As your loved one progresses in their recovery you will become aware of various pieces of rehab and other adaptive equipment. Below is an overview of some of the equipment you may need.
If the brain injury is severe you may be faced with needing a wheelchair. It may be transitionary or permanent. Below are a few things to think about.
An important thing to remember is that your insurance may have limitations regarding wheelchairs. For example, they may limit you to only one chair every five years. You want to make sure the people making the recommendations are thinking longer term. Secondly, you want to make sure the person fitting the person for the chair is experienced and knowledgeable. The are a multitude of options and accessories to help overcome a number of issues.
Manual - The first question is manual or power. The choice is based on the person's particular deficiencies. Manual chairs may be recommended for the people who can handle the physical demands required. They may also be recommended for people at the other end of the scale who are not yet capable of safely operating a power chair. Make sure you get the right seating material to avoid any pressure sores.
Power - Power chairs offer more capabilities than a manual chair. Some of the important differences, beyond the obvious one of one being motor driven versus person driven, include being able to tilt. This is important to give the person pressure relief after they have been sitting up for a while. Since brain injured people often get tired easily it is also very helpful in that people can tilt back and nap comfortably. There are different designs available and be sure to tell the tech if you plan to go out in the yard so they recommend a chair that works well in uneven terrain.
There are just too many models and options to discuss but one chair that I am intrigued by is the iBot. This is the chair designed by Dean Kamen and now sold by Johnson & Johnson. It has some amazing capabilities such as climbing stairs and raising up to eye level. You can contact Johnson & Johnson to see if the chair may right for your loved one.
A couple of points to keep in mind. Make sure the chair is adjustable so if the person gains weight the seat frame can be widened. Pay close attention to the leg and foot positioning. Keep in mind that after a person is up in the chair a while they will tire and their tone may kick in changing their positioning. If the person has problems with head control there are different options available, none that we have found to be very comfortable so far. There are also supports to help with trunk control. Again the seat is very important and make sure a seat is selected that prevents pressure sores.
There are all kinds of equipment used for rehab. I cover a few of the common ones below.
Mat Table - The most basic piece of equipment is the mat table. The therapist and the patient can use the mat table to stretch and exercise on. There are many different types available to purchase. I built ours using 2x4's, a sheet of 3/4" plywood, and covered it with an old exercise mat. The key design tip is to make sure it is wide enough so the person doesn't worry about falling off and make sure it is wheelchair height for easy transfers.
Standing Frame - There are a number of different styles of standing frames but they have the same goal of safely lifting the person to a standing position while they bear weight. Bearing weight is important for a number of reasons such as fighting excess tone, building bone mass, and helping with bowel maintenance.
Walkers / Rollaters - If the person is progressing where they can stand more independently or preparing to walk your therapist may suggest a walker. There are options such as arm supports available. Wheels on the front legs of the walker turn into what is sometimes called a rollater.
Gait Trainers - These are newer machines that support some of the person's weight while the person stands. Often the person in the gait trainer uses a treadmill to practice walking. It can be a much safer option as the gait trainer will support the person and prevent the chance of a fall.
Exercise Balls - These balls come in many different shapes and sizes. They are often referred to as Physio balls after one of the leading makers of the balls. They really help with trunk control as the person sits on the ball with the therapist. The person has to work the trunk muscles in order to keep their balance.
Hospital Bed - The most common piece of home medical equipment is the hospital bed. For some reason all of the home hospital beds seem to look the same, like 1950's industrial beds. There are options available such as motorized head and leg lifts. The manual option uses a crank. Our suggestion is to push for a fully motorized bed.
Secondly, we also suggest you request full length side rails. Be careful with the rails, we speak from experience when we say that they can leave a space big enough between the bed and rail for the person to slip get stuck. We now put long foam pieces in the space at night. If you read the other pages you may have read about the air mattress we have from KCI. If you family member is severely injured and will spend a lot of time in bed we recommend you push the insurance company for an air mattress.
Feeding Pump - For the injured survivor still using a feeding tube you may need a feeding pump. The pump lets you fill the bag with the liquid food and then meter the flow rate. We used to let it run slowly overnight. Learning how to prime it properly will allow you to avoid most of the problems of the annoying beeps. Make sure you flush the g-tube with water as soon as it completes the cycle. Also, make sure the head of the bed stays raised for the person with a g-tube to avoid reflux.
Pulse/Ox Meter - The Pulse/Ox machine monitors the hearty rate and the oxygen saturation level. It uses an adhesive strip on the finger or toe to provide the input. It will alarm if the levels go above or below ranges you can set. If your loved one is unable to speak really push your doctor to write you a prescription for a Pulse/Ox. By monitoring the heart rate you will be able to tell if something is wrong. It was one of the best decisions we made as it really gives us peace of mind. You may have to push on the insurance company as this is not a standard item they approve for home care.
Blood Pressure - There are a number of relatively inexpensive blood pressure monitors for home. Work with your nurse and he or she can teach you how to take a reading and set up a schedule as to how often you need to monitor it. Make sure you write the readings down in the daily log you are keeping. That way you can refer back to the logs for any trends.
Thermometer - There are inexpensive digital thermometers you can buy to use at home in case you do not already have one. Again, work with your nurse to see how often they want you to take the temperature and make sure you record it in the daily log. Taking the person's temperature often is very important if the brain injured person is starting to eat or drink again. A fever may be the first sign of aspiration pneumonia.
Suction Machine - A suction machine is a key piece of equipment. I would regard it as critical if the person is having to re-learn to drink and eat by mouth. We use ours multiple times throughout the day and for mouth care. There may also be times where the person is not able to keep up with their saliva and the suction machine is a necessity. A tip we picked us is to put a little mouthwash in the empty canister and it will keep down any odors.
Equipment Forum / Swap
We would like to start a forum here where people can donate to others any pieces of equipment they longer need to other families in need. E-mail us with your items to donate or items you need and we will post them here.