Background
Marilyn is an 81-year-old female who was hospitalized after she sustained injuries from a fall related to neurosarcoidosis. She was in acute care for 7 days where she received a full medical work up, labs, PT, and OT.
While her medical condition stabilized, she remained with significant decreases in functional transfers, no functional ambulation, ADL/IADL skills, and decreased functional strength and activity tolerance. She benefitted from post-acute care at the skilled nursing facility (SNF) level.
As she progressed in treatment at the SNF, Marilyn became more ambulatory (although not for household distances), and required less assistance with transfers. A home evaluation was recommended to determine her needs. While her husband is available to help with her care at home, he is also somewhat debilitated and would require equipment to help her.
Marilyn’s medical history also includes depression, anxiety, impetigo, and rheumatoid arthritis.
Recommendations
The therapists at the skilled nursing facility contacted Lifeway Mobility to perform a home evaluation and make specific recommendations for equipment. A Certified Environmental Accessibility Consultant (CEAC) professional from Lifeway Mobility completed a thorough home evaluation and made the following recommendations. With Marilyn’s impending discharge from the skilled nursing facility, these are considered short-term product solutions (products needed immediately).
Basic Mobility Modifications
Stair Lift:
Marilyn lives in a two-story home with the only full bathroom on the second floor. As she is unable to climb stairs, a stair lift was recommended.
The Bruno Elite stair lift was chosen for its offset swivel seat, allowing Marilyn to more easily transfer to and from it; its armrest control switch, allowing ease of use with her RA; and the multiple upholstery colors available to match her décor.
While a wheelchair lift was initially recommended to allow Marilyn’s wheelchair to ride up and down the stairs, there was not adequate room in the home. Instead, the purchase of a second, refurbished wheelchair was recommended for use on the second floor.
Exterior Wheelchair Ramp:
An exterior ramp from the front door was necessary to allow Marilyn ease of access to and from the house. A modular aluminum ramp was chosen as safe and reliable option in any weather.
The aluminum ramp was custom-designed with two switchbacks to minimize the ramp’s rise while allowing her husband to assist.
Threshold Ramps:
Marilyn’s home has multiple types of flooring including wood, high-pile carpet, and linoleum. Threshold ramps were recommended to provide a comfortable transition between rooms with different flooring types.
Bathroom Modifications
Sliding Transfer Bench with Swivel Seat:
A transfer bench was necessary for the safety of Marilyn and her husband. As a standard tub bench was difficult for Marilyn, a sliding bench style was recommended. The swivel seat allows Marilyn’s husband to help – so she can shower when she wants to, not just when the Home Health Aide is available.
Grab Bars:
Grab bars were recommended inside the tub to allow Marilyn to help herself. A 45° angle of placement would allow Marilyn to assist in pulling herself over the tub’s edge without exacerbating her RA or placing unnecessary stress and strain on her husband.
Super Pole
A Super Pole was recommended for the bathroom to assist Marilyn with transfers. The pole is preferred over a wall-mounted grab bar because it would allow her to use both entire arms to assist with the transfer when necessary, not just her hands. Proper placement was critical to allow her to maximize her mobility while remaining safe.
Transfer Solutions
FlexiGrip:
For bed mobility, the Flexigrip strap was chosen to allow Marilyn to more easily pull herself from supine to long sit. Thick, padded handles ensure that she can use the device comfortably and effectively, while the nylon material is easy to clean. An extension strap was added for length, as Marilyn has a California king mattress.
FlexiBelt:
A step up from traditional gait belts, the EasyBelt’s design makes it comfortable for Marilyn and easy for her husband to use. A wide clip securely attaches the belt around Marilyn’s waist, and both horizontal and vertical straps allow her husband to easily grasp it and help Marilyn with all functional mobility. The EasyBelt is made from PU-coated nylon, so it can be wiped down easily with disposable cloths.
Cost Savings & Outlook:
With a potential cost of over $156,000 annually for skilled nursing care and $66,000 for assisted living, staying in the comfort of your own home just makes sense. Living independently at home can have many mental and emotional benefits as well.
Lifeway Mobility has provided Marilyn and her skilled nursing facility with an in-home assessment of safety and function, and has recommended the best solutions to attain the best outcomes.
We are confident that these recommendations will significantly improve Marilyn’s quality of life, as well as that of her husband and caregivers. These products will help Marilyn be more comfortable, safe, and independent.
*Names and details have been modified for privacy reasons.