Spasticity and joint contracture not only directly affect the self-care abilities of an elder but also pose challenges to their carers. If carers fail to apply appropriate caring skills and precautions, they could get both themselves and the elder injured.
Occupational therapists provide training to carers on the application of the following skills and assistive devices in their care delivery process. This can enhance the self-care ability of the elder and alleviate stress and challenges faced by the carers.
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Preventive Splintage (Figure One)
 Figure One: Preventive Splintage |
Two mechanical principles are applied in preventive splintage: "sustained" and "external traction" Through appropriate design, fitting and choices of materials, preventive splintage provides continuous external traction to increase the flexibility and length of soft tissue and keep the joint in position The splints are made by thermoplastic materials. Velcro and straps are added to keep the splints in appropriate position. Padding is also added to ensure comfort and prevent frictional wounds. |
Wearing Time: Wearing for six to eight hours a day is generally adequate; excessive wearing time may not provide extra benefit Method: Use the "slow" and "stop" approach; then keep the limb in extended position by the splint; do not overstretch. Make sure the direction of spintage is correct; do not reverse the position Maintenance and cleaning:
Wipe the splint by alcohol or diluted detergent;
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Clothing Adaptation (Figure Two)
: Figure Two: Adapted Clothing The shirt can be opened in the armpit seam and trousers can be opened from the waistline down the seam |
Adapted clothing focuses on function and appearance, but also provides appropriate protection. They can help the elders to maintain their dignity. Through the use of special tailoring techniques, Velcro, widened trouser leg/sleeves and other methods, carers can help the elder to dress and undress more easily. |
Key points for clothing adaptation:
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Daily Living Skills (Figure Three)
: Figure Three: Daily Living Skills - One-handed dressing technique |
Use adaptive dressing techniques and procedures. For example, for upper garment, put on the sleeve of the weaker / affected side first during dressing, and take off the sleeve of the stronger / unaffected side first during undressing Choose light and loose clothing , pants with elastic waistband and shoes with Velcro fastenings Pay attention to safety, especially when dressing and undressing pants in sitting position - place a chair at the affected side to provide support, maintain balance and prevent falls |
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Assistive Device (Figure Four): Figure Four: Assistive Device - Seat Cushion |
Assistive device is a device or appliance that helps to achieve a specific task in daily living Choosing a suitable chair, cushion, bed, lifting and transfer devices for elders can improve their sitting posture. It can also assist the lifting and transfer process and reduce the physical exertion of carers |
When using pressure relieving seat cushions, specially designed seats/ wheelchairs, lifting and transfer devices, there should be careful assessment and guidance before application. The following should also be paid attention to:
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