Practical Care of a Child With
Hydranencephaly:
Carrying and Lifting
Safe Lifting
http://www.novita.org.au/content.asp?p=93
Lift Systems
Ceiling Track Lift systems
In many ways a ceiling track lift system is the
most practical as you simply move the lift unit from track to track rather than
having to push a large portable lift with a wide base. However the ceiling
systems are much more expensive than a portable lift.
The
original track systems mean a permanent (or semi permanent) track installed in
the ceiling of your home.
Here
are some links to current lift systems that are a more permanent mount. I use a
system such as this and really like it. But, if we move it has to be taken down
and reinstalled and we have to make sure we move to a home where it’s possible
(both from the point of view of the landlord and the structure of the building)
to install it.
http://bhm-medical.com/v_portable.html
http://www.barrierfreelifts.com/ The C series and PC 2 are ceiling track
lift systems
http://www.jacquespilonmedical.com/?mode=Ceiling+lifts This shows the Wispa
Ceiling lift system which is what I’ve used for both of my children for over 10
years.
The
following system is a portable system where the tracks aren’t mounted
permanently so there is no major installation needed to be done and they can be
taken down and moved for traveling or should you move. I’ve heard from several
people who use this type of lift and they love it.
http://www.rehabmart.com/2003/hoyers/RM_Hoyer_Lifts_Ceiling_Guardian.html
Floor Lifts
Here are some sites with info on floor lifts.
Previously these were all that was available. In our area the government will
only pay for the cost of a floor lift. Families who need a ceiling lift system
then have to find the rest of their funding from somewhere else. Service
agencies are good to check with should you need to do this.
http://bhm-medical.com/floorlifts.html
http://www.barrierfreelifts.com/ The Lexa, Raisa & Diana lifts are floor
lifts
Ceiling Lift systems come in 2-3 types. The first is continuous, where there is
tracking through the entire house (or where ever a child will be). The motor and
lift unit stay on the track and have a charger at the end of the track. This is
often what is used in care facilities.
The
other is a portable system. You just have track in the rooms where you will need
to use the lift and move the motor unit from one piece of track to another. This
is what I’ve used.
I’ve
learned a few things in the years that I’ve used this lift that I’d like to pass
on:
1. If
at all possible, put the track directly from the bedroom over the bed to the
bathroom so you don't have to struggle with moving the lift and getting the
child in and our of his/her chair before and after the bath. We had it directly
like that for Kayda and it was great. However when it was time to install the
lift for Trevor at our new place we decided it would be too difficult and cost
too much to have a straight track from Trevor's room to the bathroom. so he has
separate tracks. It's a real pain. I'm so glad I now have help to bath him.
2. If you put track in your living room or
family room or wherever your child is going to spend a lot of time, make sure
you position the track so that it works for multiple pieces of furniture and you
don't need to rearrange the whole living room every time your child's seating
needs change. Trevor has just started to need to sit on the couch but where it
was didn't work with the lift track. So I moved things around (2 weeks ago). Now
it looks like he might be more comfortable in my recliner once he's in casts
so...I may have to rearrange things again. What a pain.
The
above problem wouldn’t happen as easily with one of the portable lift tracks
such as the Guardian. You could just move the track when your child’s needs
change.
Carrying Your Child With
Hydranencephaly
From: Handling
the Young Cerebral Palsied Child at Home, by Nancie R. Finnie, Chapter 3 pp
69-76
Please note, not all the contents of this chapter will apply to a child with
Hydranencephaly. I have taken out sections totally unrelated to a child with
Hydranencephaly.
Great
care must be taken when picking up and carrying the cerebral palsied child. The
child should be in a good position before being lifted and given adequate
support where necessary. Extra care should be taken when lifting the child who
has little or no head control, remembering that good handling of the shoulder
girdle and arms makes it easier to control his head.
The
first and most important point to remember is to sit the child up symmetrically
before lifting him, bending him well forwards at the hips. As we have already
pointed out, many cerebral palsied children when lying on their backs have very
stiff hips. If you feel resistance when bending his hips, try to bring the head
and shoulders forward at the same time as you bend his hips; or, with the
heavier and older child, roll him on to his side where it will be found easier
to bend the head and shoulders forward and so facilitate the bending of the
hips.
Wrong way to pick up a child who is stiff:
 
figures 44 a & b
These 2 pictures show the
incorrect way to lift a spastic (stiff) child whilst he is lying flat on his
back, making it harder to bend his hips, bend and open his legs and to bring his
arms forward to place on your shoulders.
The
above pictures show the incorrect way of lifting the child and the difficulties
that may arise. The following pictures show the correct way of handling the
child preparatory to lifting him, making it easier both to lift and to hold him
as you adjust his position for carrying.
Right way to pick up a child who is
stiff
  
