Parenting 101: Wheelchair Edition
April 8, 2018 1:53 PM   Subscribe

My kid is temporarily -- maybe one month-ish? not quite sure yet -- using a wheelchair. Halp.

Kid BlahLaLa (mid-teens) broke his leg very badly and recovery's going to take a while. Right now we've got: a cast from groin to ankle, with no bend in it. He can crutch for short periods of time -- like, out of the wheelchair, into the bathroom, then back to the wheelchair.

There's a whole bunch of stuff I need to figure out:

-- Best practices for keeping him washed. Hospital staff emphatically told us not to rely on cast covers (for showering) because the cast is so big and heavy. At any rate, he can't stand without his crutches, and when sitting the leg is jutting out at a 90 degree angle (which is painful) so showers are out for right now. What really are the mechanics of a sponge bath? How do you do it without getting the cast wet at all? How do you wash his hair? How does his bum ever get washed if he's sitting on it when I'm cleaning him?

-- He wants to shave. What's the best way to do that when he can't stand at a sink?

-- When he returns to school, how does he carry his crutches along with him? The #1 reason for this is bathroom accessibility.

-- I don't have a handicap placard for my car, and I'm not sure it's worth pursuing given the shortish nature of this. Am I wrong? I'm in Los Angeles if it makes a difference.

Biggest of all right now: what are the unknown unknowns for this? Whether you're a parent or a disabled person or any combo of those -- what am I not even asking at ths point?
posted by BlahLaLa to Health & Fitness (20 answers total) 2 users marked this as a favorite
 
How about dry shampoo for his hair and baby wipes for his butt?
posted by brujita at 2:09 PM on April 8, 2018


My Amazon app is being annoying so I can't link, but if you search for "wheelchair crutches holder" on amazon, there are some options.
posted by gatorae at 2:16 PM on April 8, 2018


There are short-term disabled hangtags. You so want one, because walking is painful, and finding room to unload the chair is a challenge.

If possible, get forearm crutches (aka "axillary" or "Canadian" crutches) because they won't chew up his armpits or shoulders as badly. Also, they're less bulky so easier to carry on the chair.
posted by Jesse the K at 2:28 PM on April 8, 2018 [10 favorites]


aw, that sucks. Never dealt with a cast, but based on taking care of a relative with a complex hip replacement/repair that involved some of the same mobility stuff:

- yes, get the placard. It'll be nice to have it even when he's on crutches (rainy days, or extra tired days, etc.)

- a haircut cape may be useful for both shaving and hair washing. Shaving, cover a table or desk with a towel, get a couple of washcloths, basin of hot water, razor, mirror, and shaving cream-- should be good to go. Hair washing, salon-style, leaning back against a low sink with a folded towel to cushion his neck.

- shower, get a handheld attachment (on as long a tube as you can find). First few days, we placed a tub/toilet chair sideways so that my relative was seated facing out (right side to the shower head) with the operated leg lifted onto a chair outside the shower. They got themselves wetted up with a very low-pressure flow, turned it off to soap up, and then rinsed off with a low-pressure flow. Covering the seat of the tub/toilet chair was a washcloth with a bit of soap in it, and they did an extra cleaning wipe after standing. You could essentially do the same thing without the shower, just using a damp soapy washcloth followed by a clean wet washcloth. Sometimes it's easier with the person lying down in bed on a thick towel.

- also, wet wipes when using the toilet and/or periodically throughout the day (since sitting tends to make you sweaty) plus a dusting of cornstarch or Gold Bond keeps swass at bay.

- tub/toilet chair I'm referring to is one like this. The commode pail is removable, so you can just set it directly over the toilet, and then to use as a shower chair, close the lid. If you want to use it in the shower, you'll definitely want to check the dimensions of the bottom part of the legs (can be a tight fit in small showers).

- rent specialty equipment and furniture, if you can (though do price it out if he's going to be in a cast for many months). For example, none of our living room furniture was comfortable enough for the amount of sitting my relative was doing, so we rented an extra-cushy recliner that had the features they needed. We also ended up creating a foam cushion out of egg crate toppers, wrapped and pinned into a sheet (so it could be washed) so that they could recline on the couch. It's just a lot of sitting. Likewise, we added foam toppers to their bed, since not being able to turn over without help meant pain and wakefulness on the plain mattress.

