Activities of Daily Living Performed by People with Spinal Cord Injury
Original Editor - User Name
Top Contributors - Jess Bell, Ewa Jaraczewska and Kim Jackson
Introduction[edit | edit source]
Activities of Daily Living (ADL)[edit | edit source]
Eating and Drinking[edit | edit source]
C1-4: Full assistance in eating
Independent in drinking with AT – such as a mounting system
C5: Set-up and AT in eating: U-cuff and wrist ext splint
Independent with AT in drinking: Add hooks to drinking bottle or cups, add straw if bottle/cup cannot be lifted high enough
C6 and C7: Independent with AT in eating: Can use tenodesis grasp, use u-cuff, can also use ringed cutlery, might be able to weave cutlery through fingers.
Independent in drinking: Use tenodesis grasp or can use hooks NB do not burn when holding hot beverage.
C8-T1: Independent in eating and drinking: Can manage with standard cutlery or might need build-up handles
Grooming[edit | edit source]
C1-4 Full assistance in grooming tasks
C5 (No active wrist ext) Mod ass for some grooming tasks with universal cuff and wrist ext splint
C6-7: (Wrist ext and therefore tenodesis grasp) I in most with u-cuff or intertwining utensil bw fingers. They seldomly use their tenodesis grasp to hold heavier objects as would be to weak.
C8-T1 I in all tasks – may require built up handles for some tasks
Dressing[edit | edit source]
C1-4: Assistance with all aspects of dressing, but they can direct their carer in what close they would like to wear.
C5: Can place arms into sleeves but generally needs assistance for all other aspects of dressing
C6: Can become independent in all aspects of dressing but requires extensive practice and modifications to some of their clothing
C7-C8: Independent with practice
Showering[edit | edit source]
- C1-4 Assistance with all aspects of washing - can direct the washing
- C5 Can wash parts of body with assistive technology and can hold an adapted hand held shower head to rinse body, but generally needs assistance for all other aspects of washing
- C6 Can become independent in all aspects of washing with extensive practice, with appropriate assistive technology and an environment that facilitates independence
- C7-C8: Independent with practice
Toileting[edit | edit source]
Bladder management: Problems that need to be overcome:
- Urinary retention -cannot control the bladder sphincter muscle – thus cannot void on command and experiences leakage
- Unable to feel when want to void/when bladder is full
How to overcome this
- Routinely empty the bladder using an appropriate and safe method
Pressure Care[edit | edit source]
C1-C5 Requires assistance to relief pressure using the forward lean technique. A person can be independent in pressure relief by tilting their power wheelchair but the wheelchair should be able to tilt at least 50 degrees and a lot of wheelchairs do not have adequate tilt range (so when ordering a power wheelchair for a high tetraplegic consider the tilt range). A carer can manually tilt a wheelchair backwards to relief pressure as well.
Communication[edit | edit source]
C1-4:
Use preserved function in head, neck, mouth and voice with assistive technology: Mouth/head stick, speaker phone, headset, touch screen, mounting system on wheelchair and hospital bed
Can sign document holding a pen in mouth, can turn pages if document/book is placed on an appropriate reading stand and using a mouth stick or using electronic versions
C5-7:
Use assistive technology and available function: Universal cuff and writing splint (C6/7), speakerphone, large buttons on phone, touchscreen, headset, lanyard (prevent phone from being dropped); stylus or finger extension splint to use with touch screen, hook on a phone to help lift it to the ear (not as common as technology has improved greatly)
C8: Can generally manage without aids, night require build up writing device
Using a computer: Big strides are constantly made with regards to improved access for people with disabilities to use computers – please ask, phone around and explore.
Typing splints, mouth/head sticks can be used (no adaptation to the computer)
Consider mouse and keyboard alternatives.
Voice dictation software
Instrumental Activities of Daily Living[edit | edit source]
Domestic Tasks[edit | edit source]
When using a duster/sweeper/mop with limited hand function - use one with hook eye on the handle- can hook thumb through to help with grip
Use palm to press spray bottle if limited hand function
Use a scouring pad and stick to wash the bath
Store cleaning supplies together in a basket that can be put on your lap
Parenting[edit | edit source]
Consider
- Balance, posture, pressure changes on cushion, safety and transfers
Use of carriers, wraps and lap belts – ability to manage closures and shoulder/back pain that can be exacerbated
Alternative methods of carrying
When transferring the baby – ensure you are as close to the surface as possible to increase stability, safety and decrease risk of injury
Pillow can be placed on lap to carry child
When lowering baby to ground - use elbows on knees - when putting weight on your elbows and knees it creates leverage and mores proximal stability
Use velcro wheelchair seat belt to help secure baby when transporting
Car seats:
- Light weight
- Swivel car seats
- Buckle release tool
Strollers
- Lightweight
- Adaptive wheelchair compatible strollers
Feeding[edit | edit source]
Bottle feeding
- Adaptive bottle holders
- Nursing/bottle feeding specific pillows
- Bottle warmers
- Burping considerations
- Strap a bottle holder onto wheelchair
Breastfeeding positioning
- Reclined, sidelying, seating
- Use of positioning pillows
Feeding solids
High chair considerations
- Heigh, portability, straps/securement, accessibility to put child in high chair
- Strap a booster seat onto a barstool for feeding
Changing Diapers and Nappies[edit | edit source]
Consider the changing surface and changing pad
A dining table can be used for diaper changing
Dressing[edit | edit source]
Install loops onto zippers, use of velcro or magnetic closures
Padded space on lap can help with task that can be done from the wheelchair such as dressing
Bathing[edit | edit source]
Consider using the kitchen sink (if safe)
Sleeping[edit | edit source]
Bedside bassinets and co-sleepers eliminates the need to transfer out of bed to feed/comfort baby
Consider cot that opens sideways
Adjustable/lower height crib
Play[edit | edit source]
A bed can be a level play area
Toys with loops, handles or hooks
Safety[edit | edit source]
Provide physical boundaries
Baby gates need to be wide enough for wheelchair to pass through and should ideally not have a threshold.
Consider magnetic cabinet locks if limited hand function
