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Wheelchair Comfort Tips

Wheelchair Comfort Tips

The following post is part of our monthly QPAM Q&A feature.
Question: “How can I best provide comfort to my child in a wheelchair?”
Answered by: Jared

 

If you have a child who has limited mobility and therefore spends much of their time in a wheelchair, this post may be of particular interest to you. The process of achieving comfort in a wheelchair can be very involved.  For an individual who is non-verbal, the situation can be even more difficult.  Over the years, I myself have studied and experienced a tricky little thing referred to as autonomic dysreflexia.  This factor – primarily but not exclusively coped with by those who have spinal cord damage – is what happens when a pain or stimulus of some sort is inflicted below the point of damage (or sensation).  Simply put, although you may not feel the irritant, your body will react to it.  The following lists, compiled from personal experience and inquiries into the troubles others with various physical difficulties face, may assist parents in narrowing down the discomfort their child is experiencing.

Potential Signs of Discomfort / Autonomic Dysreflexia

  • Sweating
  • Chills
  • Goosebumps
  • Flush or pale face
  • Increased heart rate
  • Abnormal breathing
  • Facial grimacing
  • Abnormal behaviour
  • Sighing
  • Gagging

With any new behaviour, always consider the potential for discomfort as the cause.

Potential Causes of Discomfort

Head-to-toe check…

  • Bent or knotted hair
  • Hair caught in glasses, hat, chair headrest, etc.
  • Dry or cracked lips
  • Sitting position in the wheelchair (may require regular adjustments)
  • Bunched up clothing (especially behind back)
  • G-tube irritation
  • Bloated stomach
  • Soiled, sweaty, bent or wrinkled brief/diaper
  • Sitting on an object or scrotum
  • Full bladder / constipation
  • Twisted or wrinkled pant legs
  • Laces too tight / shoes too small
  • Bent or squished toes
  • Wrinkled socks
  • Hangnails
  • Dry or itchy skin
  • Scratches / bruises / pressure ulcers
  • Uncovered areas of the body in cold weather / heat buildup

An important point to note is that if only certain areas of the body are felt, these areas and the senses belonging to them are hyper sensitive.  Sound and light, or the absence of these, can be extreme irritants.  Exercising the senses your child does have (by reading a book, for example) can be calming.  Also, keeping people out of the personal space bubble may relieve stress, as individuals in wheelchairs are seated much lower than the average human stands, which therefore can give an extreme feeling of claustrophobia in a crowd.

For comfort in the case of…

Cold or other respiratory issues:

  • Breath stacking can help expand lung capacity and bring up mucous
  • Using a hand to cup the chest sends vibration into the lungs, helping break up and loosen mucous
  • To help airflow, lie in “Trendelenburg position” by inclining the head of the bed with pillows or a wedge
  • Vicks Vapor Rub may help loosen congestion in the chest and face

Muscular pain / skin irritation:

  • Change positions at scheduled times to avoid stiffness and pressure
  • Gentle massage (perhaps with warm cream) and range of motion to the arms and legs can be calming
  • Keeping skin covered will help avoid shock to the system from sudden temperature change
  • Warming pads (used with caution – fabric placed between it and skin) may ease aches

Always monitor changes, such as a new medication or antibiotic, and consider the possible symptoms resulting from this.  Doing so is often key to discovering the factor of irritation.  Ask your doctor if these methods/procedures would be beneficial to you.

If you have any suggestions for this resource, please feel free to share!

~J

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2 thoughts on “Wheelchair Comfort Tips

mandie says:

wow! this is so awesome! I can most deffinetly relate almost all this back to my son who is both non verbal and wheel chair bound, thanks for sharing! one question, what is breath. stacking? Ive onlyy ever seen it done in ICU when hooked up to a ventulator?

    Quinte Pediatrics says:

    Breath stacking is a lung exercise in which 3 breaths (or whatever number the respirologist suggests) are given from an ambu bag, with a one-way valve attached to it. The bag can be connected to a trach, mouth piece, or face mask. Breath stacking is similar to someone with a fully functional respiratory system taking a deep breath.

    ~J

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