From Dawn to Dusk

Here’s an excerpt from my upcoming eBook entitled, Two Step Solutions:  Making Life Easier.  The intended audience is the person facing a temporary setback who might not normally think about fall and injury prevention when he or she is used to living life independently.  Everything can change, including the way we do everyday tasks and activities.  In this eBook I will take a tour with the Gentle Reader through a typical home whether it is a house or an apartment, examining simple strategies, tools and equipment to make life easier until he or she gets back on one’s feet again.

From the moment you open your eyes in the morning until the moment you close them again at night, some things very likely are different for you than for the typical person. Let’s take a closer look at the daily routine of an atypical person: the one with a temporary or ongoing disability.  We are living a “new normal” for a time and this is what our world might look like with a few adaptations to make it work more smoothly for us. Take what fits for you and pass on the rest to someone else who may benefit too! Now it’s time to start as you wake up at the beginning of your day . . .

Bedroom, Hughes House from Pond5

Bedroom, Hughes House from Pond5

The Bed

How are you positioned in bed? If you wake up in pain, take a closer look at the shape of your pillow, the firmness of your mattress, and the positioning of your physical frame. Keeping our head/neck, torso, and hips/knees/ankles in what we call neutral alignment is a consideration here. Try to avoid twisting, pushing one body part forward from this alignment or bending anywhere but at the hips/knees/ankles. For example, is your rib cage twisted? Sleeping with an anatomical-type pillow that cradles your head with a dip in the center can help if your neck is stiff and sore. Placing a pillow under your knees when lying on your back or placing it between your knees when lying on your side can: 1) ease stress on the low back and 2) reduce the risk of pressure sores when the knees rub together. Exceptions: persons with a history of hip or knee replacements/arthritis might want to avoid the pillow as it can increase joint stiffness and decrease available range-of-motion over time. In the latter case it might be better to have the legs straighter. Also if you are using pressure relieving garments or bedding, check first with your healthcare professional before markedly changing your sleeping position.

Check the height of your bed. If your feet don’t hit the floor when sitting squarely at the edge, it’s too high. This poses the risk of falls when getting into- or out of- the bed. Do what you can to lower the bed height even if it means having someone saw off a couple of inches off of the wooden legs or adding a low/secure stepstool.  If when sitting at the edge of the bed your knees are higher than your hips then the bed might be too low. This requires extra effort when rising to a standing position and increases the distance when lowering yourself from a standing position. Increasing this distance poses risks for a fall and for spinal compression if you sit down to hard on a repeated basis.  Adding bed risers that securely to each leg underneath may be needed.

If you are moving (or “transferring”) from a wheelchair or walker to the bed, try to have the height of the bed match the height of the wheelchair seat. Removing the wheelchair armrest and scooting across the two level surfaces is ideal. Replace the wheelchair armrest once safely in the chair. (This applies to any type of chair too: moving across level seat heights can increase safety and reduce effort.) Adding a one-half bedrail or a floor-to-ceiling transfer pole may provide additional handholds needed to perform the transfer safely.  

Typical bed rail that slides between a mattress and box spring.

Typical bed rail that slides between a mattress and box spring.

Transfer Pole with accessories can be rated for bariatric use too.

Transfer Pole with accessories can be purchased in a version that is rated for bariatric use too.

Moving around in the bedroom

First, have someone else take a look at the layout of your bedroom. If you do your own analysis, you might not see the obstacles lurking there or be willing to change them! In working with hundreds of home health care patients I have noticed that folks usually see the way things have been for a long time and have a tough time visualizing it any other way. Having “fresh eyes” look at the bedroom in addition to other rooms of your living space can be quite valuable. Your independence and prevention of injury might be enhanced by a few simple changes so it helps to have another pair of eyes to help identify them.

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Be sure to “FOLLOW” this blog for more Active Tips and Gentle Moves TM.  Please share your own tips in the Comments below!

Julie, O.T.

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