Figure 45
a.
One of the
ways of lifting a severely affected spastic child when he is lying on his back.
First bring him up into a sitting position, controlling him at the shoulders,
holding him under the top of his arms, which should be lifted and turned out.
This will help to bring his head and arms forward and facilitate the bending of
his hips and knees. Note: Your forearm is just above the base of his skull
not higher up on the head.
b.
If
necessary the legs should be kept apart and turned out by holding them just
below the thighs.
c.
& d An
alternative way of controlling the child, kneel in front of him and bring him
forward to sitting before he is lifted. The control at the shoulders is the
same; your forearms help to keep the legs wide apart which facilitates the
bending of the child’s hips.
See
also that he is in a sitting position when you put him down.
Note:
The following may not be entirely appropriate for a child with Hydranencephaly,
as they usually can’t learn to grasp or hold their heads up. But I thought the
basic information was good and so am including it.
Far
too many children, long after they are babies, are carried as shown in Figs. 46
a & b Not only is this bad for the child emotionally, but it does not give him a
chance, if supported in this way, to do anything for himself. It also robs him
of the opportunity of seeing what is going on around him.
 
Figure. 46
a.
A child
carried as a baby, completely supported and unable to look around.
b.
Note when
carrying the child in this way the tendency is to pull him towards your,
especially at the hips. This is an abnormal position and similar to that which
the child adopts when lying on his back.
Figures 47 a, b, c illustrate a way of holding the child with a good base for
carrying, and show how support can gradually be reduced. If held in this way it
will be seen firstly, that the child is able to put his arms around his mother’s
neck, provided he has the ability to grasp, and secondly, he is able to make use
of what ability to balance.
  
Figure 47, Having taken the child into the sitting position lift him and hold
as illustrated. First place his arms over your shoulders and then part his legs
to put around your waist. As the child learns to balance gradually reduce your
support.
This
position also enables him to look around while he is being carried.
Figure
48 A rather primitive but nevertheless effective way of carrying a severely
affected child, giving him support and leaving your arms free.
Figure 49a shows how a normal child is carried. It will be seen that the outside
leg is always bent.
The normal child being
carried by his mother bends his left leg (the outside leg) and straightens the
other.
In
the cerebral palsied child, one leg is always more apt to bend than the other,
especially if the head is turned predominantly to one side, as we have already
described. Ideally, then, his mother should just change him over to her other
side, ie. Where the right leg is more apt to bend he should be held on the left
side of his mother. In practice, this is not always possible as most of us are
either predominantly right-handed or left-handed.
Fig. 49b shows how this
difficulty can be overcome.
If a spastic child tends
to adopt this pattern of the legs in all positions, instead of changing him to
the other arm, bring him forward and in this way you will be able to bend and
part both his legs.
Figures 50 a and b
illustrate methods for carrying spastic and floppy children, showing the
important points of control.
 
Figure 50a: A simple way
of carrying a spastic child at home.
Figure 50b: A simple way of carrying a floppy child at home.
Wrong way to pick up heavy spastic child
Fig. 51a. Incorrect way to carry a heavy spastic child. Holding in this way, the
arms are pilled together and this results in the legs becoming stiffer, closer
together and often crossed. It is then difficult to bend the hips and part the
legs to sit the child.
Correct way to lift a heavy spastic child
Figure 51b: By keeping the arms over your
shoulder and holding the legs high up on the thighs, it is possible to keep the
legs apart and turn them out, it will be much easier to sit the child.
Other pages in this section:
Cerebral Palsy
Orthopedic Considerations
Medical Treatments for Spasticity
Orthopedic Surgery links and
resources
Orthopedic Surgery Personal Experiences
Therapy for children with
Hydranencephaly
Range of Motion Therapy
Other Types of Therapy
Principals of Positioning
Positioning:
Orthotics and Splints
Orthotics and Splints Experiences
Equipment
Wheelchairs
Alternate Positioning
Standers
Personal Care: Practical
Information
Practical Care: Transportation
Sleeping Medications
Glossary
| 