- honestly, if I had had the space to do it differently, I'd have avoided having my relative's main comfy place be right in front of the tv. It was extremely bad for their mood, sleep, and willingness to get up regularly and do recommended exercises.
posted by notquitemaryann at 2:38 PM on April 8, 2018 [1 favorite]


Hospitals often use shampoo caps for washing hair. If you have a sink which would allow you to back the wheelchair up to it (perhaps a kitchen sink with a sprayer?) you could do a hair salon type shampoo.

You can use bath wipes for bathing (or something like these). There are also no-rinse cleansers available. You can also do a classic soap/water/washcloth/basin type bath, which is messier/more labor intensive but may result in feeling cleaner. This would most easily be accomplished in bed, and you would need some kind of waterproof mattress protector if you go with the soap and water option. It's likely that he's mobile enough to take care of washing most of the more sensitive areas, but he will probably need help with the back. Is he able to roll to the side at all? That's the best way to get access to the backside, or if not I suppose you could do it standing. There are lots of youtube videos and instructions for how to do a full bed bath.

For shaving, it might be easiest to use a hospital-type table over the bed with a mirror and basin. Having a bed table may make life easier in general (eating, homework) if he is more comfortable sitting up in bed or on the couch than sitting at a table.

Your health insurance may cover some of these items. If you are still in the hospital you could talk to the social worker/case manager about how to get durable medical equipment (and ask the nurses/techs to show you how to do a bed bath!) If you are outpatient, your provider's office may have someone who can get these types of items for you. Some thrift stores have a lot of medical stuff (e.g. hospital table) and some communities have a "lending library."
posted by charmcityblues at 2:40 PM on April 8, 2018


Ohh right and check the side effects of any pain meds he's taking (if any). Be sure to keep fiber chews as well as diarrhea meds on hand, because nothing is worse than stomach upsets in either direction when getting to/sitting on the toilet is difficult.
posted by notquitemaryann at 2:41 PM on April 8, 2018 [3 favorites]


The shampoo caps that charmcityblues mentioned are surprisingly refreshing. Baby wipes are great for sponge baths.
posted by i_am_a_fiesta at 2:51 PM on April 8, 2018


You may want to rent a walker (with no wheels) as well as crutches. When I was in a wheelchair, I had an aide shower me once a week at a swimming pool designed for accessibility. They had a private shower stall for this purpose, large enough for wheelchair, aide, and person. I sat on the seat and the aide used the hand-held shower arrangement. To wash my backside, I would stand up from the seat (which had a hand-held shower attachment) and lean on the walker. Much safer than using crutches for the same task. I had no cast so I didn't have to concern myself with splashing, but I would think a cast cover would work if there is a helper operating a hand-held shower attachment and you did not aim spray at the cast. You could of course replicate this at home with a shower chair and hand-held shower, so long as you have a walk-in shower.

I was sponge bathed at home once a week as well. I had rented a raised toilet seat, which was required for my condition at the time. I think it was a very tall commode with the bucket to receive the waste removed. But it was also very handy for the sponge bath, as I was able to sit over the toilet (ie, not hop a bathtub or transfer to chair in shower). I could also shut the lid for washing. The aide brought a bin with soapy water and a bin with clean water to the bathroom. Wash with a washcloth from the soapy bucket, then rinse with a washcloth from the clean bucket. Again, I used the walker to stand and clean the backside. You can hold the walker with one hand and wipe with the other.

To wash my hair, I went to the kitchen sink and was propped up with cushions high enough to get to the sink. Or you could use a basin for the rinse.

In between sponge baths there is both dry shampoo and cleaning solutions that do not require rinsing. If you go to one of those home health care centres by the hospital where they sell adaptive product and medical supply, you should be able to find the cleanser. I got a bottle by stealing it from the hospital on discharge.

You can shave with a basin but this seems like a pain in the ass, you'd be surprised at how fast your son will be leaning on counters and otherwise hopping around to satisfy his daily needs. Again, a walker in the bathroom is great for leaning, even one-handed. I'd leave him hairy until he figured out leaning.

Crutches can be transported on a wheelchair. I forget how I arranged mine on the chair, but it was done. Basically you hang them off the back or, if they don't fit, keep them on your lap and hold them up to move them. I splashed out on the crutches and bought the Crutcheze, suitable for keeping phone and drinks with you. Excellent for use at work/school. You will also want spill-proof coffee cups, suitable for being turned upside down, if your son likes hot beverages.

Getting a wheelchair card for my car was easy and it was totally worth it. I had it for 5 months after my injury. The best part of the wheelchair placard - it enabled me to park in permit parking only spots all over the city, which was very important and allowed me to park closer in street parking situations. This was essential, it saves blocks.

