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Managing Severe Hand Contractures in the Older Person.
Hi, I am an NHS Community Occupational Therapist that is seeing an increased number of referrals for elderly clients, often with Dementia, and or in care homes with severe contractures of the hand. The referrals are made, generally, too late for palm protectors/ passive/ active ROM exercises/ Thera putty etc. I am looking for advice that I can pass onto the care homes a) to prompt earlier therapy intervention b) promote good hand hygiene/ tissue viability regimes (often when the clients are reluctant to engage with staff) and c) how to best manage the complex scenarios: such as poor hand hygiene/ severe pain and pressure sores to palm/ fingers/ thumb with dignity. Many thanks to OT Hub for sharing.
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To address these issues, it's crucial to educate care home staff about the importance of early intervention and regular monitoring of hand function. Encourage them to refer clients for therapy at the first signs of stiffness or limited mobility to allow for preventive measures like passive/active ROM exercises and palm protectors. For hand hygiene and tissue viability, recommend gentle, routine cleaning even for reluctant clients, using soft materials and moisturizing lotions to maintain skin integrity. In complex cases involving pain and pressure sores, involve multidisciplinary teams for pain management, and use custom splints or padding to reduce pressure while preserving the client's dignity.