Going home after pelvic injury

How Occupational Therapy can help you at home

Occupational therapy (OT) staff help people of all ages who have physical, mental or social problems as a result of accident, illness or ageing, to do the things they want to do. These could be daily activities that many of us take for granted, from grocery shopping or brushing your teeth, to more complex activities such as caring for children, succeeding in studies or work, or maintaining a healthy social life.

After a pelvic fracture an occupational therapist plays an important role in helping with daily activities and this includes planning for your discharge and taking into account any of your needs relating to your home environment.

What things will the OT assess and recommend?

Your OT will ask you to give information about your home, which may include measuring the heights of some of your furniture at home so you can practice standing from or getting onto hospital equipment (such as beds and chairs) of similar heights before leaving hospital. Providing these details about your home environment will assist with recommending a discharge plan for you. If necessary, the OT will arrange for your home to be assessed by a member of the OT team in Social Services.

Apart from the home environment, the OT will talk with you about how you were completing your day-to-day tasks before coming into hospital, including work and leisure activities. They will then look at what you are able to do now, usually focusing on the things that are most important for returning home from hospital, this might include getting into the bath or shower, or preparing a drink or meal. Your OT will then work with you to help you to return to your previous abilities if you are able. This may include practice of these tasks or provision of equipment.

Sometimes equipment may be recommended to increase your independence or make activities easier. Some examples are summarised below:

  • Bathing – a bath board for over the bath or a perching stool for a strip wash.
  • Small aids – a reacher to pick items up off the floor, long handled shoe horn to assist with putting on your shoes and socks.
  • Toileting – a raised seat to make the toilet seat higher or a frame to give you arms to push up from or a commode if required.
  • Seating – special blocks to sit under your armchair to raise it or a high backed chair.
  • Bedroom – special blocks to raise your bed or a lever on the side of the bed to help you to go from lying to sitting.
  • Wheelchair – if you require a wheelchair for mobility the OT will also consider equipment to assist you to get on and off the wheelchair.

The OT will assist you to find somewhere in your local area to provide this equipment. Unfortunately, more often than not, due to the short term need for this equipment there will be some cost to you.

Keeping this in mind the OT can keep practicing with you to ensure that you only need to consider the equipment that is essential for discharge.

Further practice with this equipment may be required once you return home and this can be arranged by your care team with your local rehabilitation service                                                   

How you and your family can help?

Simple things like bringing in your own clothing early in your admission to allow for a return to your usual day-to-day tasks can be very helpful. Getting up from bed and dressing in your own clothes can often make a huge difference in your rehabilitation.

Providing accurate information about the layout and the heights of the furniture at home would assist the OT to assess the suitability of your home environment for discharge. Digital photos can also assist with this process and the OT may discuss this with your family. Your family or friends may need to be available to allow access to local services to assess your home or when delivery of equipment is required.

What if you are told you are not allowed to put weight on either leg?

If your orthopaedic consultant tells you that you are not able to put weight on either leg your therapy team will work with you to assist you to get out of your bed without standing up. There are a few ways that this can be done – with or without equipment. Your therapy team will discuss and demonstrate these with you when they come to see you.

The occupational therapist will provide a wheelchair to meet your needs whilst you are in hospital. Along with the physiotherapist they will help you to practice getting on and off of the wheelchair and getting around safely in your wheelchair. The occupational therapist will also look at how you can transfer onto a toilet or commode without putting weight through your legs.

Your home environment is very important when you need to use a wheelchair. A visit to your home is ideal to ensure that the wheelchair is able to get into as well as around the house. Your OT we may also try to organise a visit from your local services or may recommend that you return to your local hospital so that they are able to complete discharge planning from there.

Nutrition during recovery

During your recovery it is important for you to maintain a healthy diet. Bone fractures can put a lot of stress on the body which means the body needs extra nutrition to help the healing process.

The most important nutrients in healing bones are

  1. Protein for growth and repair of cells and tissues: meat, poultry, fish, eggs, legumes (peas, beans, lentils, dahl), cheese, milk and yoghurt.
  2. Carbohydrates and fats for energy: breads, breakfast cereals, pasta, potatoes and rice.
  3. Vitamins and minerals to help the body repair itself: These are found in all foods but you may require supplements to provide your specific needs.

Try to ensure a protein and carbohydrate food is included in each of your meals. A balanced diet is one with plenty of variety so include fruit and vegetables too.

Your appetite can be affected during your recovery and you may not feel hungry. This can be caused by:

  • medications
  • pain
  • nausea
  • decreased mobility
  • disrupted bowel motions (diarrhoea or constipation).

If you feel that your appetite is poor and/or you have recently lost weight please speak with your nurse as you may require a referral to the ward dietician. Supplement drinks are available that will provide important nutrition. 

If you have any special dietary requirements, allergies or intolerances please notify your nurse who can help arrange the correct diet for you.