Care for

Elderly and
the
Disabled
Module Objectives

At the end of the module the trainee will be able to:

1. Describe what is aging and aging process
2. Know what are the special consideration in caring for
elderly.
3. Develop awareness about the rehabilitation process
and the different assistive devices
4. Identify the different therapeutic exercises: Hot and
Cold therapy, Aquatic Exercise and Basic Massage.
5. Learn how to take care of dying at home.
Module Outline:

1. Aging Process
2. Special Consideration in Caring for the Elderly Body.
3. Support Alignment and Positioning
4. Rehabilitation of the Client and Assistive Devices
5. Therapeutic Exercises: Hot and Cold Therapy, Aquatic
Exercises and Basic Massage.
6. Care of the Dying in the Home
Training Platform
Approaches

1. Reading CRB/PCM
2. FB Live
3. Zoom Meeting
4. Video Clips
5. Online materials
6. FB Messenger
Project/ Research
Work (Equivalent to 40 hrs.
work)
For this class your end project will be a
1. Research on different kinds of positioning in bed
2. Make Video of on gait training using assistive
devices
3. Make Journal on what did you learn in this module
4. Make a reflection of about Dying
5. To be submitted on: at the end of the module
Assessment

Quiz Quiz Quiz

Rubrics for Project

Criteria Percentage

Correctness 30%

Concept/Interpretation 25%

Comprehensiveness 25%

Creativity Craftmanship 20%

Total 100%
Rubrics for Skills Demo

Criteria Percentage
Mastery of Skills 50%

Understanding the 25%

Concept
Presentation 15%

Personal Appearance 10%

Total 100%
Modular Grading

Criteria Percentage
Assessment 25%

Skills Demo 25%

Modular Exam 20%

Project, Attendance, 30%

Behavior, Class
participation
Total 100%
 How do you feel about
Food for Thought/Discussion
Aging?
Lesson
1
Aging and Aging Process
What is Aging?

• The process of becoming older.

• It represents the accumulation of changes in a
human being over time and can encompass
physical, psychological, and social changes.
Facts to Remember
as you Care for
Older People

• They want to remain independent

• They enjoy sexual relationships
• They can maintain good health
• Senility is not the same as old age
• They want to be contributing members of the
society
What is Aging Process?

• it is the changes in the body caused by growing

older.
• it has many phases:
1. Physical
2. Mental
3. Social
 What are the Changes During
Food for Thought/Discussion
Aging?
Changes during Aging

• With age, your skin thins and becomes less

elastic and more fragile, and fatty tissue just
below the skin decreases. You might notice that
you bruise more easily. Decreased production of
natural oils might make your skin drier. Wrinkles,
age spots and small growths called skin tags are
more common.
1. Physical Changes
During Aging

• Reflex slow
• Circulation becomes less efficient
• All bodily processes are slow
• Skin losses elasticity Senses becomes less
acute
• Muscle loose strength
• Healing takes longer
2. Mental Changes During
Aging

• Dementia - is a gradual decrease in a person's

ability to make judgement
• 2 main types of dementia:
1. reversible dementia - is often caused by
a physical, social or chemical stimulus, when
stimulus is removed , the person reverts to
his pre dementia status.
2. irreversible dementia - can be caused by
small portions of the brain losing functions
due to small strokes.
3. Social Changes
During Aging

• Retirement
• Change in income
• Change in level of activity
• Fear of illness
• Isolation from friends and family
• Death of a spouse
• Change in housing
Reality
Orientation

• is a technique using the remaining brain cells to

reduce the confusion often seen in clients with
dementia.
Homework

• Please read CRB page 64. ( Your role as a

Homemaker/Home Health Aide
• Please read PCM pages 34-35
• Answer this?
• What do you think is the best skill during the
aging process as a caregiver?
 Lesson
2 Consideration in
Special
Caring for the Elderly
What are the areas of special concerns
in dealing with
elderly?
Food for Thought/Discussion
Areas of Special
Concern

• Safety
• Exercise
• Sleep Changes
• Medications
• Accompanying a client to the doctor
• Sexuality
• Abuse
Safety

• it is the prime concern for caregivers.

