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Monday 20 November 2017
Derbyshire Healthcare NHS Foundation Trust
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Why is equipment needed?

Occupational Therapists and Physiotherapists may suggest equipment to help children and young people to carry out activities they want to be able to do independently.

Equipment might also be suggested to help their parents and carers to help the young people carry out an activity.

Some equipment is useful to ensure that young people do not injure themselves or to prevent injury of others when they assist the young person to carry out activities that are important to them.

Often people are not sure whether they want to use equipment as sometimes activities can be quicker to achieve without equipment but equipment can make a difference as to how dependent on others a young person feels. Some children and young people would rather use a piece of equipment than rely on their mum or dad or a friend to help them or do a task for them.

Other children and young people would rather not have a piece of equipment because it makes them feel different to their friends or brothers and sisters.

If your therapist suggests a piece of equipment might be useful to try, talk to them about what it would help with and what the reasons are for trialling the equipment in the first place.

We might suggest equipment to be used at home, school or in other situations like a youth club or church. Sometimes people choose to use different equipment in different places e.g. a walking frame for walking long distances like at the park but use sticks around school where distances in the classroom are shorter and space to manoeuvre a walker may be limited.

Equipment is chosen and suggested according to your needs as both a user of the equipment, your family or school circumstances and the specific environments you use.

Try to be honest about what you think and feel and explain if you don’t want equipment and your reasons for this.

As therapists we want to be able to work with you and understand that some equipment might work well for one child/family/school but not for others.

Sometimes equipment needs to change if children’s abilities or environments change. This means equipment recommendations might alter e.g. if their condition improves, if they get stronger, if their condition worsens or they get weaker, as they grow, if they move house or change school and sometimes equipment might change following an operation.

We may suggest a range of equipment to enable you to do things. You might only need something small and portable like a pencil grip to help with your writing or you might need big pieces of equipment like a wheelchair or a hoist or a special bath or shower.

Sometimes you might find that your Occupational therapist works with you regarding one piece of equipment and your physiotherapist works with you with other equipment and sometimes we might decide together with you and your family what might be good to try.

What kinds of equipment are there?

Equipment can be divided up according to what its function is i.e. what it does.

Some equipment might help you with daily living activities like washing or dressing or making a snack. Some equipment might help you with walking e.g. a frame or sticks or crutches or with other physical exercise e.g. bicycles and tricycles that are easier to pedal or that provide extra support for balance or to help keep feet on pedals.

Other equipment might help people to help you, like a hoist that can be used to help you get into your wheelchair from your bed if you find transfers hard.

Here are some examples of equipment you might already have or might like to try.

Occupational therapists might show you:

  • Electric toothbrushes
  • Long handled sponges so you can wash yourself independently
  • Toilet seats with handles around them or shaped seats to help you to balance on the loo.
  • Bath seats or bath lifts to help your balance or help you get into the bath and down into the water.
  • Shower seats so you don’t have to stand up if you are wobbly on a slippery floor when you have a shower.
  • Beds that move up and down to help with transfers or care and comfort e.g. some have elevating back rests to help lift the head and upper body.
  • Stair lifts, through floor lifts or stair climbers to help you go up or down stairs
  • Hoists that can be fixed to the wall or ceiling, or hoists on wheels that can be pushed between rooms to that can be used for transferring from chair to wheelchair or wheelchair to bed. Slings are used with the hoists to support your body as the hoist lifts you up.
  • Car seats for children who need extra support around their body to help them sit comfortably and balance well in the car.
  • Clothes with Velcro seams or fasteners that are easier to manage then buttons to help with dressing and independence
  • Cutlery with shaped handles that is easy to hold onto, scoop or cut with.
  • Kettle tippers to help make hot drinks
  • Pencil grips and sloping boards for school work
  • Computer keyboards and switches that help with school work and games
  • Splints for your hands to help hold them in a good position for carrying out activities or to help to maintain the range of movement and flexibility in your fingers or your wrist.


Physiotherapists might show you:

  • Walking frames - these come in different shapes and sizes depending on what you need. Some go behind your body and you push down onto them with your hands to stand up straight. Others go in front of your body and you lean forwards onto them, leaning on your elbows to help you stand up. Some have supports for your chest or your hips.
  • Sticks - some sticks have 4 feet on the bottom of them (quadropods), some have 3 feet (tripods) and some only have 1 foot. They are like crutches but without the support around your arm.
  • Ankle Foot Orthoses (A.F.O’s) - these are foot splints to help with your walking or keep your legs as relaxed as possible. They are made by the orthotists at the hospital. See the link to…….to see how they are made
  • Standing Frames - standing helps to strengthen the muscles in your legs and around your hips and bottom. It also helps make your bones stronger. Sometimes people need to have help to stand still and straight. Your physiotherapist might talk you about using a standing frame to help you stand up without people holding your hands to balance.


