Bathroom Safety and Accessories - Canes - Catheters - Crutches - Diabetes Care - Drug Effects - Hot and Cold Therapy - Impotence - Incontinence - Joint and Muscle Aches - Neck and Back Pain - Ostomy Diet Tips - Oxygen Equipment - Respiratory Diseases - Skin Care - Folding Walkers - Wheelchairs - Wound Care

Bathroom Safety and Accessories

Bathroom Safety Tips

Most people think of the elderly and the physically disabled when they think about bathroom safety, but fully one third of all the falls that happen in or around the home occur in the bathroom. Although the bathroom is difficult for the elderly and disabled, they may actually have an advantage because they are more watchful for hazards, and they are more likely to buy and use bathroom safety devices.

What to Look for in Bathroom Safety Products

• Grab bars must be strong enough to withstand the stress that will be placed on them. They must be long enough and wide enough to grasp easily, and they must be treated to withstand exposure to moisture.
• Shower stools must have rigid seats and backs and cross-leg construction. Legs must be rubber-tipped and they should be corrosion-resistant.
• Bath security rails must clamp to the bathtub.They must provide a firm grip, be corrosion-resistant, and should be padded to avoid scratching tub surfaces.

Bathtub Rails Offer Many Benefits

• Provide safety, comfort, and convenience while getting in or out of the bathtub.
• Eliminate stooping and add a strong measure of confidence.
• Ensure privacy for the elderly and the physically handicapped.

Selecting Bath Aids

To choose appropriate bathroom aids, first determine use patterns. Then make selections based on adaptibility to existing fixtures; the particular functions needed; and the strength, height, and ease of cleaning the safety device.

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Canes

How to Fit a Cane

1. When fitting a cane, make sure you are wearing shoes that you will be wearing when using the cane. Normally, the top of the curve of the cane should be even with the femur head (hip joint).

2. The cane fits properly when, while standing straight with the cane tip six inches forward and six inches to the side, the elbow bent at approximately a 30 degree angle.

How to Adjust a Cane

Aluminum canes can be adjusted by using the spring button. If a locknut is present, loosen before adjusting height. Tighten the locknut after adjustment.

Wooden canes can be cut with a saw. Remove rubber tip and mark the correct length allowing for 1/4" thickness in base of rubber tip.

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Catheters

Facts About Catheter Size

The diameter of the catheter is measured in a unit called French (FR). When prescribing a 14 FR catheter, the physician is requesting a specific tube diameter size. The smaller the number, the smaller the diameter. Catheters used for intermittent catheterization range from 5 to 20 FR with 12 and 14 FR the most common for adults.

Facts About External Catheters

Always remember, there are a few "musts" to get the best results with an external catheter system.

1. Be sure the condom catheter is the correct size and fit.
2. Be sure the skin is clean and dry before the condom catheter is put on.
3. Be sure the tip of the penis is positioned in the cone of the catheter, but is not rubbing on the bulb. Squeeze the sheath.
4. Learn how often the catheter should be changed to give the greatest comfort and security: if it's loose, change it.
5. Examine the skin carefully each time the catheter is changed.
6. Check and empty the leg bag regularly, and look for tubing kinks.
7. Keep the collection tubing, bags, and fixtures clean and odor-free.

External Catheter Sizing

• small = size of thumb (width)
• medium = size of two fingers (width)
• large = size of three fingers (width)

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Crutches

How to Fit Crutches

1. Align the crutch tips approximately 6" to the front and 6" to the outside of the feet.

2. Crutches fit correctly when the tops of the crutches rest on the chest cavity 2 inches below the armpit, and the elbow is bent at approximately 15 degrees to 30 degrees.

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Diabetes Care

Facts About Diabetes Care

• One important goal of diabetes care is to keep blood sugar levels near the normal range of between about 70mg/dL and 115md/gl.
• People can't always tell what their blood sugar level is by the way they feel. Testing is the only way to be sure of the value. Regular blood sugar testing can help every person with diabetes understand how daily actions affect blood sugar control. Testing is especially important for people who take insulin, women with diabetes who are pregnant, anyone with diabetes who is sick, and for anyone who has frequent or severe low blood sugar reactions.
• Blood sugar is usually checked before meals and at bedtime. Records of these tests can show repeated series of high or low blood sugar readings from day to day. This information makes it possible to judge daily control and make changes in meals, physical activity, or medications to improve blood sugar levels.

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Drug Effects

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Hot and Cold Therapy Reference Guide

Cold

• Suspected Bone Fracture: Apply cold pack; stabilize injury; see doctor right away.
• Joint Injuries: Elevate injured area; Apply cold pack.
• Moderate Burns: Apply cold pack for 5 minutes at a time; do not break blisters or apply creams/sprays.
• Hives: Apply cold pack for itching.
• Back Pain: Apply cold pack for injured area for 10 to 20 minutes several times daily.

Hot

• Arthritis, Neck Pain, Aching Muscles: Apply heat packs frequently.
• Chronic Back Pain: Apply moist heat frequently.

Cold or Hot

• Headaches: Place hot or cold packs around neck or head.
• If pain persists, home remedies should be followed by a doctor's exam.

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Impotence

Causes of Impotence

• Age: Impotence is a common problem of older men

  Age	Impotence %
  50-59	5-10%
  60-69	25%
  70-79	40%
  80+	50%

• Organic problems, the leading cause of impotence
• Psychological problems due to concern of lost masculinity
• Medical conditions that affect blood flow or nerve function: diabetes; vascular disease; hypertension; multiple sclerosis; spinal cord injury; end stage renal failure (dialysis); pelvic surgery that damages blood vessels or nerves that contribute to erection process; prostatectomy; ostomy; radiation therapy; side effect of many medications; abuse of alcohol, tobacco and other drugs causing damage to vascular and nervous systems.

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Incontinence

A Common Problem

Incontinence is a condition that is seldom discussed, but is one that affects a great many people. Many people are embarassed by this problem, but your doctor will treat it like the common and treatable medical condition it is and so should you. The most immediate thing you can do for incontinence is to start using products specifically designed for incontinence protection. Incontinence products are tested for odor control as well as absorbency.

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Joint and Muscle Aches

Common Joint Injuries (Knees, Ankles, Wrists, Elbows, Shoulders)

Rest and elevate injured area. Apply cold pack for 30 minutes. (If swelling or pain is more than slight after this, see doctor.) Apply ice 30 minutes on and 15 minutes off for next few hours. Bear weight cautiously. Heat may be applied, but only after 24 hours.

About Support Hosiery

• The concept of gradient support hosiery began in 1950. Gradually manufacturers developed products that offered support for tired, aching legs without sacrificing style.
• Firm pressure at the ankle gradually decreases higher in the leg, promoting blood circulation and reducing swelling.
• Support socks for men and support hosiery for women have gained in popularity for people who must stand or sit for long periods of time. Physicians often recommend support hosiery for patients with swelling or varicose veins.

Benefits of Massage

For thousands of years, a simple massage has been one of the easiest and least expensive ways to improve the condition of your body and mind, allowing you to relieve muscle aches, focus better on daily activities, and reward yourself with the gift of total relaxation.

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Neck and Back Pain

Back Pain

For a sudden, wrenching back injury in a localized area, immediately apply cold packs for 10 to 20 minutes, several times a day during the first 48 hours. To treat a widespread backache that sets in hours after injury, or for chronic discomfort, apply moist heat.

Easing Neck and Back Pain

There are currently over 80 million people suffering from neck and back pain in the United States. And that number increases by 7 million every year. The proper sitting position can help decrease the chances of you joining those ranks (and also decrease the pain if you are already one of them). When sitting, keep your feet flat on the floor, your knees level with your hips, and your lower back supported.

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Ostomy Patients: Diet Tips

Ileostomy: Blockage may be caused by: high fiber foods, seeds, corn, celery, popcorn, nuts, coleslaw, Chinese vegetables, coconut macaroons, grapefruit, raisins, dried fruit, fried foods, apple skins, and orange rinds.

Ileostomy and Colostomy: Loose bowels may be caused by larger, more liquid meals eaten at temperature extremes, and green beans, brocolli, spinach, highly spiced foods, raw fruits, and beer.

Gas production may be caused by the cabbage family, onions, beans, cucumbers, radishes and beer.

Odor-producing foods include: cheese, eggs, fish, beans, onions, the cabbage family, some vitamins or medications, and asparagus.

Reduction in fecal odor may be obtained by consuming cranberry juice, buttermilk, or yogurt.

Urostomy: In most cases, urostomy patients enjoy a completely normal diet. Cranberry juice, yogurt, or buttermilk to help to combat urinary odors. Asparagus produces a strong odor in urine.

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Oxygen Equipment

Tips for Using Oxygen Equipment

• Don't change the flow rate without consulting your doctor.
• Avoid alcohol and other sedatives when using oxygen. They can slow your breathing.
• Prevent skin irritation from tubing by tucking gauze pads behind your ears and against your cheeks.
• Use water-based lubricants to moisten lips or nostrils. Never use oil-based products.
• Order a new supply of oxygen from your dealer at least 2 to 3 days before you'll need it.

Caring for Your Equipment

Oxygen Concentrator

• Wipe cabinet with a damp cloth and towel dry each day.
• Clean air filter at least once a week. Clean the compressor filter as directed.

Cannula or Mask

• Wipe with a damp cloth every 8 hours.
• Wash nasal prongs with liquid soap 1 to 2 times a week.
• Rinse well.

Humidifier

• Wash bottle daily in warm, soapy water.
• Rinse well and air dry.
• Disinfect bottle and top 1 to 2 times a week.

Metered Dose Inhaler or Nebulizer

• Rinse mouthpiece with warm water after each use.
• Separate plastic parts and disinfect daily, as directed.