• it is the primary responsibilities as a caregiver.
• ways to maintain a safe environment:
• encourage your clients to discuss their capabilities
realistically.
• use of banisters and properly installed grab bars.
• provide good lighting with switches that are easy to
operate
• encourage safe practices in the kitchen
• set the thermostat on the water heater at safe
temperature.
Exercise

• benefits of exercise
• a feeling of well being
• increased strength in bones.
• increase strength and tone of muscles
• increase in cardiac and respiratory capacity
• decreased weight
Sleep
Changes

• changes are:
• total hours of sleep
• time of sleep
• effects of medication
Medication

• interaction of medication often results in unexpected

side effects.
• elderly people have several disease with different
medications.
Accompanying a Client to a
Doctor

• do not go with the client unless you have been

specifically asked to do so by your agency.
• after returning home from doctors visit document the
entire experience.
Sexuality

• closeness and sexuality are necessary at all ages.

• if caring for a couple respect their privacy and
confidentiality
Abuse

• is any act that causes another persons harm.

• be alert for signs of abuse or neglect
• common signs:
• bruises on a client that are hard to explain
• request from a client not to be left alone with a
particular person.
Lesson
3 Body Support
Positioning
Alignment
 What is the importance of
Alignment Bodily and
Positioning?
Food for Thought/Discussion
Client’s Daily Activity of Ability

• the capability of the client's to perform an activity on a

given day.
• important to observe the activity tolerance each day.
• activity tolerance -the most activity the client will be able
to do
Homework

• please read the guideline on assisting client CRB

pages 200-201.
Positioning a Client in bed

• medical terminology:
• body alignment - arrangement of the body in a straight
line, placing of body parts in correct anatomical
position.
• involved - body part undergoing therapy or part of a
disease process.
Positioning a Client in bed

• uninvolved - body part not affected by the disease

process.
• functional - able to be used.
• nonfunctional - having no use, not usable
• pull sheet - a sheet placed under the client and used by
the caretaker to facilitate moving the client in bed
Anatomical Position

• is the description of any region or part of the

body in a specific stance. In the anatomical
position, the body is upright, directly facing the
observer, feet flat and directed forward. The
upper limbs are at the body’s sides with the
palms facing forward.
Commonly Used
Position

• Positioning a client on his back

• Positioning a client on his uninvolved side
• Positioning a client on his involved side
• Please refer to CRB Chapter 11 Section 3
Procedures

• moving a client up in bed with his help (refer

CBM pages 204-205)
• moving a client up in bed, two people (refer CBM
pages 205)
• moving a client up in bed, one person (refer CBM
pages 206)
Procedures

• moving a client to one side of the bed on his

back (refer CBM pages 206-207)
• rolling the client (log rolling) (refer CBM pages
207-208)
• raising the client's head and shoulders (refer
CBM pages 208)
• applying support stockings (refer CBM pages
209)
Moving a client up in bed with his
help

https://www.youtube.com/watch?v=Y-czzynJhjg
Moving a client up in bed, two people

https://www.youtube.com/watch?v=2T2HtI16GGc
Moving a client to one side of the bed
on his back

https://www.youtube.com/watch?v=rrEBhavydbw
Rolling the Client (Log Rolling)

https://www.youtube.com/watch?v=-_OkMf_umyE
Elastic Support
Stocking

https://www.youtube.com/watch?v=zARySfecmYc
Raising the Client’s
head and shoulder

https://www.youtube.com/watch?v=5XuV9sSYH3M
Moving a Client up in
bed, one person

https://www.youtube.com/watch?v=SCvBusvxTnM
Lesson
4
Rehabilitation of the
& Assistive Device
Client
What comes in your mind when
you hear the word
“rehabilitation”
Food for Thought/Discussion
Rehabilitation

• is the process of relearning how to function, in the

best possible way, as an independent person
despite disability.
• process by which people who have been disabled
by injury or sickness are helped to recover as many
as possible of their original abilities and live with the
remaining disabilities.
Factors to Consider during
Rehabilitation

• Ability
• Previous level of function
• Dominant - stronger half of pair
• Priorities- something that a client wants to do
• Equipment
• Environmental barrier
Range of Motion

• is the measurement of the amount of movement

around a specific joint or body part.
• It is commonly measured during a physical
therapy evaluation or during a course of
treatment. Other impairments that your physical
therapist may measure include strength, gait,
flexibility, or balance.
Types of Range of
Motion

• Passive Range of Motion

• Active Range of Motion
• Active Assistive Range of Motion
• Self Assistive Range of Motion
Passive Range of
Motion

