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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!

Even if she is already home, call her MD and request a referral for PT assessment of safety, recommendations for equipment to improve her safe mobility, and to teach you and her how to use any new equipment, learn a new transfer technique, etc.
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
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Reply to Clairesmum
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Are you able to have a bathroom converted to a wet room? That way you could have a light weight wheelchair just for use in the wet room and to and fro, and enable her to be washed seated. Struggling with weight bearing is difficult because handholds and rails whilst helping still require someone to do a fair bit of lifting for toilet needs. Maybe a personal care assistant would be possible to assist you, talk to hoyer and see what they can suggest (I presume they still make under their own name), of not any lift supplier should be able to suggest possible solutions of various sizes and abilities to be folded away.
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Reply to TaylorUK
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My husband has MS and is wheelchair bound. The best piece of DME I have purchased are Stander curved poles. We now have 3 of these. They require no drilling or permanent holes in ceiling or floor. Are held tightly in place with compression. The 2 loops on the poles provide hand holds for "climbing" out of the chair. Also loops turn for easy access. They are hard to describe, but try a Google search. Amazon has them as does Walmart.
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Reply to janny02
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A quick solution for a doorway that is just a little too narrow is to remove the door and perhaps the innermost trim too that the door closes on. This added more than 3 inches (just the trim may add another 1/2 inch or more) to mom's bathroom door when she had hip replacement surgery; just enough to allow her walker through the door. Use a tension rod and a curtain for a "door" if you really need one and install a curtain tie back to hold it out of the way when you need the full doorway. After she healed, we reinstalled the trim and door.
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Reply to TNtechie
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You will want equipment that will prevent or limit the development of pressure ulcers for someone who is immobile most of the time. Someone suggested an air mattress with dynamic air flow that redistributes pressure. I second that. My husband with dementia sits in his recliner all day and is unable to get up and move about on his own. He had developed stage 2 pressure ulcers. In addition to the air mattress which helped at night, I purchased a dynamite air flow cushion for his recliner/wheelchair. It runs on rechargeable batteries (12 hours) or can be directly plugged into house current. It automatically changes pressure points at set intervals. Within two weeks of using the seat cushion, his ulcers are nearly cleared. I wish I had found this cushion earlier to have avoided the discomfort that resulted from the sores. Medicare will only cover an air mattress and even then only if the pressure sores are present and severe. Medicare does not cover the dynamic air flow cushion at all - only a pump up static cushion and again if the sores are severe to need wound care. The seat cushion can be purchased for $299 on Amazon. The brand I purchased is called Apex. There are other brands similarly priced. Good for you that you are planning ahead for your loved one’s care. Better to prevent the sores than to try to heal them later.
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Reply to OpenMind
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albleich: Perhaps one of the biggest and most important issues is the clearance in your bathroom doorway to accommodate a wheelchair and therefore providing access to toileting. Perhaps she will otherwise be using a bedside commode and methods for cleanliness due to immobility and non weight bearing. Good luck.
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Reply to Llamalover47
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Really good suggestions; I'm copying them for myself for when I need more support.

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
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Reply to GardenArtist
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I have no idea what a DME is but I am wondering why at 93 with so many difficult physical problems and the configuration of your home, why is she not in a facility? I do not understand how you can assume this level of responsibility and still have a life and be sane.
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Reply to Riley2166
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Countrymouse Nov 1, 2021
Durable Medical Equipment - hoists, pressure cushions, slings, wheelchairs, commodes, stand-aides...
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For bathing, I would suggest a Pro Bathchair Lift. Call Kelli 509-630-9571 for info...if you can wheel her into the bathroom to sit on chair that sits on edge of tub. You can lower the chair all the way to bottom of tub and get a much better bath. My mom has tiny narrow bathroom and I installed one. Best money I ever spent.

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.
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Reply to my2cents
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my2cents Nov 1, 2021
Also, meant to say, go to the bedroom and sit on the bed. What would you need nearby? At night, to avoid trips to bathroom and back, put potty chair next to bed with back of chair against wall. Allow enough room between bed and potty to stand, turn around, use it, and turn again to get in bed. Add night tables near bed to hold items - pills, pads/diapers, phone, etc.

Anything you can do with PT/OT to get her up and a little stronger will help all of you in the long run
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Make sure before you leave you meet with case manager and get all DME equipment delivered to your home beforehand. You can refuse to leave until you have the equipment at home for her safety. Also request in home health and therapy (OT and PT will come with home health and OT can assess her needs and your home and make any suggestions that may help). They will set up in home health agency before you leave. You can also request a social worker through home health that may be able to guide you to local things that she qualifies for (local chapters offering aide services or meals etc).

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
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Reply to Momheal1
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Cover99 Nov 1, 2021
Is this a subtle way of saying she would be better in a facility?
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Are they not recommending therapy once she returns home? If not, I would request it. Tell them Mom needs to acclimate to new surroundings. That you need someone to tell you what measures to take to make ur house safe for Mom.

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.
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Reply to JoAnn29
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There are hinges that you can put on your doors that will allow a full swing, that should give you another 2 inches or so. Does not sound like a lot but it can make a difference.
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.
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Reply to Grandma1954
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Sorry, I only just heeded your comment about not having time to get a home therapy consult, hmm. If you've already been given contact details for a recommended therapist, don't be afraid to push to the front of the line, and lay it on with a trowel about falls risks, skin integrity, etc. These professionals are used to being given short notice, it shouldn't take them too long to get to you.

What is she already using in rehab?
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Reply to Countrymouse
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1. A slide sheet (also called a glide sheet). Single most useful item anyone can have in the house, and costs pennies (well. Less than $20). Get a proper one, by which I mean in its simplest form with no "new improved" handles or anything like that. If continence care is an issue, good idea to get a couple. Make the size generous but not ludicrous (we see some like circus tents).

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.
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