Use Oxygen Safely

• Do not smoke or allow others to smoke near you.
• Use the nonsmoking section in restaurants.
• Do not use flammable products, such as aerosol sprays, oil-based lubricants or lotions, rubbing alcohol, or paint thinners.
• Keep an all-purpose fire extinguisher at home. Install a smoke detector. Inform fire department that oxygen is kept in your home.
• Secure a cylinder to a fixed object. If it is knocked over, gas may escape and the cylinder may "take off" like a missile.
• Inform electric company that you use an oxygen concentrator. If power is disrupted, you will have priority.
• Alert visitors to the tripping hazards of long tubing.

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Respiratory Diseases

Living with Chronic Obstructive Pulmonary Disease (COPD)

Medications

• Can open airways
• Fight lung infections
• Reduce coughing
• Thin mucous
• Decrease anxiety
• Relieve pain

Learning to Breathe Easier

Additional Breathing

• Place one hand upon your chest: This hand should remain still as you breathe.
• Place other hand on your abdomen (thumb should be just below navel). This hand should rise and fall as you breathe.
• Inhale through nose to a count of 3. Exhale to a count of 6.
• Repeat for about 15 minutes.
• Practice often. Learning to coordinate abdominal movements and breathing takes time.

Pursed-Lip Breathing

• Inhale slowly through nose.
• Pucker lips, and exhale slowly, making a soft, hissing sound.
• Try pursed-lip breathing with abdominal breathing.

How to Control Mucous Build-Up

Controlled Coughing

• Take a slow, deep breath through your nose.
• Hold your breath for a few seconds.
• Open your mouth slightly and let out 2 or 3 short, sharp coughs.
• Relax and repeat.
• Your health-care provider can show you other methods to loosen and drain mucous from your lungs.

Asthma Resources

American Academy of Allergy and Immunology; 611 E. Wells St.; Milwaukee, WI 53202; (800) 822-ASMA (2762); (414) 272-6071

American Association for Respiratory Care; 11030 Ables Lane; Dallas, TX 75229; (972) 243-2272

American College of Allergy, Asthma & Immunology; 85 W. Algonquin Road, Ste. 550; Arlington Heights, IL 60005; (800) 842-7777; (847) 427-1200

American Lung Association; contact your local chapter

Asthma and Allergy Foundation of America; 1125 15th St. N. W., Ste. 502; Washington, D.C. 20005; (800) 7ASTHMA (727-8462); (202) 466-7643

Allergy and Asthma Network / Mothers of Asthmatics, Inc.; 2751 Prosperity Avenue, Ste.150; Fairfax, VA 22031; (800) 878-4403, (703) 641-9595; FAX: (703) 573-7794; www.aanma.org (Send SASE with 52 cents postage for complimentary newsletter).

National Institute of Allergy and Infectious Diseases; National Institutes of Health Office of Communications; 31 Centre Drive; Building 31, Room 7A50; Bethesda, MD 20892; (301) 496-5717; www.niaid.nih.gov

National Jewish Medical & Research Center; 1400 Jackson St.; Denver, CO 80206; (800) 222-LUNG (5864); (303) 388-4461

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Skin Care

Nursing Plan For Prevention of Skin Breakdown

• Assess the patient's skin at least every two days, daily if possible.
• Do not massage any reddened skin.
• Determine the cause of a reddened area. It could be the result of incontinence, friction, pressure, allergic reaction, or bacterial or fungal infection. If the cause is pressure a) Set up a two-hour turning schedule to reduce pressure; b) Use transparent dressing on areas prone to friction; c) Consider pressure-reduction devices such as air-flow mattresses or sheepskins.

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Folding Walkers

Choosing the right walker can help keep you active and improve your quality of life. Folding walkers are portable, easy to store, and ideal for travel. A folding walker that's lightweight and has an easy-to-operate folding mechanism can keep you on the go wherever you go.

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Wheelchairs

Caring for Your Wheelchair

• Use car or chrome polish on metal parts.
• Use vinyl cleaner or mild soap and water on vinyl parts.
• Check axle nuts on large wheels weekly for tightness.
• Check models with spokes weekly for tightness.
• Lubricate squeaking parts with WD-40 or light machine oil.

Selecting a Wheelchair

Today, wheelchairs come in a wide variety of styles and sizes. There are lightweight chairs, heavy-duty chairs and special hemi model chairs for those who have the use of only one hand. Consumers might be wise to rent a chair before buying one to make sure it fits their needs and their lifestyle. Renting should be seriously considered by anyone with a temporary disability.

Wheelchair Specifications (dimensions in inches)

• * = adjustable: 17.5, 19.5
• ** = adjustable: 15.75, 17.5, 18.75, 20
• # = 14-18
• ## = 20-25
• (a) = with footrests, add approximately 12 inches
• (b) = with footrests, add appoximately 5 pounds, 3 pounds for Breezy models

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Wound Care

Special care must always be taken when caring for a wound. Before dressing a wound, clean it thoroughly with sponges and cleansing solution. Then pat the wound dry with a different, clean sponge. Once the wound is clean and dry, apply the dressings appropriate to the severity of the wound. When removing old dressings, always remove one layer at a time, not all at once.

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