• Passive range of motion is the movement

applied to a joint solely by another person or
persons or a passive motion machine.
• When passive range of motion is applied, the
joint of an individual receiving exercise is
completely relaxed while the outside force moves
the body part, such as a leg or arm, throughout
the available range.
Range of Motion
Exercises

• https://www.youtube.com/watch?v=t6hE_ntz4Ho
Active Range of Motion

• Active range of motion is movement of a joint provided

entirely by the individual performing the exercise. In
this case, there is no outside force aiding in the
movement.
How to Do Active Range of Motion
Exercises

• https://www.youtube.com/watch?v=m9k4aVPYJOA
Active Assistive Range of
Motion

• Active assist range of motion is described as a joint

receiving partial assistance from an outside force. This
range of motion may result from the majority of motion
applied by an exerciser or by the person or persons
assisting the individual.
• It also may be a half-and-half effort on the joint from
each source.
Active Assisted Shoulder
Movements

• https://www.youtube.com/watch?v=N1T1RXhw-u4
Self Assistive Range of
Motion

• are exercise are used when one limb(the affected limb)

is unable to complete range of motion exercise
independently.
• unaffected limb is used to help the affected limb with
the self range of motion exercise
Self Range of Motion
Exercises

• https://www.youtube.com/watch?v=7G97Fu3GuVU
Upper Extremity ROM
Exercises

• Shoulder flexion and extension

• Shoulder abduction and adduction
• shoulder horizontal abduction and adduction
• shoulder internal and external rotation
• Elbow flexion and extension
• Forearm pronation and supination
• wrist flexion and extension
• radial and ulnar deviation
• finger flexion and extension
Lower Extremity Range Of
Motion Exercises

• Hip flexion and extension

• Hip abduction and adduction
• Hip internal and external rotation
• Hip flexion with knee flexion
• Knee flexion and extension
• Ankle dorsiflexion and plantarflexion
• Subtalar inversion and eversion
• Toe flexion and extension
Transferring Clients from
Place to Place
• To transfer a client means to help him move from one
place to another
• Transfers goes well depends on
• How much confidence your client has in you
• Know yourself
• Know your capabilities
• observe the clients abilities
• Guarding belt - (any leather belt) device placed
around the waist, used to assist a client during
ambulation.
• Mechanical lift - machine used to lift a client from one
place to another
Procedures

• Helping a client to sit (refer CBM pages 262-263)

• Using a portable mechanical lift (refer CBM pages 264-
265)
• Helping a client to stand (refer CBM pages 265)
• Helping a client to sit (refer CBM pages 266)
• pivot transfer from bed to chair (refer CBM pages 266)
• Transfer from bed to chair (refer CBM pages 267)
Helping a client to sit

• https://www.youtube.com/watch?v=O8CIforASTA
Using a Portable Mechanical
Client Lift

• https://www.youtube.com/watch?v=JdvQp1OKO0k
Helping a Client to Stand and
Sit Chair

• https://www.youtube.com/watch?v=UjfSwEQoe2c
Pivot Transfer from Bed to
Chair

• https://www.youtube.com/watch?v=rdsCbquuoXE
Transfer from Chair to Bed

• https://www.youtube.com/watch?v=_Bj0FbjFFJY
Ambulation Activities

• Ambulation refers to the action of walking

• The PT will set up the plan for the client and you will
follow.
Assistive Device

• Are external devices that are designed, made, or

adapted to assist a person to perform a particular task.
• Any device that is designed, made, or adapted to assist
a person perform a particular task. For examples,
canes, crutches, walkers, wheel chairs, and shower
chairs are all assistive devices
Canes

• Are ambulatory assistive devices used for improving

postural stability. It is generally prescribed for people
with moderate levels of mobility impairment, It is
typically used when minimal stability is needed.
• Canes in common day to day usage are known as
walking sticks.
Types of Canes

• Wooden sticks cane

• Standard cane
• Offset canes
• Quadripod (quad) cane
• Hemi walker
Parts of Cane
Parts of Cane
Canes: How to Choose,
Measure, & Use

https://www.youtube.com/watch?v=8nvPeXIglI8
Ambulation (Cane)

• The first thing to know in ambulating with a cane is that

the cane must be on the opposite side of the affected
leg and in tandem with it so as to simulate normal gait
and to increase balance and aid in weight distribution
Ambulation (Cane)

