Training Features
- Independent Living Philosophy. I ask the group to give me their definition of independent living. We discuss what independent living is, how it got started; also Ed Roberts who is known as the “Father of Independence.” We tell the importance of Personal Assistance Services (PAS). We distribute this manual, as well as a manual that is designed for the consumer, which includes: the definition of PAS, the responsibilities of the personal assistant, neglect and abuse hotline numbers, the consumer’s responsibilities, etc. We also discuss the consumer as employer, and the consumer-driven model of care vs. the medical model. We discuss real-life experiences with other consumers and their attendants. This information is provided in both manuals.
- Communication. We discuss the three basic behavioral responses we use to resolve conflict. What is passive, aggressive, and assertive? We watch the videotape that discusses the use of these three different forms of communication with a consumer and attendant. We role-play using different conflicts that can arise between consumer and attendant and how to resolve common issues. We discuss corrective and positive feedback. We discuss how to communicate to someone with disability.
- Hands-on. We begin by demonstrating good hand-washing techniques with the use of an anti-bacterial soap, and how to rinse the hands by holding them down under the water allowing the bacteria to run off the hand. We discuss the proper way to put on and take off a glove.
- Bowel programs. We discuss the proper positioning if the consumer does their bowel program in bed, and we discuss the positioning for those who do their bowel programs in a shower chair over a commode. We discuss why they are called bowel programs. We discuss how to avoid bowel accidents, what promotes good bowel health, some causes of diarrhea, some causes of constipation, what is meant by digital stimulation, and how to insert a suppository.
- Urinary management. We show the different types of catheters that are used, what is meant by intermittent catheterizing, what is a condom catheter, and what is a suprapubic catheter. We demonstrate catheter insertion with the use of smaller mannequins of the male and female anatomy only. We demonstrate how to inflate and deflate the bulbs, and how to check for leaks in the catheters before insertion. We talk of different type of leg bags and bedside bags, and how we clean the bags. We demonstrate both clean and sterile techniques and how to irrigate catheters. We also discuss making up a travel bag for emergencies.
- Urinary tract infections. I give them a handout written by Dr. Michael Acuff, SCI Specialist at Rusk Rehabilitation Center. We watch an 8-minute video on urinary tract infections which discusses what signs to look for if you suspect a urinary tract infection as well as preventive measures.
- Autonomic Dysreflexia. Autonomic dysreflexia (AD) is discussed for those who work with individuals with spinal cord injury. We hand out a brochure and discuss the symptoms as well as the causes that can bring on AD. We also discuss real-life experiences that have occurred with consumers. We discuss what is happening to the body and why this must be taken seriously and treated as a medical emergency. We learn how to take blood pressure and monitor the blood pressure every 15 minutes the first hour to make sure the pressure is dropping. We learn what we can do to alleviate the problem and what to look for that is causing the problem.
- Thermoregulation. The signs and symptoms of poor thermoregulation are discussed. We learn what emergency procedures we can do for being too hot or too cold, and what can be done to avoid poor thermoregulation.
- Identification and Prevention of Pressure Sores. We discuss what a pressure sore is and the stages of a pressure sore. Facts and figures on pressure sores are presented. We discuss skin maintenance, nutrition, and pressure relief, including how to conduct pressure relief activities in bed, in the chair, etc. We show graphic photos of the four stages of a pressure sore. We learn how to inspect the skin. We show different types of wheelchair cushions and discuss how proper seating and positioning is important, how you can put a cushion in backwards and cause your consumer a pressure sore, and how to inflate and deflate air pressure cushions such as the Roho.
- Range of Motion. We show how to assist with range of motion and what is meant by active and passive. We discuss the purpose of range of motion, the different types of range of motion, and the definition of contractures.
- Transfers. Training group participants transfer each other using the pivot transfer, transfer board and Hoyer lift. Good safe techniques are taught and back basics are discussed to prevent injury to the attendant as well as the consumer.
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