I would make sure you have enough firm cushions about. Getting up from a low seat is difficult. A cushion is helpful to raise the butt level in the car, on the couch, etc. You can just get an extra wheelchair cushion for this.

In terms of obtaining equipment - Red Cross has an equipment loan program for prescribed things, my commode, walker, etc came from there. They also loan wheelchairs but they suck. The wheelchair rented and covered by my extended medical plan was superior.
posted by crazycanuck at 2:52 PM on April 8, 2018 [2 favorites]


Is there a reason that Kid would be against an electric razor?
posted by Ms Vegetable at 3:01 PM on April 8, 2018 [1 favorite]


School bathroom should have ADA stall and grab bars, could he test drive maneuvering? He might need to back in. Some stalls are minimum-size which will be tough for him, so talk to the school nurse, who might have more generous proportions in the health suite.

Padded bike gloves will help his hands with the chair and the crutches. If he gets routine crutches there is replacement? additional? padding that can ease his experience. There are also better tips for rain & wet surfaces - if you search on “rain boots for crutches” you’ll find them.

At home you’ll be moving furniture and they will sort this at school as well, though they are pulling from experience (or should be). Barber bibs or lobster bibs for shaving with towels underneath will get him by. If he’ Pulled up near a table with a mirror & what he needs.

Some of this is creative problem solving.

Get the temporary accessible parking hang tag from MVA, the proximity will help when he’s tired, and he could be in the chair longer. Also, most metered parking is accessible, so expect to pay meters when they are involved with public parking. This is a big shift from 5-10 years ago that those new to disabilities, even temporary ones, may not be aware of.

Best wishes on his speedy recovery!
posted by childofTethys at 3:05 PM on April 8, 2018


My husband had an injury that didn't involve a cast, but did involve absolutely no weight bearing, not even on crutches, at all, and showers involved a shower chair in a walk-in shower, a sprayer, and... me.

Also, to be honest, we temporarily moved to a relative's house that was better suited for a wheelchair - no steps up into the house, wider walkways, walk-in shower, etc. Is there a friend or relative with a better-accessible place that he and one parent could temporarily move to for at least the first, most painful, week or two until he figures out how to maneuver better?

I also second the walker recommendation above. He used a walker for a week or two before crutches really worked.

And YES, get a handicap placard. Even after recovery, he will be slow moving for a while.
posted by raspberrE at 3:11 PM on April 8, 2018 [1 favorite]


Seconding to use an electric razor if possible. Norelco OneBlade is good, and only $35 dollars.
posted by andoatnp at 3:23 PM on April 8, 2018


If your son just wants to have a shave before he can lean and DIY, take him to a barber shop and have them do it. They have the means to do this. It will help him feel clean.

In terms of wardrobe - have you considered what you will do for pants? This sounds like a challenge. I guess you'll just have to buy really huge drawstring pants and cinch them up. The wardrobe situation will block him from returning to school, you might consider delaying his return until he can wear a more normal wardrobe that he can easily manipulate in the bathroom.

I would also buy him a brand-new, very supportive pair of running shoes and replace the regular shoe laces with elastic. He should always wear a shoe (or two) inside for safety. The new and supportive requirement is to help make sure he doesn't tweak his good leg (hopping is hard). You could potentially buy two pairs - one indoors and one outdoors (the outdoors one can have regular laces, since he won't be taking it off/on as much) for less mess in your house.
posted by crazycanuck at 3:30 PM on April 8, 2018 [1 favorite]


Best answer: Before returning to school, make sure you talk to the school about his exact needs-- more time to move between classes? designated place in each classroom to sit, so that he has unobstructed view and room for the leg to stick out? are any of his classes on upper stories, and if so how close to the elevator? The school should have experience with this and be in ADA compliance... but should be and really are are sometimes not terribly close to each other. If possible, speak with each of his teachers individually, as well as the principal and whoever has the job of accessibility in the school (sometime nurse, sometimes counselor).

Do a dry run before his school return, a day in which he spends as much time in the chair, moving around, doing bathroom transfers, and hauling his stuff on the chair (crutches and books on the back) as he would for a normal school day. Optimally, go to a mall or park for this, somewhere you can leave quickly if he gets tired. This should alert you to any logistical things you haven't thought of, and will also help him figure out how much energy he will need to make it through the day (because this is going to be exhausting until he gets used to it).
posted by Rush-That-Speaks at 4:05 PM on April 8, 2018 [2 favorites]


As someone who's also had majorly awkward broken bones- remind him that the pain, awkwardness, tiredness and general weakness are the absolute worst they'll ever be right now, so encourage him to be patient. He will feel MUCH better and more capable in a week, and better still in 2 weeks.

