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The Comfort of HomeA Complete Guide for Home Caregivers
By Maria M. Meyer Paula Derr
CareTrust Publications, LLCCopyright © 2007 CareTrust Publications
All right reserved.
ContentsPart One: Getting Ready 1. Is Home Care of You? 2. Using the Health Care Team Effectively 3. Getting In-Home Help 4. Paying for Care 5. Financial Management and Tax Planning 6. Planning End-of-Life Care 7. Preparing the Home 8. Equipment and Supplies Part Two: Day by Day 9. Setting Up a Plan of Care 10. How to Avoid Caregiver Burnout 11. Activities of Daily Living 12. Therapies 13. Special Challenges 14. Diet, Nutrition & Exercise 15. Emergencies 16. Body Mechanics-Positioning, Moving and Transfers 17. Hospice Care 18. Funeral Arrangements and the Grieving Process Part Three: Additional Resources 19. Common Abbreviations 20. Common Specialists Caregiver Organizations Glossary Index
Chapter OneEquipment and Supplies
Where to Buy Needed Supplies * 118
Where to Borrow * 119
How to Pay * 121
Medical Equipment * 122 Equipment for the Bedroom Equipment for the Bathroom Mobility Aids
Assistive Devices * 128 Sight Aids Listening Aids Eating Aids Dressing Aids Devices for Summoning Help Cooling Devices Computer Equipment Homemade Aids and Gadgets Equipment Cost-Comparison Chart SpecializedHospital-Type Equipment
Resources * 134
To provide proper at-home care, you will need certain supplies. There are two types:
general medical supplies
durable medical equipment
Before buying anything or signing a rental contract, ask your doctor, physical or occupational therapist, or nurse. Salespeople may not be trained to assess what the person in your care may need. Occupational therapists can advise you on low-cost substitutes for expensive equipment. With the proper doctor's orders (referrals) and documentation, some equipment is covered by Medicare or private insurance. Get in touch with your insurance carrier to see if what you need is covered and follow the company's rules for getting approval before buying.
Where to Buy Needed Supplies
Buy medical equipment and supplies from dealers that are well established and that are well known for good service. Be sure to get advice about where to buy from your health care professionals or hospital discharge planner. To compare prices, use the chart on page 133.
Look in the Yellow Pages under Surgical Appliances, Physicians and Surgeons, Equipment & Supplies, and First Aid Supplies. Sources include
surgical supply stores
home health care agencies
medical supply catalogs
Where to Borrow
For short-term use, think about borrowing equipment from the following local groups:
Visiting Nurses Association
home health care agencies
National Easter Seal Society
faith-based groups, senior centers, leisure clubs
How to Pay
If you need assistance in paying for medical equipment:
Ask the doctor to write an order for a home evaluation (assessment), including an evaluation of needed equipment.
Find out if the equipment is partly or completely covered by private health insurance with home care benefits.
Check state retirement and union programs.
Medicare does not help pay for assistive devices, but does pay for durable medical equipment in some cases. To be covered, the equipment must be prescribed by a doctor and it must be medically necessary. It must be useful only to the sick or injured person and must be reusable. Medicare will pay for the rental of certain items for no more than 15 months. After that time you may buy the equipment from the supplier. If the person in your care has met the deductible, Medicare will pay 80% of the approved charges on the rental, purchase, and service of equipment that the doctor has ordered.
You will need to have special equipment for different rooms in the house, as well as equipment to increase the person's ability to get around.
Equipment for the Bedroom
The equipment you need to have depends on the person's medical condition. This equipment might include some of the items listed below.
hospital bed-allows positioning (adjusting) that is not possible in a regular bed and aids in resting and breathing more comfortably and getting in and out of bed more easily
alternating pressure mattress-reduces pressure on skin tissue
egg-carton pad-a foam mattress pad shaped like the bottom of an egg carton that reduces pressure and improves air circulation
portable commode chair-for ease of toileting at the bedside
trapeze bar-provides support and a secure hand-hold while changing positions
transfer board-a smooth board for independent or assisted transfer from bed to wheelchair, toilet, or portable commode ([??] See p. 328)
hydraulic lift-for use on a person who is difficult to move
over-the-bed table-provides a surface for eating, reading, writing, and game playing (could be an adjustable ironing board)
mechanical or electric lift chair-for help getting up from a chair
blanket support-a wire support that keeps heavy bed linens off injured areas or the feet
urinal and bedpan-for toileting in the bed
Equipment for the Bathroom
The equipment you will need depends on the person's needs. You should consider providing the following:
raised (elevated) toilet seat-used to assist a person who has difficulty getting up or down on a toilet (available in molded plastic and clamp-on models for different toilet bowl styles)
commode aid-a device that acts as an elevated toilet seat when used with a splash guard, or as a commode when used with a pail
toilet frame-a free-standing unit that fits over the toilet and provides supports on either side for ease in getting up and down
grab bars for tub and shower-properly installed wall-mounted safety bars that hold a person's weight
safety mat and strips-rough vinyl strips that stick to the bottom of the tub and shower to prevent slipping
hand-held shower hose-a movable shower hose and head that allows the water to be directed to all parts of the body
bath bench-aid for a person who has difficulty sitting down in or getting up from the bottom of the tub
bath transfer bench-a bench that goes across the side of the tub and allows a person to get out of the tub easily
bathtub safety rails-support for getting in and out of the tub
Mobility aids include devices that help a person move around without help. They also help the caregiver transfer the person in and out of bed and from bed to a chair.
