Therapeutic positioning for non-walking individuals

[KyleC]

Yet another question from me!

Individuals who spend most of their day in a wheelchair can benefit greatly from therapeutic positioning. For those not familiar: It is a designated time, once or twice per day, where that person transfers from their wheelchair to another device: Often a hard foam mattress or wedge, stand assist device, floor mat, etc. I imagine the person's ideal positions are determined by a physical therapist, and then a device/configuration is implemented to support this position for a set amount of time (for an hour, or as indicated).

I have worked in homes where this was the norm for everyone who did not ambulate independently. I have also worked for homes where this is never done. My goal is to implement this practice for the homes that are not already doing it, and I am looking for some idea of where to start and how best to get it going.

So, I have a few questions and I hope there are some of you out there who are willing to share your experience for the betterment of the people who are not currently receiving this type of care!

1. Do I start with an evaluation from a physical therapist? This seems like the best starting point, but most physical therapists I have worked with seem to focus on recovering function after an injury; they are not comfortable being tasked with this kind of preventative / maintenance care for those with permanent disabilities. Is there another type of specialist I should consult, or can a garden variety physical therapist serve this function if I effectively communicate the client's needs?

2. Obtaining equipment: The equipment used for positioning seems highly specialized, and doesn't seem to be readily available without going online. Are there any recommended retailers who deal in this type of equipment?

3. Working it into ADL: Much appreciation for any tips on training staff, setting the schedule, and ensuring that adequate staff are present to handle this added responsibility!

Thanks again for any answers. This will go a long way to improve the health of a lot of people, both in the short and long term.

[rotteluvr31, ADN, RN]

We all benefit from position changes, and I would strongly recommend working with a PT for an evaluation. Perhaps a local DME vendor sponsors a seating clinic where a PT can work with the DME provider to try and get the right piece of equipment.

Medicaid should purchase the required equipment, but you will probably need a Rx from the MD and possibly letter of necessity from the PT. the PY should be able to assist in designing some exercises and ROM specific to the person you are working with.

Good luck!

[ceebeejay]

I have the same question for a person in one of my houses. It's making me crazy seeing them sit all day in the chair. We change the lean from sitting to reclining but it's just not sitting well with me. Please let me know what you find out. I am staring with PT and my ADON.