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Oedema in lower limbs

Elderly Gerry

Gerry’s story

Gerry is a 78 year-old gentleman who lives in his own home with his brother. Gerry has severe osteoarthritis which affects many of his joints and results in significant pain and restricted range of movement in his hips and knees. In addition, his lower limbs have become very Oedematous and he has poor skin integrity. Gerry has difficulty with his transfers and poor mobility, he is only able to take a few steps at a time.

 

As Gerry has significantly restricted range of movement, he requires additional space when turning in bed and so he was provided with a 4 foot wide bed to accommodate this. Unfortunately as his bedroom would not facilitate this, the bed had to remain in the lounge.Although Gerry has retained his ability to manage his sit to stand transfers he has been unable to lift his legs into his low profiling bed of 20cm (35cm with mattress) for some time, and so two carers assisted him each morning and evening with his bed transfers using a hoist.The set up caused many problems for Gerry, his brother and the carers and so alternative interventions were considered. An ultra low bed was put in place, and did enable Gerry to lift his legs into bed with minimal difficulty. However he struggled with his bed mobility as it was not possible to install a bed lever and so he was still dependent on carers to assist him. In addition the knee break function on this bed broke on a few occasions.

Results

A FloorBed™ was put into place for a trial with a lifting pole and a bed lever to assist with his bed mobility. Once sat on the bed, Gerry lowered the bed as required. The floor height of the bed allows Gerry to use his feet to shuffle himself further back in the bed. When in a safe and appropriate position, he lowers the bed to the lowest point of 70 mm (220mm with mattress) from the floor and is able to slide his legs into bed rather than lift them, enabling him to manage this task independently. In addition, Gerry benefits from the lifting pole and bed levers on either side which he is able to reach at all times to assist with his bed mobility.

Gerry no longer requires assistance with his bed transfers and so the care package was reduced from two carers each morning and evening to just one care each morning.
This resulted in a saving of £7,068.00 per year

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Colin

Colin’s story

Colin is an 84-year-old gentleman who lives with his wife. He is independent with all transfers other than bed transfers, with which he has difficulty lifting his legs into bed. Colin mobilises with a walking frame but he has a history of falls when mobilising. Colin has Type 2 diabetes, glaucoma and a history of prostate cancer, resulting in an urgent need to empty his bladder. He has also had decompression surgery for myelopathy, heart surgery, a history of UTIs and experiences

a frequent burning sensation in his legs. When Colin started experiencing difficulty lifting his legs into bed, the Occupational Therapist trialled a manual leg lifter followed by a powered leg lifter. Unfortunately, these interventions were unsuccessful and he was still unable to transfer into bed independently. As a result, Colin became dependent on a carer who visited each evening to assist him with lifting his legs into bed. The consequence of this was that Colin was unable to choose when he went to bed and was assisted each evening at the same time. In addition, Colin had to remain in the chair for the rest of the night if he required access to the toilet, as he was unable to transfer back into bed. This increased the burning sensation in his legs and impacted on his sleep patterns.

Results

A FloorBed™ was put into place for a trial. Once sat safely on the bed, Colin lowered the bed to the lowest point of 70 mm from the ground. At this point, with assistance from a bed lever, Colin was able to independently slide his legs into bed with minimal effort. Colin reports that the FloorBed™ has enabled him to choose when he wishes to go to bed as he is no longer dependent on a carer. In addition, he is able to go to the toilet at night, returning safely and independently back to bed rather than spending the rest of the night in a chair.

Provision of the FloorBed™ has enabled Colin to regain his dignity and independence. If Colin no longer required assistance to place his surgical stockings each night, the care package could have been cancelled, saving the Local Authority approximately £2507.00 a year. It is hoped that the increased independent movement and use of the knee break function will permit Colin to stop using the surgical stockings, allowing the care package to be cancelled.

Click here to download the full case study.