Dressing for the person with...

1.Paraplegia - en.wikipedia.org/wiki/Paraplegia

Procedure for Donning Shirt
- position client on the bed to avoid balance problem
- balance body by putting palms of hands on mattress on either side of body
- if balance is poor, one / two pillows may be used to support back
- open garment on lap with collar towards chest
- put arm into sleeves and pull up over elbow
- hold on to shirt tail / back of dress, pull garment over head, adjust and button.

Procedure for Removing Shirt
- sitting in wheelchair / bed and open fastener
- remove garment in usual manner
- if usual manner is not feasible, grasp collar with one hand while balancing with other hand
- gather material up from collar to hem
- lean forward, duck head and pull shirt over head

Procedure for Donning Trousers
- position client on the bed to avoid balance problem
- use side rail / a trapeze to pull up to sitting position, back support with pillows / overboard of the bed
- sit on the bed and reach forward toward feet, or sit on the bed and pull knee into flexed position (and cross the legs)
- holding top of trousers, flip pants down to feet
- work pants leg over feet and pull up to hips.
- in semi reclining position, roll from hip to hip and pull up garment (pull body to side using bed rail)
** for donning trousers, reverse the steps.

Procedure for Donning Stockings
- put on stockings while seated on the bed
- pull one leg into flexion with one hand and cross over the other hand
- use other hand to slip stocking over foot
- pull stocking on

Procedure for Removing Stockings
- position client on the chair / bed to avoid balance problem
- pull one leg into flexion with one hand and cross over the other leg
- pushing stocking down over heel
- dressing sticks may be needed to push stocking off heel and toe and retrieve stocking

Proceure for Donning Shoe
- in sitting position on bed
- pull one knee at a time into flexed position with hands
- support affected leg in flexed position with one hand
- use free hand to put on shoe

Procedure for Removing Shoe
- in sitting position on bed
- pull one knee at a time into flexed position with hands
- use free hand to remove shoe


2. Quadriplegia / Tetraplegia - en.wikipedia.org/wiki/Tetraplegia

Procedure for Donning Cardigans / Pullover Garment
- position client in wheelchair and garment across tight with back pacing up and neck towards knee
- place both arms under back of the garment and in armholes
- push sleeve up onto arms, past elbow and onto shoulder
- to pass garment over head, duck head forward and pull the garment
- to work garment down over body, shrug shoulder, lean forward and use elbow flexion and wrist extension
- garment can be buttoned from bottom to top with aid of hook button

Procedure for Removing Cardigans / Pullover Garment
- sit in wheelchair and unfasten button by using button hook
- for pullover garment, hook thumb in back of neckline, extend wrist and pull over head while turning head toward side of raise arm
- for removing cardigan garment, hook thumb in opposite armhole and push sleeve down arm
- elevate and depression of shoulder with trunk rotation can be used to get garment to slip down arm as far as possible
- hold one cuff with opposite thumb while elbow is flexed to pull arm out of sleeve

Procedure for Donning Trousers
- sit on the bed wit rail up. trousers are positioned at foot of the bed with trousers leg over end or bed and front side up.
- sit up and lift one knee at a time by hooking right hand under right knee to pull leg into flexion, and then put trousers over right foot
- return the leg to extension or semi extend position while repeating procedures with left hand and left knee
- while still sitting, with pants or trousers to mid calf height, insert dressing stick in front of belt loop
- dressing stick is gripping by slipping its loop over wrist
- pull on dressing stick while extending trunk, returning to supine position and work with trousers until up to tight level
- using palms of the hand in pushing and smoothing motions, straightens the trousers legs
- in supine position, fasten trouser placket by hooking thumb in loop on zipper pull or platting Velcro close.

Procedure for Removing Trousers
- lying supine on bed with bed rail up, unfasten belt placket fasteners
- placing thumb in belt loop, waistband or pocket, work trousers past hips by stabilizing arms in shoulder extension and scooting body towards head of bed
- used arm as describe in previous step and roll from side to side to get trousers past buttock
- coming to sitting position and alternately pulling legs into flexion, push trousers down leg
- trousers can be push off over feet with dressing stick or by hooking thumb in waistband.