• From sitting to standing

• Three point gait
• Two point gait
• Stair climbing going up
• Stair climbing going down
How to Walk with a Cane

https://www.youtube.com/watch?v=5jvtk8ZZUv8
Crutches

• 3 basic types of walking crutches and they are used to

reduce weight bearing on one or both legs, or to give
additional support where balance is impaired and
strength is inadequate.
Axillary Crutch

1. They are made of wood with an axillary pad, a hand

piece and a rubber ferrule.
2. Weight should not be taken through the axillary pad as
this could lead to a neuropraxia of the radial nerve or
brachial plexus.
Parts of Crutches

Elbow Crutches
Elbow Crutches

1. They are made of metal and have a metal or plastic

forearm band. They are usually adjustable in length by
means of a press clip or metal button and have a
rubber ferrule.
2. These crutches are particularly suitable for patients
with good balance and strong arms.
Parts of Elbow
Crutches
Forearm Crutches/Adjustable
Arthritic Crutches
1. They are made of metal with a padded forearm support
and strap, an adjustable hand piece and a rubber
ferrule. These are used for patients with rheumatoid
disease, who require some form of support but cannot
take weight through hands, wrists and elbows because
of deformity and/or pain.
Parts of Forearm
Crutch
Gait Pattern ( Crutches
)
1. Four point gait
2. Three point gait
3. Partial weight bearing PWB
4. Non weight bearing NWB
Gait Pattern ( Crutches
)
• Two point gait
1. swing to
2. swing through
• Stair climbing
3. going up
4. going down
Crutches, Canes, and Walkers
Nursing NCLEX Assistive Devices
Review

https://www.youtube.com/watch?v=k2-w3LZlCVk
Axillary Crutch Gait
Patterns

https://www.youtube.com/watch?v=cpAk7V8F8_o
How to Go Up & Down Stairs
with Crutches (with non-weight
bearing)

https://www.youtube.com/watch?v=XfM0qMou6f0
Walker

• Walker with four legs will give you the most stability. A
walker lets you keep all or some of your weight off of
your lower body as you take steps.
• With a walker, you use your arms to support some of
your body weight.
Standard Walker
Speech and Language
Therapy

• It is one of the service provided by the home health

team.
• It is given when the client has difficulty communicating.
• PATHOLOGIST - is the professional who evaluates the
need for the therapy and who plans the therapy
program.
Aphasia

• The disorder impairs the expression and understanding

of language as well as reading and writing.
• When a person has difficulty with their language or
speech.
Hearing Loss

• Many people lose some ability to hear sounds clearly as

they age.
• HEARING AID - mechanical device used to help a
person perceive sounds.
Occupational
Therapy

• Type of treatment can help if you have pain, injury,

illness, or a disability that makes it hard for you to do
your job or schoolwork, care for yourself, complete
household chores, move around, or take part in
activities.
Occupational
Therapy

• It can help you do specific things like:

1. Eat without help from others
2. Take part in leisure activities
3. Do office work
4. Bathe and get dressed
5. Do laundry or clean up around the house
Lesson
5
Therapeutic Exercises: Hot & Cold Therapy
Aquatic Exercises and Body Massage
 What does therapeutic
mean? exercises
Food for Thought/Discussion
Hot Therapy

• HMP (hot moist Pack)

• Paraffin Wax bath
• Whirlpool therapy
Hot Moist Pack

• Hot packs are a type of physical modality often used in

physical therapy clinics.
• They are applied to your injured body part by your
physical therapist.
Hydrocollator Unit

• A stainless steel tank in which

silica gel are heated.
• contains wire rack
• Thermostatically controlled
between 76 and 80 degrees
Celsius.
Hydrocollator
Pack

• A fabric envelope containing

silica gel ( its capability to
absorb as many times its own
volume of water and when
heated, to give off moist heat
30 to 40 minutes.
Hot Moist Pack

• Indications
• Contraindications
• Advantages
• Disadvantages
Hot Moist Pack

• Hot packs are a type of physical modality often used in

physical therapy clinics.
• They are applied to your injured body part by your
physical therapist.
Moist Heat Pack Instructional
Video

https://www.youtube.com/watch?v=oFCXcEbOe5E
Hot
Compress

• Are primarily for home use and are not practical for
clinical use.
• A warm compress is a method of applying heat to the
body. Heating sources can include warm water,
microwaveable pads, wheat packs and electrical or
chemical pads.
Two Main Types
of Warm
Compress
1. Moist warm compress.
2. Dry warm compress
Paraffin Wax Bath