For washing below the belt, consider a bidet attachment for the toilet.
Or perhaps pouring or squirting water (with a perineal squirt bottle or travel bidet bottle) between his legs while sitting on the toilet?
posted by pseudostrabismus at 4:58 PM on April 8, 2018 [1 favorite]


Best answer: Man- that sucks. Stretching out with that cast to wash seems very difficult.
Since you are in LA maybe a reclining lawn chair outside might help. You could literally lay him flat and let him scrub up with lots of soapy water and wash his hair and you could really rinse him. You could have him lay the opposite way so he could prop up his leg so water doesn't run down.

This might only be once a week or something but I think might be the closest to the feeling of a good shower.

Just a few buckets filled in the tub with warm water should do it.
posted by beccaj at 6:16 PM on April 8, 2018


My young son broke his leg and got a whole-leg cast, and they said no kid could use crutches at age six...but he used crutches. The school required a wheelchair and a special bus for like six weeks, and that’s the only time he used the chair. Go to the end of the driveway with crutches, sit in the chair as the bus arrived, and then reverse the process when school was over.

He adapted to the cast quickly and was doing way more than we expected on his own at home. I think we did sponge baths with a washcloth; he wiped up in the bathroom on his own. And at that age he wasn’t shaving yet. He stood at the kitchen sink for a fast hairwash.

Good luck to all of you: the adjustment sucks, but kids are resilient and will adapt.
posted by wenestvedt at 3:23 AM on April 9, 2018


I had a similar situation re: bathing not that long ago, with a standard bathtub setup.

I ended up using a detachable showerhead and a bathing stool. The height was adjusted so it was the same as the shower lip. I would duct tape a trashbag to my cast side (to avoid any incidental water contact), sit half on the stool/half on the edge of the tub so that my bad leg was completely out of the tub, moved the shower curtain up to my leg (to avoid spraying everywhere), and used the detachable showerhead to clean myself. This allowed me to wash my hair and body without too much trouble. At the end of the shower, I'd wash my private bits by squatting and using the detachable showerhead to aim at the appropriate locations.

You might need to mess around with leg supports for his casted leg so he can sit in a way that is comfortable for him, but this general setup was by far the quickest and least messy way I found to get clean.
posted by zug at 11:58 AM on April 9, 2018


Oh, and for shaving, a shower mirror and said shower setup ought to work fine. He can shave during shower time.
posted by zug at 12:02 PM on April 9, 2018


Response by poster: Thanks for all the suggestions. For anybody facing this in the future, this is what ended up happening for us:

-- We did get the handicap placard. By doing it at AAA I was in and out in five minutes. This turned out to be essential, less for parking close to where we needed to go (because he's riding in the wheelchair, so he doesn't care really), but for having that extra space at the side of a handicapped parking spot -- to get the wheelchair in and out, and to get him in and out.

-- We absolutely could not make the shower/bathtub work. They just wouldn't, even with a shower chair, detachable showerhead, etc. We did sponge baths & hair washing on the patio. Not ideal, but good enough. After five weeks he moved into a long-leg brace, but that can be removed for short periods, so now shower + shower chair works.

-- Mr. BlahLaLa shaved him.

-- We had to cut up a couple pairs of pants because the giant cast just wouldn't fit underneath them. Later he had a slimmer cast that would fit under baggy sweats. We purposely kept no shoe on his bad leg as a reminder that even on crutches, he wasn't supposed to let his foot touch the ground.

-- I was totally unable to find a reasonably-priced crutch solution, so he just figured out how to tuck them by his hip, with the bottoms resting next to his good foot on the footrest. Sometimes they fell down at school, but friends helped with this.

-- We didn't rent any special furniture, but we did shove a lot of our household furniture against the walls to provide maximum room to maneuver.

-- The school went above and beyond, and two staff members came in on a Sunday so Kid could do a dry run, figure out how to use the restroom, etc. I was so grateful for this.
posted by BlahLaLa at 6:33 PM on May 9, 2018


« Older Do I use less data an a Google downloaded map than...   |   Chinese, Korean etc. Sci fi shows on viki.com Newer »
This thread is closed to new comments.