Physiotherapists and Occupational Therapists together might show you:

  • Wheelchairs - some children use manual wheelchairs. Manual chairs can be “self propelling”; this means that the person using them can push themselves using the big back wheels. Other wheelchairs have small back wheels and are called “attendant controlled”. This means that someone else needs to push the chair for you. Some children have electric wheelchairs. There are 2 types of electric wheelchairs.
  • Electrically Powered Indoor Chairs (EPIC) - these chairs are for indoor use only.
  • Electrically Powered Indoor Outdoor Chairs (EPIOC). These chairs can be used indoors and outdoors. They have more power and tyres for outdoor use. Some children use an electric wheelchair sometimes and also use their manual wheelchair at other times.
  • Lycra garments - Lycra is a very stretchy material. We use clothes made from Lycra like socks, shorts and gloves to hold joints in position and to help muscles work efficiently. Sometimes muscles are floppy and don’t work hard enough. Sometimes muscles work too hard and get very tight. Lycra can be used to “wake up” floppy or “sleepy” muscles. It can also be used to “calm down” hard or “excited” muscles. We measure your joints and muscles to make sure that the Lycra clothes fit properly and help your muscles to work easier. The Lycra garments we prescribe are different to clothes you get in the shops that have Lycra in them. They have more Lycra in them and are stronger and more “elastic”. Lycra clothes are thought to help muscles work better and to help with balancing.

 

Where can we get equipment from?

Your physiotherapist and occupational therapist can access equipment to help you from various places.

These include:

  • Derbyshire Children’s Hospital e.g.for made to measure foot and hand splints via their Occupational Therapy Department or their Orthotics Department.
  • Derby, Integrated Community Equipment Stores (DICES) - This is a service jointly funded by Health and Social Care. The company that manage this service is called Nottingham Rehabilitation Supplies (NRS). DICES provide equipment we prescribe, to people who live in Derby City only. www.dices
  • Integrated Community Equipment Stores (ICES) - ICES are also jointly funded by health and social care. ICES provide prescribed equipment for people who live outside the city of Derby but within Derbyshire. The company that manage this service is called Medequip.www.medequipuk.com

Wheelchair Services

DerbyshireWheelchair Services are funded by the NHS. They provide wheelchairs to meet the mobility needs of wheelchair users.

Therapists can refer to wheelchair services for them to provide you with an NHS wheelchair or specialist buggy.

They have a range of wheelchairs available to them to meet a range of needs. You may wish to use a wheelchair for a specific reason like a specialised sport. If you want a special wheelchair then Derbyshire Wheelchair Services may provide you with a voucher towards the cost of the chair up to the value of the NHS wheelchair they would recommend for your needs.

The approved repairers for NHS wheelchairs in Derbyshire is:

Clarke and Partners
96 Traffic Street
Derby
DE1 2NL

Tel: 0115 9309400

If you have an NHS wheelchair and if for any reason it needs to be repaired then contact Clarke’s. They should organise a repair as soon as possible.

Sometimes they may need to refer back to Wheelchair Services.

Derby Drivability

The Drivability Centre is based at Kingsway Hospital. The Centre is run by Derbyshire Hospitals NHS (NHS Foundation Trust).

The staff here can help advise you on equipment like car seats, car hoists to help people be lifted into the car, wheelchair accessible vehicles and also how a car can be adapted for disabled drivers. They also know of driving instructors who will teach disabled people how to drive in adapted vehicles.

They can be contacted at:

Drivability
Kingsway Hospital,
Kingsway,
Derby DE22 3LZ

Tel No: 01332 371929

www.derbydrivability.com

Charitable Funding for Equipment

Not all equipment is available on the NHS, and you may need to consider other sources of funding to obtain the equipment that you need. Your therapist may be able to put you in touch with charities who fund certain types of equipment in some circumstances.

How to find out about Equipment

Talk to your therapists about what you or your child may find difficult. There should be equipment that can help you to do things independently or more easily.

Look on the web or in the local press. There are a variety of exhibitions nationally and locally for equipment. These include: