Self-care
SPINAL CORD INJURY 189
With help and encouragement of family, friends and rehabilitation workers, the child
with spinal cord injury can learn to become as independent as possible in meeting his
basic needs: moving about, eating, bathing, dressing, toileting, and in time other skills
for daily living.
Progress toward self-care, especially at first, may be slow and frustrating. The child
will need a lot of understanding and encouragement. Persons with low spinal cord
injury will find it easier to relearn self-care skills than those with higher injuries who
have less use of their hands and arms. Quadriplegics usually will remain at least partly
dependent on others for some of their daily activities. To make activities easier both for
themselves and their helper, it is important that they avoid getting fat.
Useful methods and techniques have been worked out for helping relearn basic skills.
We cannot describe many of these in detail. However, much depends on determination,
imagination, and common sense. Start with first things first—like rolling over and sitting
up in bed.
A few simple aids can often help a person become more independent. For example,
loose-fitting clothing with
elastic or easy-to-do fastener
(for example, a brassiere that
fastens in front)
a rope with
a loop for
pulling to sit
When hands are affected, devices like these (or
others that you can invent) make relearning to
eat and write easier.
convertible
wheelchair
toilet
‘Velcro’ sticks-to-itself
tape makes it possible
for the person to put on
aids by herself.
homemade bed,
the same height
as wheelchair
and toilet
padding to
prevent sores
(See p. 199.)
metal tube
soldered
to a piece
that fits
into hand
band
For additional ideas of aids for self-care, see pages 571 to 578. Suggestions for getting
in and out of wheelchairs and learning to walk with crutches are included in Chapter 43.
KEEPING ACTIVE
Many of the ‘complications’ of spinal cord injury happen
because the person spends a lot of time just lying and sitting.
To keep healthy, the body needs to keep active. Lack of movement and activity
causes poor flow of the blood. This can lead to pressure sores, swollen feet, painful or
dangerous blood clots (thrombosis) especially in the legs, increasing weakness of bones
(osteoporosis) with risk of breaking them, stones in the bladder or kidneys, increased risk
of urinary infections, and general physical weakness and poor health.
disabled village children