Standing brace for an elderly invalid?
July 11, 2021 3:30 PM Subscribe
My 95-year-old dad is healing from a wound from a pressure sore. He can't be in a wheelchair longer than 45 minutes. Do braces or exoskeletons exist that would enable him to stand up/be stood up without depending on his strength?
Dad's wound is right where he sits, so he can only be in a wheelchair for 45 minutes at a time. So not only has he lost his ability to stand and walk, he can't even spend very long out of his bed, and his legs have become stiff.
Are there devices that he could be stood up in, so that his weight would be on his arms and upper torso rather than on his sacrum? Ideally such that he could be moved or helped to move to another room than the one he's stuck in?
Dad's wound is right where he sits, so he can only be in a wheelchair for 45 minutes at a time. So not only has he lost his ability to stand and walk, he can't even spend very long out of his bed, and his legs have become stiff.
Are there devices that he could be stood up in, so that his weight would be on his arms and upper torso rather than on his sacrum? Ideally such that he could be moved or helped to move to another room than the one he's stuck in?
If he has a doctor, I'd ask them for advice. If equipment is considered medically necessary sometimes Medicare will pay to buy or rent it. I did a quick search for standing brace but what I found that looked possibly useful was really expensive and meant for people who have long term problems. I hope someone else has better advice for you.
posted by stray thoughts at 3:55 PM on July 11, 2021
posted by stray thoughts at 3:55 PM on July 11, 2021
Might a stand up rollator work? Obviously you’d need to consult his health professional(s) first.
posted by The Underpants Monster at 4:13 PM on July 11, 2021
posted by The Underpants Monster at 4:13 PM on July 11, 2021
Is there a physical therapist or case manager from the hospital or facility that treated him? I would really ask for their recommendations. Ideally, you could get him a tilt-in-space wheelchair that would allow a caregiver to recline the chair and tilt it all the way back (and they should be able to find out if insurance will cover it). Depending on his overall condition, he might be a candidate for a power wheelchair that would allow him to do his own pressure relief using a joystick. Home health PT would be a good option to work with him on safely standing up and moving throughout the house.
If you can't get a different wheelchair, try googling videos on pressure relief techniques. You don't have to fully stand up to offload pressure on the sacrum or ischial tuberosities. There is a lot of info out there to help wheelchair users, often from spinal cord injury groups.
posted by autolykos at 4:36 PM on July 11, 2021 [2 favorites]
If you can't get a different wheelchair, try googling videos on pressure relief techniques. You don't have to fully stand up to offload pressure on the sacrum or ischial tuberosities. There is a lot of info out there to help wheelchair users, often from spinal cord injury groups.
posted by autolykos at 4:36 PM on July 11, 2021 [2 favorites]
Oops, wanted to add: walkers and rollators are not designed to be pushed or pulled on to stand up and it's extremely unsafe to use them that way. Grab bars installed on the walls sound like the best option to give him something to pull from.
posted by autolykos at 4:39 PM on July 11, 2021 [4 favorites]
posted by autolykos at 4:39 PM on July 11, 2021 [4 favorites]
Agree this is a question for his PT and tissue viability nurse.
Would a donut-shaped gel cushion take the pressure off the sacrum? His TVN should know the answer to that.
Would he manage a wheeled walking frame with forearm supports? A PT could answer that.
There are specific pieces of equipment to help people get from sitting to standing (Sara Steady, Rota Stand, etc), but you need the leg strength to hold you up once you are standing, and it sounds like he may not have that.
posted by tinkletown at 4:44 PM on July 11, 2021 [4 favorites]
Would a donut-shaped gel cushion take the pressure off the sacrum? His TVN should know the answer to that.
Would he manage a wheeled walking frame with forearm supports? A PT could answer that.
There are specific pieces of equipment to help people get from sitting to standing (Sara Steady, Rota Stand, etc), but you need the leg strength to hold you up once you are standing, and it sounds like he may not have that.
posted by tinkletown at 4:44 PM on July 11, 2021 [4 favorites]
Maybe. This is one of those qualified health care professional things to solve. There is lots of durable medical equipment. there are lots of ways to do things. There are lots of individual health factors involved that can make some things better than others, and then there are things that are simply unsafe or unfeasable (costs, usefulness, insurance, location).
Health care providers should absolutely explain in detail about how this wound is being handled, and safety. Do ask questions. They should be guiding you through every step of the way if you are the primary caregiver.
posted by AlexiaSky at 5:04 PM on July 11, 2021 [1 favorite]
Health care providers should absolutely explain in detail about how this wound is being handled, and safety. Do ask questions. They should be guiding you through every step of the way if you are the primary caregiver.
posted by AlexiaSky at 5:04 PM on July 11, 2021 [1 favorite]
I think you're looking for some variety of custom wheelchair. There are absolutely several options of wheelchairs that have weight shift options for people who are unable to weight shift on their own, i.e. tilt in space, and there are standing wheelchairs, but I'm unsure if something exists that would stand him. There are many options, though. Definitely consult with a physical therapist or his doctor to start and take it from there.
posted by Amy93 at 6:08 PM on July 11, 2021
posted by Amy93 at 6:08 PM on July 11, 2021
There are standing frames that don't rely on the user to be able to stand on their own, but you'll really need to consult with a PT/OT or his physician, as you'll likely need a prescription for one. The cost is likely prohibitive, and maybe there's a rental option available. Here are other variations of the same.
posted by hydra77 at 6:19 PM on July 11, 2021
posted by hydra77 at 6:19 PM on July 11, 2021
The standing frame referenced by hydra77 is also available as a combo standing frame plus tilt-in-space reclining wheelchair referenced by autolykos. It is like a standing wheelchair with a tilt-in-space recline feature. You can get these with electrical power so the patient can make the adjustments himself. You can also get special padding with cutouts to relieve pressure while the patient is using the device in various positions. The pads have to be custom cut to fit the patient and wound location.
My search skills are not good enough to find a photo online quickly. I seem to recall a photo of Christopher Reeves using one. I know these exist because my friend who had a pressure wound on her upper thigh and buttock used one when she was transported to the doctor's office. The medical transport service provided it.
I believe you can rent these devices. If you get a prescription from his doctor, you may be able to get Medicare to rent one for you. You will likely need a PT or OT evaluation (which should be done at his home) to get the doctor to write a prescription. You can call Medicare and find out exactly what it takes to get approved for a rental of this kind of device. It should also be on the Medicare website.
This is the sort of thing you need quickly to avoid further loss of function and additional pressure sores. I hope you are able to get one for your father right away.
posted by KayQuestions at 9:32 PM on July 12, 2021
My search skills are not good enough to find a photo online quickly. I seem to recall a photo of Christopher Reeves using one. I know these exist because my friend who had a pressure wound on her upper thigh and buttock used one when she was transported to the doctor's office. The medical transport service provided it.
I believe you can rent these devices. If you get a prescription from his doctor, you may be able to get Medicare to rent one for you. You will likely need a PT or OT evaluation (which should be done at his home) to get the doctor to write a prescription. You can call Medicare and find out exactly what it takes to get approved for a rental of this kind of device. It should also be on the Medicare website.
This is the sort of thing you need quickly to avoid further loss of function and additional pressure sores. I hope you are able to get one for your father right away.
posted by KayQuestions at 9:32 PM on July 12, 2021
This thread is closed to new comments.
A knee walker / knee scooter is a possibility but I am not sure he has the upper body strength for it.
There is also something called a "prone cart" which is almost like a reverse wheelchair. This is something more like what you are describing.
posted by kschang at 3:53 PM on July 11, 2021 [1 favorite]