a wheelchair with padding and removable arms
a walker to help maintain balance and provide some support
a 3- or 4-wheel electric scooter
crutches when weight cannot be put on one leg or foot
a cane to provide light weight-bearing support
a transfer board (9" x 24") for moving someone in and out of bed ([??] See illustration p. 324)
a gait/transfer belt ([??] See how to use on p. 324)
Proper fit, as determined by a physical therapist.
ease of repair
ease of handling
a brake lever extension on the handle
elevated leg rests and removable footrests
armrests that can be taken off
For those with poor sight and hearing or other limitations, there are many aids to make life easier. Look into all the options and you will find that your job as caregiver becomes easier too.
Braille books and signs
cassette players and books on tape
telesensory devices that change printed letters into symbols that can be touched
hearing aids (order from an audiologist, or hearing therapist, who allows a free 30-day trial and is a registered dealer)
sound systems that amplify (make louder)
telephone amplifiers (for increased volume)
devices for getting close-captioned TV programs
spoons that swivel for those who have trouble with wrist movement
foam that can be fit over utensils to increase the gripping surface so they can be lifted more easily
plate guards or dishes with high sides that make it easier to scoop food onto a spoon
rocker knives that can cut food with a rocking motion
food-warming dishes for slow eaters
mugs with two handles, a cover, a spout, and a suction base
button hooks that make buttoning clothes easy
dressing sticks that make it possible to dress without bending
long-handled shoehorns so a person doesn't have to bend over when putting on shoes
sock aids that keep stockings open while they are being put on
Devices for Summoning Help
touch-tone phones with speed dials
medical security response systems
beepers for the caregiver
wireless transmitters for emergency response
Heat can be the enemy for many people with chronic illness. Learning how to "cool it!" in the summer months can be a problem. Fortunately, there are a number of cooling devices available to help the caregiver and care receiver beat the heat:
There are scarves and neck wraps that can be made cool by simply soaking in water.
Cooling vests are another staple among cooling devices.
There are devices for cooling wrists and ankles. One brand has arm and leg bands made of terrycloth into which you insert custom-size freezer packs.
There are countless hardware and software programs to make computers easier for people with disabilities to use. Alternative keyboards, puff switches for those who cannot use a mouse, screen readers, talking word processors, and voice recognition software are available today.
Homemade Aids and Gadgets
wrist straps for canes-tape tied on a cane so it can be hung from the wrist while walking upstairs
bicycle baskets-strapped to a walker to store necessities and leave the hands free
an egg carton-to organize pills
rubber safety mats-ideal for the tub, shower, or any slippery surface; also useful to make place on trays and tables for a nonslip surface
key-put the end of the key that you hold into a large cork for ease of grip
foot-operated door levers-made by attaching rope to a "stirrup" and tying it to the lever handle
language tags-cardboard tags with words that can be used to express needs
light-switch enlargements-made by putting a rubber pen cap over a light switch
enlarged pull switches-made by putting a plastic ball over small switches
clips for canes-spring clips or Velcro[R] placed on favorite chairs to keep a cane from falling
bedside rails-wooden rails attached to the floor at right angles on swivel hinges
pull rope-rope attached to the footboard of the bed to help someone change positions in bed
Specialized Hospital-Type Equipment
oxygen tanks, for use when oxygen is needed as a medication
breathing tube (transtracheal oxygen therapy equipment), for use when oxygen is delivered into the lungs through a flexible tube that goes from the neck directly into the trachea (sometimes called the windpipe)
compressors and hand-held nebulizers (inhalers), which reduce medication to a form that can be inhaled
suction catheters, which clear mucus and secretions from the back of the throat when someone cannot swallow
home infusion equipment, or IV (intravenous) therapy, which delivers antibiotics, blood products, chemotherapy, hydration (water), pain management, parenteral (IV) nutrition, and specialty medications
Excerpted from The Comfort of Home by Maria M. Meyer Paula Derr Copyright © 2007 by CareTrust Publications. Excerpted by permission.
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