Hello,
Trying to get some things in place before my mother comes home, she lived with me before a couple of hospitalizations/rehab stays left her weakened and unable to do her own transfers. We tried assisted living, but she no longer qualifies for their criteria. I’m bringing her home (w/hired help when I work), and need to equip our home appropriately so we can make this work. What is most helpful? She’s 93, wheelchair bound and struggles with bearing weight. Our bathrooms are small, not sure a hoyer lift would work. I wish I had time to get a home therapy consult, but it looks like that’s not happening in time. Any advice would be awesome, thanks!
2. A wheeled commode - I don't know if they're available in the US, but see if you can find the Uppingham Mobile Commode Shower Chair online as an example. I cheer loudly when I see one of these in a client's home.
With her struggling to bear weight, before you go any further you need a professional assessment of this from an OT. Don't worry, because where there's a will there's a way and all things are possible, but without the right advice you could waste a lot of money and still find her stuck in bed!
Tip: make a list of the tasks she wants to do. E.g. transfer from bed to commode. Use commode over toilet in bathroom. Step round from commode to toilet. Shower. Bathe. Wash hair. Walk to bathroom.
I've just got myself in disgrace again because our OT went to do a shower assessment, looked at the client's shower, said "not on your Nelly" and left. But what was wrong with a bathboard over the bath in the family bathroom? - I wondered aloud in front of the client's wife, and advised her to ask (no I did not tell her she should get a bathboard! I know my boundaries). The OT hadn't assessed that because nobody asked him about baths and he (probably) didn't know the client could access this bathroom.
Anyway - so my point is, have a good clear bullet point list of what tasks she needs the DME for and your OT will find a way.
What is she already using in rehab?
A Hoyer lift should then fit. Or a Sit to Stand might work.
If you truly can not get her into a bathroom get a Shower Wheelchair with a commode hole and basin. This would be more sturdy than a regualr commode that has just 4 spindly legs on it.
A Hospital bed with an alternating pressure mattress. This can help with preventing pressure sores and the hospital bed can make changing her position easier. The mattress on the hospital bed is also easier to clean and sanitize.
Remove an throw rugs you have that are in areas where she will be. If you have carpeting if that can also be removed (you can make that a longterm project) no carpeting is easier if there is use of a wheelchair, Hoyer Lift, sit to Stand or any other wheeled equipment.
My bathroom doors are only 24 in wide. It was recommended to me to have the door widened to Moms bathroom and put in a pocket door. It couldn't be done in my house because a main heater vent ran up that wall. A lot of reconstruction we just could not do. But it was a good idea. We did put in a walkin shower for her.
request a hoyer lift - commode - hospital bed and air mattress - all if not most are covered by Medicare - some have smaller copays. You can google DME equipment covered by Medicare and see if anything else on the list you may feel could be useful and make a request for it.
wheelchair (Pt can get a script from her dr going forward if they feel she will benefit for a custom wheelchair provided by Medicare - let a therapist see if having a custom chair will help her get around better and let them customize to her needs).
Personal items like the slide sheet and chux pads - depends - stuff for bed baths until you find a better solution or not (there are no rinse products available) none of this is covered by Medicare. I order most from Amazon. Best wishes
Although rehab is supposed to get them stronger, my mom was more debilitated than when she got there and got released. Released her in a diaper (that she never wore before) and in a wheelchair. Although documented all this walking she was doing, she sure couldn't do it when I was observing or when I got her home. Took me about 2 mos to get her up.
Don't invest in a lift chair. My own mom said if I give up lifting myself with arms, I won't be able to walk at all. She's still walking - not 100% great - but walking with her rollator walker.
Anything you can do with PT/OT to get her up and a little stronger will help all of you in the long run
Something else which I'm even finding useful now is a grabber:
One version:
https://www.homedepot.com/p/Unger-36-in-Nifty-Nabber-Trash-Picker-Grabber-92134/100353536
Another, which I find a little bit easier to use. It also has a magnetic tip which would help for smaller magnetic items:
https://www.healthproductsforyou.com/p-reacher.html?utm_source=google&utm_medium=surfaces&utm_campaign=shopping%20feed&utm_content=free%20google%20shopping%20clicks&gclid=EAIaIQobChMI6unChbD48wIVQWxvBB1NzAB8EAQYBCABEgKAJfD_BwE
Magnetic tool with a decent sized plate for picking up metal items:
https://www.harborfreight.com/heavy-duty-magnetic-pickup-tool-42288.html
A physical therapist should also be able to tell you what it covered by Medicare (usually needs an MD order written in specific language) for approval for Medicare coverage of the item. THEN Medicare tells you which DME providers have Medicare contracts.
A hospital bed with upper side rails will help with bed. mobility, so she is not flat on her back or on just one side all of the time.
You might purchase a ROHO brand seat cushion for her - Medicare only covers a fairly basic cushion if a person does not have bedsores . This brand is recommended by wound specialists who are trying to get pressure sores to heal. If you can't afford ROHO, look for similar style items. Being able to adjust the pressure to her body weight makes it more comfortable.
She might qualify for an adult reclining WC - easier for sitting up as you can adjust the footrests and level of recline of WC back (extends above top of head), to facilitate weight shifting and support her trunk and neck because she is weak.
she is likely to improve a little bit at home, but not return to her level of functioning as she was before the merry go round of hospitals and rehabs.
Good luck
If she presently is in rehab their PT usually are happy to advise what she needs.
If you get any push back be sure to involve the social worker where mom is now.
Handrails and a raised handicapped toilet with side rails can be installed in a small bathroom. Shower chair and a bedside commode will probably be recommended. Amazon has throw away commode liners that will be a huge help.
Be sure to ask for PT & OT services when she is moved home.
I hope once she is home and eating/ sleeping better she can regain some mobility.
Caring for mom now will be exhausting for you if you are still working. Think about some evening part time help. If your health declines it will not help mom.
A lift chair is great to help them stand before pivoting to transfer. Be aware some have two motors and others one. Makes a difference when needing to put feet up while watching tv. The one motor reclines the head as it lifts the feet.
A medi alert and/or cameras can increase communication.
My DH aunt, 95, with dementia, was at home bed bound but she was on hospice and had a daily cna for bathing. She is totally incontinent, so that was a huge help. She also had an aide in the morning and one in evening to help with ADLs. those were private pay.
She is in a rehab right now trying to get to be point where it sounds like your mom is now. Aunt can only take one or two steps.
I would have your mom wear incontinence briefs or pads just in case of accidents.
This will be very hard on you. Please try to get some help. The slightest bit makes a difference. The morning aide I had for aunt was a jewel. She made her a hot breakfast, got her dressed for the day, visited with her, did the laundry, ran the vacuum. Left her lunch where aunt could easily manage it. She always made a each day brighter. I really miss her.
Aunt has original Medicare with a supplement insurance. I am not familiar with the “advantage” plans.
Oh I just remembered that you said you had your mom at home after rehabs. You may already know a home health to call. They will walk you through the benefits your mom qualifies for.
Good luck. Let us know how it goes.