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My husband has Parkinson disease and dementia. He is not able to walk to far because of his balance and fall risk. At home he uses a transport chair because of his mental capacity we need to push him around. The problem is he leans over to the right and forward in the wheel chair as if he's going to fall out. Has anyone else experience this problem? Is there a product I can place in his chair so he can be comfortable and at the same time prop him up.
Any assistance you can provide me, will be greatly appreciated.


Thanks,
Ann

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I forgot to add...if the chair reclines then recline it a bit so he is "forced" to lean back a bit more than he would if he is sitting up straight.
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I would speak to an occupational therapist. Your primary care physician can order a home care consult for wheelchair positioning and safety. There are various devices that can be trialed One thing that comes to mind is a lap buddy or lap belt. However, an occupational therapist is the expert. Good luck.
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You can use wedges that will "prop" him in the right direction.
The ones they sell for use on a bed might be a bit large but that could be cut down. If there are fabric stores you can buy a piece of foam and cut it to the size and shape you want.
Another option would be a pillow. The neck pillows they sell for travel might work, they are filled with beads so it makes shaping them easy.
You could also try a child size "memory foam or gel" pillow they are smaller and more easily placed.

As he begins to have to use a wheelchair more often a Broda Chair is great. It can be reclined, there are "wings" near the head (think the old fashioned Wing Back chairs) and the cushion can be moved an numerous positions. They are a bit difficult to maneuver as the wheels are small but you soon get to know the "quirks" of the chair and it gets easier.
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The feeding tray that attach to wheelchair are usually used for some. You cannot! You cannot use a gait belt of anything else (sheet, apron, rope) to strap them into their wheelchair...that's called a restraint. You can do that in the privacy of your own home but my God people.

It sounds like he needs to be checked out by a PT for a wheelchair to be adapted to his condition. They have ones that lean back with long backs, etc...; they can get very creative. Wish him well for me and I am shocked he has not been referred to see a PT for a wheelchair evaluation. FYI; anyone in here tying people to wheelchairs with rope, sheets, gait belts in medicare approved facilities STOP. You are breaking the law...only approved devices which needs a docs Rx...my God...
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Imho, you could try a "Lap Buddy" adaptive device for the wheelchair.
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Google search provided these answers:

https://www.1800wheelchair.com/category/wheelchair-safety-fall-prevention/
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I have seen items like this in medical facilities - the patients lean and could fall out. The only thing I can think of is that there are some kind of straps or "restraints" which hold them to the chair so their bodies can't flop and have injuries. I don't think anyone could say no to this if the intention is to keep the patient from falling out of the chair. I don't know what else to offer you but I am sure this is a common problem.
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You might want to get an extra-large gait belt, but pad it on the front with a folded towel. Put it around your dad, a little higher than his waist, and then buckle it behind the back of the wheelchair. This should work.
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There is a cushion called a lap buddy. It soft, vinyl or plastic cover and fits across the lap with cutouts that fit into the arms of the chair in the front. It's. comfortable without being too much restraint. I have seen them used in many nursing homes
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Years ago there was a small jacket with extra long ties in the back that could be put on patient and tied in back around wheelchair back to hold patient upright in chair.

the problem can be that you may not be able to have a table on the chair to place items your husband might be able to use.

using both of these .,. Jacket and table ... at the same time may still be considered double restraint and illegal.

in 1993 before i knew anything my father was in a nursing home with a severe stroke from which he eventually died.

he was a very social person and i wanted him near the nurses desk to be near people. The facility gave him a wheelchair table which he would slide under and they shrug and say we cant use anything else.

i didnt know about jackets so he stayed in bed alone.

then i became a nurse aide and learned about jackets and geri chairs and socialization. I wouldve bought a geri chair ! but as you can imagine i wasnt advised of those.

