Positive Daily Living
Introduction
In this chapter, there is a range of tried and tested ideas to help you tackle some of the most common daily problems for a child with arthritis. Arthritis affects the child’s joints and impacts upon most areas of daily living. There are some principles about how to protect her joints from further damage or strain. As parents, you will need to incorporate these principle into daily life, and teach the child how to begin to look after her joints herself. An occupational therapist is the best person to advise you and tell you where to purchase any extra gadgets. Ask your family doctor or paediatrician to refer you to an occupational therapist.
Help with daily living activities
The most important things to remember are :-
- Avoid tight grips over long periods – for example when using pens, pencils, hairbrush etc). Try to choose handles that are extra thick or padded or add tubing yourself, (use foam pipe insulation tubing from DIY shop). This will reduce joint strain, stiffness and spasm. Lightweight laptops and computers are especially helpful in developing writing skills and keeping up with schoolwork.
- Distribute weight over bigger joints – for example buy a backpack with wide padded shoulder straps and firm body wall as a school bag or for travelling. This avoids straining the small joints of the hand when using a hand strap. Ask for an extra set of school books to keep at home so that she does not have to carry them to and from school.
- Keep moving - for example, encourage her to shake her hands every 15 minutes or so and gently move the elbows, shoulders, and neck. Encourage her to get up and have a walkabout – if you explain to school staff they do get used to children doing this without disrupting the class. This prevents the joints from getting too stiff and ‘locking’.
- Avoid twisting hand movements - You can buy gadgets to help with taps, plugs (with a loop) and tins openers that help reduce the workload on the joints of the hands.
- Avoid positions that increase the likelihood of deformities – for example encourage the child to have flat hands rather than fists when watching television or getting up to stand. Encourage children to sit with their legs as straight as possible on a supporting leg- rest/stool rather than sitting on their folded legs. Encourage children to sit straight in front of the television/blackboard/cinema screen so that they do not have to tilt or strain their necks.
- Encourage your child to be as independent as possible. Find ways to help them without doing the task for them. This helps develop their confidence, and self-esteem, and prevents them from feeling unskilled and dependent.
Occupational therapists are healthcare professionals who can provide a systematic assessment of the young person’s needs for training, equipment or assistance in order for them to carry out normal daily living activities. The assessment should include an estimation of the young person’s maximal level of independence. Very simple equipment (such as grab rails near the bath or light switches on cords) and adaptations can make daily life a great deal easier while helping the young person to be as independent as possible. Try to keep the floor surface clear of obstacles like rugs and wires that can easily trip a child with arthritis.
This may involve other professionals in order to reach a situation in which the quality of life for the young person and carer are considered. Lifting a growing child is a particular task that the carer’s health must be considered too. Many carers experience back pain. Get advice from a physiotherapist or occupational therapist if you find you need to lift the child a lot at home.
