Setting Up A New Room

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GXTrex

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We are looking into setting up a separate room for my dad with a Hoyer, hospital bed, and commode. We are debating between using the living room (rearrange furniture, plenty of space, but no privacy) vs my old bedroom. The bedroom offers him privacy, but I am worried about equipment size in the room. It is decent size, about 10'x12' and the door is 30" wide door.

He currently can walk using the walker, and has a manual wheelchair. I am of course thinking ahead to when he needs a hoyer and electric wheelchair. Did anyone make it work through a 30" wide door? How difficult is it to maneuver the wheelchair through the door into a hallway? Is there anything else we should be aware of when deciding? Thanks a lot
 

lgelb

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The width of the power chair is generally no more than 28" and should be more like 26" unless he is overweight. A straight shot should be fine. Do you have room to turn the wheelchair around to come back out? It can pivot on its own axis pretty well, but there is an issue of depth so as not to hit anything. It is awkward to operate it in reverse from the joystick side so I would not recommend that for a narrow doorway.

You do need some space to get the lift in perpendicularly under the bed for transfers, so part of the answer hinges on where the doorway is in relationship to where the Hoyer would need to go under the bed -- the closer the better. The Hoyer needs running room for turns so you are not backing up and adjusting a lot with your dad in the sling. And you need a couple of inches between the head of the bed and wall.

In a similarly small room, we took the wheelchair back out once my husband had transferred into the Hoyer before doing the bed transfer or vice versa. You could also transfer him into the Hoyer before entering the bedroom, if there's more room elsewhere. The Hoyer is narrow enough to go through 30".

It's probably better if the bed length is along the longer dimension of the room.

Let me know what did not make sense!
--Laurie
 

GXTrex

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@lgelb

He is not overweight so I hope he gets a 26" wide power chair. He will have to turn out of the bedroom to go down the hallway which concerns me. Is it safe/easy to transport him while in the Hoyer? The door is on the opposite corner of the room from where the bed would go.

Does Medicare/Medicaid cover an electric Hoyer or just a manual one?

Thanks so much Laurie (My moms name is Lori haha)
 

lgelb

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Manual. But you need an electric one. (Same goes for the hospital bed) It is often not worth even getting the allowance for the power lift since you can buy on line if needed for less than what the DME system will offer.

But your ALSA chapter may have a loaner lift and/or bed, maybe a loaner power chair while his is on order when things get to that point. If he is close, it would be wise to start the order process, though he will need to need it by the time the request for reimbursement is made.

For a 90 degree turn coming out of/going into the bedroom, if you are going to use the wheelchair in the bedroom, he might need a front wheel rather than mid wheel drive chair. Make sure that is taken into account when he is evaluated for the chair.

Most PALS would prefer less time rolling in the Hoyer vs. riding in a wheelchair, because they are swaying in a sling even when you are trying to hold onto them to prevent that (much easier to do with two helpers than one, as well). So less distance in the Hoyer is desirable, but transport can be done safely even with one person, if you go slowly and have your route planned out.

For any turn that you do a lot like that, you will want to experiment for the smoothest experience.
 

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For us, which doesn't mean it is the solution for all, setting up in the lounge room was perfect. It meant Chris was always in the middle of anything going on. He did have a fear of being kind of 'put aside in a room'.
Out house design prevented him from moving into any of the bedrooms, office, bathroom etc in a PWC. Our bedroom was too small for all the equipment. I would take him to the shower on the commode.
But also, it was just Chris and I, so moving the house around this way was simple.
 

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My husband (PALS) was by no means overweight, but his PWC, a Permobil F3 was 31" wide at the arms (widest part). We renovated our LR/DR into an accessible BR/BA, both with wider doorways. Are you able to modify to put in a wider door? Turning radius varies by chair.

A hoyer would be narrow enough to get thru the doorway, but again, turning radius needs to be checked. Our ALS loan closet gave us a power lift. It was a Godsend. We had issues with the manual hoyer because he was so tall. The lift height was much greater with the power model we were given.

There are so many variables, it is difficult to figure out logistics when you don't yet have the equipment.
 

lgelb

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You can gin up a CAD drawing (free trials on line) with room dimensions, plug in the hospital bed since you know its size (36-38" w, 80" l unless he's 6'+, in which case you'll want a 84" length), then match up to the l/w/d and turning radius of the equipment. It's not perfect, but you can get an idea of what's possible. You can also "rotate" a cardboard cutout.

Turning radii for the chairs are also available on line. Jersey is right -- it's a key consideration, because just fitting through the doorway isn't enough -- he has to be able to make the turn. But again, the alternative is transferring to the Hoyer before going through the doorway.
 

GXTrex

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Thanks everyone for the advice. I don't think we can increase the door width. Is that difficult/expensive?

We can use an offset hinge to get the most out of the doorway.

What power chair do you recommend? So I can look up dimensions or turning radius. Do we have a choice once we have the prescription?

I am a mechanical engineer so I have access to CAD which I used to map out our bathroom.
 

Jrzygrl

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My husband was evaluated at a seating clinic. The OT and DME rep then recommended a few and let him try them out. He was then given a choice. I think a lot depends on their physical stature as well as your home setup.

I took a simple piece of graph paper to lay out our space (it was even used and accepted when we had to apply for permits).
 

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This thread has been hugely helpful as we start planning for accessibility, wheelchairs, and a Hoyer lift. Thanks to all.
 

lgelb

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The initial order is just for a power wheelchair evaluation, which is conducted by a DME rep and/or a PT or OT. One usually rubber stamps the other. They recommend a model, that should be based on the PALS' physique, progression, caregiver, and setting, but you have final say. Make sure you approve a spreadsheet with all the parts/options they want to order. Then they submit it to the insurance co.

Permobil is most often the brand of choice, but there are other options. The models that start with M are mid wheel (M3/M5) and F (F3/F5) are front wheel. Seat elevation is worth it, as is anterior tilt if your dad can still stand, even with support. Of course, tilt, recline and power footrest control are mandatory.

The DME rep can better look at your home or CAD doc and advise you on whether widening the door will be necessary based on available wheelchairs. Your local ALSA chapter may have a loaner that you can try, or sometimes the DME does.
 
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GXTrex

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What is most practical drive option front vs mid? What do most PALS typically use?
 

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For me, the only advantage of a mid wheel drive is that, when turning, it pivots about the middle of the wheelchair. This gives it a slightly smaller turning radius.

Some users find it easier to learn to drive the mid wheel drive than the front wheel drive, but for me, the front wheel drive was so easy to drive it did not matter.

There are virtually no rehab rear wheel drive wheelchairs on the US market. Many prefer those because they can be more compact.

Between mid wheel drive and front wheel drive, I vastly prefer the front wheel drive because front wheel drive handles uneven terrain better than mid wheel drive.

For perspective, I own 3 front wheel drive wheelchairs, 1 rear wheel drive wheelchair and 1 four wheel drive wheelchairs. I have spent quite a bit of time in mid wheel drive wheelchairs while testing them out (many hours), but have found they do not fit my need.

My recommendation is to go to a wheelchair shop (DME) and spend hours trying out wheelchairs. I spent over 4 trying out the model wheelchair I wound up with for my first one before I ever signed the paperwork to get it.

Steve
 

swalker

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Here is a link to a thread I wrote several years ago about getting a wheelchair. I think most of it is still applicable.


Steve
 

GXTrex

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@swalker
How far along did you begin this process? My dad is in and out of the hospital so it's hard to plan
 
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