 a month on a rent-to-own basis (outlined by Medicare) and it becomes the property of the renter after 13 months of continuous rental.