Equipment and Supplies
One grief I face daily is seeing the equipment at many long term care facilities. Most of it is in some state of disrepair all the way to barely useable. Supplies of basic items such as tissues, sanitizers and pens are usually minimal.
Wheelchairs are one of the items I see daily that need repair. Worn seat covers, torn armrests, and brakes that don't stay locked securely. Not many years ago the state inspectors cited a home for having tape covering a torn armrest of one resident's chair. I'd rather see the tape instead of a rubbed raw forearm, but they cited infection control because the glue can hold bacteria. Today many W/C armrest covers are torn and repaired with tape. Some have brakes that don't lock securely and pose a risk to the patient and staff. I can't tell you how many times I've stood a person from their chair only to have it scoot away because the brakes didn't stay locked.
Of course I have to pick on the equipment we get to use in the gym. The ankle weights that are well used and worn, walkers that are wobbly and have worn wheels, reachers that are bent and missing parts, or just the fact that there is little or nothing to work with. Gait belts are a requirement, but in some places I've been there are few available.
With all the cuts in reimbursement and companies attempting to maximize profits, requests for new equipment usually falls low on the purchase list. Often it takes months to receive requested equipment, especially larger items. Back in the early 90's when Medicare reimbursed for equipment I remember being told to go to the supply room before seeing a new patient with a knee or hip replacement. There we stored reachers, bath brushes, dressing sticks, sock aids, shoe laces and shoehorns. Every patient that had orthopedic surgery on their lower extremities was issued the necessary equipment.
We work with what we have though, and make efforts to educate patients with items they need. Since most adaptive equipment is an out of pocket expense for most people I try to only recommend what is absolutely needed. Buying a piece of adaptive equipment you'll only need for a few weeks before you are able to be independent again is a waste if there is any alternative.
Until next time, hope all your "Thoughts" are Good-