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My 95-year-old father is in an MC facility under hospice care. He now uses a wheelchair. Lately when I visit him, he looks like he may slide out of the chair at any minute. He will not/cannot move his hips to the back of the seat despite repeated directions & hands-on help. His back is stiff & appears as though he cannot bend forward at the waist. He is dead weight, despite having lost many pounds. Even if we are lucky enough to get him positioned properly, he slides back down within a few minutes. The seat cushion is no help.
He has gangrene in his left foot (which is being treated by hospice) & he will NOT bend his knees to place his feet on the foot rests at the bottom of the chair despite numerous verbal cues in his ear & physical assistance. If you manage to get his feet on the foot rests, he moves them off almost instantly. Consequently, his feet drag on the floor when you push the wheelchair. He does lift his feet at intervals while you are pushing him. He is on routine pain medication & does not seem to be in pain.

He has several falls already & will have another if I can't get this "fixed". It seems that he would do better if the chair legs could be tilted back towards his body so as to keep them less likely to drag on the floor, but I could be totally off base. I have looked at several different types of wheelchairs that tilt back, but the foot placement is the same as a regular wheelchair & cannot be adjusted.

It occurs to me that an OT/PT evaluation may help, but persons with that type of expertise are generally not available where we live. I would appreciate any thoughts on how to position him properly in the wheelchair. I don't want to give up the wheelchair altogether because I like to take him outside when the weather is nice since the residents never get out of the MC area. I'm in the process of trying to find out how he does in a regular chair, but can't get any answers at this time on Sunday afternoon.

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There are cushions that are fatter at one end and thinner at the other. The thinner part goes to the back so it slants back a little. Makes it harder to slide out. As said, a wheelchair should not be used all day but these facilities do. Mom had a geri chair where the seat slanted down towards the back. It was high backed and the back slanted so she was able to take naps. She scooted all around in it.
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Thank-you MACin CT. The hospice nurse deemed him ready for a hospital bed, so they sent one. I think this will be easier on him as well as the staff.

Now all I have to deal with is how terrible dad looks. He has that thin skin and is/was on "blood thinners" so he looks bruised and battered.
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Midkid58 Feb 2022
Yeah--that is really hard to adjust to. My FIL, end stage Leukemia, bruised if you held on to his arm to help him walk without falling. He fell at home, a lot, and I go over there in the am and find literally pools of blood and small sheets of skin on the wrought iron railings. It made DH queasy so he wouldn't go with me.

There's just not much you can to to help that. It's really a catch-up kind of deal. They fall, you evaluate and treat. I was going to his condo 2xs a day and debriding the wounds and putting a whole tube of Neosporin on each 'wound' and rewrapping them. He'd always manage to have a fresh wound when I'd come at night to put him to bed.

It was a sad end to an active, busy life. He literally looked like I'd beat the living daylights out of him--and it was simply the leukemia, doing what it does.
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Old knees don't bend good.
Old hips don't bend good.
That's what an elder told me & hey, mine are bad enough already!

He may not SAY he has pain - but is there a grimace when the knees get bent to place the feet on the footplates?

Another vote here for a chair that tilts. Either the *tilt in space* wheelchair (bigger & heavier) or go full comfort style in the well padded recliner Princess type (even bigger & heavier). They can be wheeled out to the patio but a regular wheelchair would be needed for car trips.

Call Hospice to arrange.
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The regular wheelchairs that everyone is most familiar with were never designed to be something people remain in all day long, and they are definitely not appropriate for anyone who does not have the muscle tone to sit back and hold themselves upright. Watching people perpetually slumped over in improper wheelchairs in the nursing home was one of my pet peeves, because staff there should know how to direct family/caregivers on how to access properly fitted assistive devices😠. Ask for an OT evaluation with the aim of getting him into a tilt in place chair!!
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Beatty Feb 2022
You've seen my Mother then. Mostly refused anything but her upright wheelchair (so stayed slumped) 🙄
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Mac is right. My mother did the same exact thing and wound up falling out of her wheelchair a LOT. She'd sit at the very TIP of the seat and couldn't push her butt backwards into the chair. Hospice brought her a high back wheelchair that tilts back and she didn't fall out once since she went into it. Once she started losing too much core strength, she began slumping over to the point where it became impossible for her to sit upright anymore and she became bedbound.

Talk to hospice. Your father can't take verbal directions anymore with dementia at play at 95. My mother had aphasia too where she couldn't understand language anymore, so it was useless to try to explain things to her. Sad and hateful disease, dementia is.

Good luck
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Will the MC allow a posey vest or wrap to be used for him because he's under hospice care? Or a wheelchair tray that can be removed?
Care facilities don't really use these anymore because they can be considered a restraint.
The MC might allow if hospice tells them your father needs these things.
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