A sadder time made sadder.
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drooney May 2020
Think those jackets may be considered a restraint now. Perhaps possible to use an easy release seatbelt or the lapbuddy. Not sure, but many things we used to use to contain residents in chairs, are now illegal!
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My husband also slumps forward. We’ve found that a sheet wrapped around him and tied at the back of the wheelchair is much more comfortable than a gait belt. Another problem is that he sometimes leans too far back and slides forward out of the chair. Our granddaughter who is a home healthcare nurse showed us how to fashion a harness from the sheet by wrapping it first around each leg in a figure eight before tying it behind him. We haven’t tried this on him yet but plan to today
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My father leans forward/sideways in his chair. These are some of the things that have helped. 1) make sure the wheelchair is higher in front than in back & have a seatbelt installed. 2) make sure there is an inflatable cushion in chair. 3) Slide a hospital table under wheels of wchair until table wheels lock under wchair wheels. Sometimes I will push pillows in areas around armrest, shoulders, etc. When my dad starts leaning way over in chair, I take him to bed for a nap which seems to help.
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While I think that the Brodas and geri chairs can be great for people who live in a facility both are very large and although they do have wheels they are not really easily manoeuvrable. My mom's concept 45 was versatile enough to take her into the bathroom at home as well as out for walks around the neighbourhood, and the back, seat and headrest were all chosen by an OT for her needs.
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Mom had the same problem. We used a Broda chair which is adjustable so they lean back. Tricky for me to maneuver but she never fell again.
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Have you considered getting a safety belt for the wheel chair? It’s his neurological condition that causes him to lean forward. Also. you consider should getting him a custom designed wheel chair for his disability. A rehabilitation hospital has these experts.
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Don't use wheelchair unless it is short term transport. They will tend to lean and sink to the point they can fall out, not to mention how uncomfortable they are. Further they are that more difficult for toileting. The risk for skin breakdown is very high with wheelchairs. You can get gerichairs which are much softer and safer and get a specialty cushion to prevent bedsores. You can also use walkers for balance issues.
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There are wheelchair seatbelts as well as table type devices that hook on to the chair to prevent forward leaning. There are also a variety of devices available to prevent or reduce side leaning while promoting improved posture and increasing safety. These products are available through healthcare product sites online or Amazon. Just make sure whatever you select fits properly and doesn't cause skin irritation.
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I've seen people supported by gait belts holding them in their chairs, but it's not something I would want to try as the belt can be too tight and uncomfortable. I don't have any other thoughts at this time, but just wanted to offer that warning.
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There might be another type of chair to prevent leaning, but like someone else said here - he might be trying to relieve pain on his bottom from sitting so long. Cushioning the rear end is real important and you might have to try several before you find the right one.

My grandmother had a tray sort of thing that reminded me of the tray you put on a kid's highchair. It was soft and kept her upright. Looked pretty similar to this: https://www.beesmed.com/posey-company-6515-restraint-lap-4in-hugger-notched-blue-for-18in-chair-p-75864.html?utm_campaign=googlesimple&utm_medium=product_search&utm_source=googlesimple
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I too hate wheelchairs. When Mom was inbrehab they put her in one the whole time she was there. They kept saying she was trying to get out, no she wasn't, she was trying to get comfortable. I'd ask for a cushion. The aide would get me one and I'd find out later the Therapist took it out. She felt Mom didn't need it.

When Mom was in the NH, they gave her a chair that the bottom tilted back. Kept her from being able to get up. The back leaned back sobshe could nap and had cushions on the side of her head to keep it in place. I loved that chair.

Like willies idea.
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My mom occasionally tilts. Even though she can walk short distances. Example she can stand and walk with assistance a small distance, far enough that I can get a commode or wheelchair behind her. I put a hoyer sling on the wheelchair. This helps because I can use the cloth loops to realign mom in the chair. I use a lift from the wheelchair to recliner. I hate leaving her in the wheelchair all day. It is to uncomfortable.
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cwillie May 2020
That's the beauty of a custom chair, they are practical and probably more comfortable than any other seating, especially if cushions and props are required to keep them upright.
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Search "lateral support for wheelchair" and several products will come up. I also saw something called a "Lap Buddy" which is like an inflatable bumper that fits over their lap and out the sides so that your LO can't attempt to stand up unaided and will keep him from going forward.
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I'm going to suggest you investigate getting him fitted for a custom wheelchair, yes they can be expensive but there may be some medicare coverage if it is prescribed as medically necessary. My mom had a tilt in place chair with a headrest and lateral supports and that is where she spent her entire day for several years (both while at home and after she moved to long term care) so it was worth every penny we spent. IMO it is one of the things that might ultimately save money in the long run, I bought many assistive devises that needed to be changed or upgraded as she deteriorated - the only change to the chair was adding in a ROHO seat cushion when she began to show signs of pressure on her tailbone, unfortunately nobody suggested that to us in the first place.
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ssspivey May 2020
I agree. My father sits in his Medicare covered custom wheelchair all day. It is rented monthly until paid for. You need a doctor or physical therapist order. The wheelchair company will come and assess and order specifications and will make adjustments as needed until the chair is paid for. There are side support cushions and you can lean the chair back. There are even arm supports if needed. You cannot get the chair in a regular vehicle or fold to transport. You would need a custom van. On another note, facilities will not allow any type of belt as they are considered a restraint. We have a pommel cushion that keeps from slipping down but it is hard and not like the one he had before that helped prevent sores.
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There are different kinds of torso supports specific for use with wheelchairs. Check with your medical supply store or just google the term. There are some that are vest-like and Velcro to the wheelchair to promote better positioning. Another consideration may be a reclining wheelchair. As he becomes weaker, it may be more comfortable for him. Either way, hope you find what you need.
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