Quadraplegic functional skills. Showering (1968)

foreign [Music] [Music] [Music] [Music] [Music] public gets stereotyped ideas of people in wheelchairs they don't know if you broke your neck in an accident if you had Polio as a child or what happened to you that doesn't really bother me too much what does kind of get me is the fact that a lot of people think you're helpless I think you need a tenant care all the time for bathing in all your grooming activities well for some high level quads I guess that's true but there are a heck of a lot of us who can be and are independent Tom was originally classified as a C5 C6 in determining ability however remaining muscle function as well as contractures complications body proportion weight and weight distribution are all important factors in the key muscle groups for ADL Independence Tom's triceps are graded zero he has scapular depressors with sufficient strength to lift his weight in addition he has good radial wrist extensors and his hand functions are accomplished by tenodesis action a shower seat with a back can be installed in almost any bathtub the back should be padded in the same manner as the seat however over the years Tom has found it possible to use a smoothly finished board and still avoid complications the seat must be secure and stable to be safe for the quad the height of the shower seat should be adjusted to match the height of the wheelchair some homes and many institutions have shower stalls rather than tubs John lifts and hooks his front casters over the low lip at the entrance to the shower the lips should be no higher than two inches to facilitate the various transfers quadriplegics and others use small brackets clamps or chains could be used to stabilize the chair to some permanent fixture if greater stability is needed John was diagnosed as a C5 C6 his key muscle groups are graded the same as Toms with the exception of his triceps which are poor and poor minus this shower stall has a fold down bench seat a quad can take advantage of the design of the seat by moving to the corner and using both the side and back wall for support if necessary water temperature must be carefully tested when the water is turned on it should be directed so it does not touch any part of the body the temperature should be checked on an area with normal sensation and adjusted as desired if the quad's ability to determine temperature is poor you should have someone test the water for him the teeth and mouth can be used to loosen or tighten caps on tubes and bottles if it is difficult for the individual to squeeze the shampoo onto his forearm he should try another area such as the back of the hand if there's one thing I've learned to be invented during my Rehabilitation they taught me different ways of doing things they also encourage me to experiment adapt my surroundings and abilities that might have been the best advice I ever had grab bars along the shower walls are helpful they should be placed at a hike which is functional for the quad you can use the bars to stabilize themselves as he leans bends reaches or anytime he shifts his weight when they beat able-bodied people ask you how you do certain things and how you manage to be independent there's one thing they always bring up doesn't it take you a long time to do things well it does but after a while you get so you can do things pretty efficiently considering when I came to school I knew I had to make it to my eight o'clock the bus would leave for class at 7 30. and if I wasn't on it I'd be out of luck so I got up early enough to get everything done it wasn't much fun getting up and it was still dark outside and everybody in the dorm was asleep so I worked at doing things in less time and experimenting with different methods that would be quicker for me eventually I got my routine down to 45 minutes this type soap may be easier for the quad to handle than the regular bar soap another alternative is a hand knit with soap in it some individuals use a liquid detergent or concentrate shampoo to wash away a shower attachment like this is quite useful for the quadriplegic a similar attachment can be purchased at a hardware store for use on almost any faucet with this the quad can direct to water where he wants it others use the standard shower head but should still utilize some method for testing the water temperature for washing the feet back and other areas that are difficult to reach a shower brush with a long handle can be used after my accident I laid there in the hospital bed and had to be bathed that didn't go over so well with me when I was finally able to take a shower of my own it really felt great the shower seat should be dried before the transfer so there are no wet soapy spots that the quad can slip on a dry towel folded and placed in the wheelchair will protect the cushion and help dry the buttocks caution should be exercised during the transfer back to the chair since the walls and floor of the stall may still be damp and slick the head against the wall is one way to study the body during the transfer while the wheelchair is positioned at the shower stall the arm is put back on and the brakes are released to get the wheelchair back over the lip John simply pushes off against the entrance of the stall this transfer illustrates the importance of having the shower seat the same height as the wheelchair with the two matched Tom can slide into the wheelchair with a minimum of lifting a sliding board can be used between the chair and the seat if the two are at uneven Heights or if there is a gap between them the first few days after my accident I just lay there I couldn't move my arms or anything and I got to thinking what am I going to be able to do what will I do for a living I really got a feeling of fear I've talked to other people since then who've gone through the same thing and they all felt the same way I did when you're depressed and scared like you are at the beginning it's hard to be convinced that you'll ever be able to make it on your own I know they didn't sell me on it at first oh I don't mean to say that I'd given up all together but it was hard for me to look ahead and realize that any Independence was possible many quads shower in conjunction with their toilet schedule While others shower in the morning or evening as time permits when the quad must move in close to a sink he should take precautions against his legs coming in contact with hot pipes with the lack of sensation a serious burn could occur the pipes should be insulated or separated from the legs by a partition I gradually begin coming out of my depression and started realizing there was a lot I could do I began to tackle things one at a time starting with the simplest for the most part the female quadriplegic showering and grooming routine is similar to the males one problem is hair setting Evelyn uses curlers covered with a velcro-like material that the hair will cling to she uses the pins as an added step for securing the rollers a hair net could also be used to keep the curlers in place to tease her hair Evelyn bends over and rests her arms on the table this allows her to use the weight of the hand to hold her hair in place while combing my life changed pretty dramatically after my accident when I got out of the hospital I was considered functional but I still had a long way to go before I would consider myself independent and began a period of hard work and intensive training it took me five years to accomplish some of the things I wanted now I'm married I've had a baby and I hold down a full-time job an electric shaver is most practical for quads and especially at the beginning of training battery-powered Shavers may be more convenient than those with cords since electric Outlets are often difficult to reach [Applause] although the majority of quadriplegics shave with electric razors there are others who prefer to use a safety razor they feel it gives them a closer shave and a better appearance the disabled after all are just as concerned with their appearance as are able-bodied people if an individual uses a safety razor he should be very careful and patient as he shaves by using both hands he can get a better grasp and more control of the razor a towel spread across the lamp protects the legs in case the razor is dropped foreign the use of the mouth and teeth proves to be an indispensable aid for the quiet if caps are too tight they should be initially loosened by someone damage to the teeth or mouth is possible that too much force is used as with the razor Tom prefers to hold the toothbrush with both hands the Palm to Palm grasp gives him better control cuffs which fit over the hand can be designed to hold a toothbrush razor hair brush and many other objects electric toothbrushes work quite well for the quadriplegic the individual need only worry about holding the brush in the right position better cleaning of the teeth may result as well but glass used for rinsing the mouth should be paper or unbreakable plastic a cup with a large handle can also be used now that I look back on my Rehabilitation period things look a lot different than they did then I finally realized I managed to achieve my Independence the therapist was always having me try something a little harder than what I had just accomplished pretty soon I guess so I started pacing myself I think that's the key working at something a little out of your immediate reach set goals for what you think you can achieve when you get close to achieving the goal make a new one if you do this you'll develop the attitude that you've accomplished a lot but you'll never be satisfied to stop get as close as you can to being independent then you can laugh at the guy you think squads are those poor helpless people in wheelchairs [Music] [Music] [Music]