• Paraffin wax is a white or colorless soft, solid wax. It’s

made from saturated hydrocarbons.
• Low melting point of 55 degrees Celsius
• Liquid mineral oil is added in order the wax to be at low
temperature
• Has a low thermal conductivity
Paraffin Wax Bath
Paraffin Wax
Paraffin Wax

• Indications
• Contraindications
• Advantages
• Disadvantages
• Techniques
Paraffin Wax: Great Treatment
for Hand Pain, or Hand Arthritis

https://www.youtube.com/watch?v=h9SSBD_ffjI
Whirlpool Therapy
Whirlpool

The whirlpool is a large tub that is filled with

water. The body part that is to be treated is then
placed in the tub of water, and a small motor
agitates the water. While in the water, you can
move your body part to help improve the motion
around the injured area
Whirlpool

• A whirlpool may be used by your physical

therapist to help improve circulation, mobility,
and comfort after an injury or after surgery.
• A typical whirlpool treatment lasts for 10 to 15
minutes. Your physical therapist may have you
perform certain exercises while your body part is
in the whirlpool to help improve the range of
motion in the part being treated.
Hydrotherapy Whirlpool UCF
DPT

https://www.youtube.com/watch?v=a6HB9rDKGUc
Cold Therapy

• Cold therapy (also known as cryotherapy), is the

application of cold to an area of injury. The cold
helps to numb the affected area and reduce
pain. It also affects the cells at the injured area
by decreasing swelling and promoting healing.
Cold Therapy

• Apparatus for ice techniques.

• Commercial ice machine - vary in size and
produce 40-250kg over 24hrs.
• Cryogel cold packs consist of a polyvinyl alcohol
gel which is enclosed in a poly-ethylene-vinyl
acetate bag.
Cold Therapy

• Indications
• Contraindication
• Advantage
• Disadvantage
Application Technique

• Iced towel technique

• Ice packs
• Cryogel packs
• Ice immersion
• Ice cube massage
• Brief icing for stimulation
Aquatic Pool Therapy

• Aquatic therapy, also called pool therapy, is

therapy provided in a heated pool. The water
provides support and helps your child gain
strength and coordination in a calming and
relaxing place.
Aquatic Pool Therapy

• Hydrostatic pressure supports and stabilizes the

client, allowing people with balance deficits to
perform exercises without a fear of falling,
decreasing pain and improving cardiovascular
return.
• Turbulence and wave propagation let the
therapist gently manipulate the client through
the desired exercises.
Safety of Aquatic
Therapy Program
• Even though aqua therapy typically takes place
in a fairly shallow pool, it is not risk free. To
provide a safe environment for clients, aquatic
therapy practitioners should be trained in first
aid, CPR, oxygen administration, automated
external defibrillation, blood-borne pathogens
and risk awareness (check local codes for
actual requirements).
Safety of Aquatic
Therapy Program

The respiratory muscles are forced to work

harder in the water, allowing for a natural
strengthening that benefits the client long
after the therapy session has ended.
How Aqua Therapy
Work

https://www.youtube.com/watch?v=Uh0UG
oSBQGU
Basic Massage

• a systematic manipulation of the body tissue for

therapeutic purposes.
• physiological effects:
1. improve circulation
2. increase warmth on the skin
3. rapid elimination of waste
Basic Massage
Techinique

• Effleurage (Stroking) — Main uses are at the

beginning or end of a massage or as connecting or
linking movements.
• Petrissage — Deeper strokes applied by the
fingers, thumb or heels of a hand. Kneading, picking
up, wringing and rolling are all forms of petrissage.
Basic Massage
Technique

• Tapotement — Used for stimulating and toning an

area. Forms of this technique include cupping and
hacking, among others.
• Frictions — Applied on the surface tissue, these are
rubbing movements on the skin.
• Vibrations — Generally used to relieve fatigue and
pain, these movements can help cure a certain area,
creating a natural sedative.
Basic Massage
Techniques.

https://www.youtube.com/watch?v=tSJKFpvQhGA
 Lesson
6
Care of the Dying in the Home
 What is dying in Elderly
Care?
Food for Thought/Discussion
Working with the Client Who
is Dying

• Steps in the Dying Process

• Special Emotional Needs of the Dying
• Be a Good Listener
• Advance Directives for Health Care
Working with the Client Who
is Dying

• Physical Care of the Dying

• Postmortem Care in Home
Additional Videos

https://www.youtube.com/watch?v=JZPh9uK30eQ
https://www.youtube.com/watch?v=FRmwRqgIJsM
https://www.youtube.com/watch?v=US0OacbBzbU
http://youtube.com/watch?v=GrT8xZBxLEc
https://www.journals.elsevier.com/journal-of-aging-
studies/recent-articles
https://www.gfmer.ch/Medical_journals/Geriatrics_geront
ology.htm
https://www.alzheimers.org.uk/blog/new-developments-
dementia-research-2019
Postmortem Care

https://www.youtube.com/watch?v=m6qyYWvTIew
Transferring
Ambulatory Patient
• Purpose: to provide the needs of the patient and
to give relaxation and also to promote flexibility
of the joints and endurance of muscles.
• From Bed to Wheel chair
• Wheel chair to Commode
• Commode to Wheel chair
• Wheel chair to Bed.
Materials

• Materials:
Vital signs taking (materials) Gloves & Mask
Wheel chair Soap
Safety belt Dry Tissue
Slipper Large Towel
Pitcher with water Bell ring
Special
Considerations/Procedure

1. Gathered the materials. -to save time and effort &

Check the doctor’s order.
2. Greet the client. -to show respect
3. Introduced yourself.
4. Informed/explained the procedures.
5. Know the capability of the patient
(independent/dependent).
Special
Considerations/Procedure

6. Know the affected side of the patient (FX,

Paraphlegic/hemiphlegic).
7. Know the condition of the patient especially vital sign
condition.
8. Give clear and specific instructions to patient.
9. Ask the total cooperation of the client and encouraged
the patient to be self help independent… (Maintain body
mechanics...Maintain your weight bearing pattern
(WBP)…Maintain your based of support (BOS).
Special
Considerations/Procedure

10. Slowly raise the head of the patient, if not

contraindicated.
11. Place one arm under the patient’s leg and one arm
behind the patients back. Slowly pivot the patient so
that the patient’s leg dangling over the edges of the bed.
12. Bring wheelchair close to the side of the bed in
45°degrees. If the patient has a weaker side, place the
wheelchair on the patient’s strong side.
13. Lock the wheelchair brakes.
Special
Considerations/Procedure

14. Use transfer belt if needed and secure. - locking

mechanism (knee to knee)
15. Have the patient’s body up to standing position in the
count of three; pivot the patient towards the commode.
16. Privacy of the patient must be provided. -especially
when the patient is in the commode.
17. Make sure that the commode is open before the patient
uses it.
Crutch Walking

Equipment: crutches
Procedure:
1. Inform the patient you will be teaching crutch
ambulation
2. Asses the patient for strength, mobility, ROM, visual
acuity, perceptual difficulties and balance.
3. Adjust crutches to fit the patient
4. Lower the height of the bed
5. Have patient dangled legs
Crutch Walking

6. Position the crutches lateral to the feet.

7. Apply gait belt around the patients waist if needed.
8. Assist the client to a standing position with the crutches
9. Four point gait:
• position crutches to the side and in front of each foot
• move right crutch forward 4-6”
• move the L foot forward
• move the L crutch forward
• move the R leg forward
• repeat 4 point gait
Crutch Walking

10. Three point gait:

• Advance both crutches and weaker leg forward
together.
• Move the stronger leg forward, even without
crutches.
• Repeat 3 point gait.
11. Two point gait:
• Move L crutch and R leg forward 4-6”
• Move R crutch and L leg forward 4-6”
• Repeat 2 point gait
Crutch Walking

12. Walking Upstairs (up with the good):

• Instruct patient to position crutches as if walking
• Place the strong side leg to do on the 1st step
• Pull the weak leg up and move the crutches up to
the 1st step
• Repeat all steps
Crutch Walking

13. Walking downstairs (down with the bad)

• Position the crutches as if walking
• Place weight on the strong leg
• Move crutches down next lower step
• Move the weak leg down the step
• Move strong leg same step as weak leg and crutches
• Repeat all steps
14. Do after Care
Questions?
Clarifications
 Than
yo
for your active
participation!