Wednesday, November 7, 2012

Looking for assistive devices?

I learned a lot, working with special education students. One of my students was granted an ISA-funded computer: voice-to-text, text-to-speech, Kurzweil, printer, scanner, headphones, and a laptop he could take to classes.

The other drawback was that he felt guilty using it, while other students could not. It took up a lot of space in my classroom, too. The affect is a big barrier to such devices.

The features were terrific. He could dictate his pieces of writing, the computer would guess at the correct spellings, it could read his class text for him, and it would become familiar with his reading and writing style, and learn a special vocabulary and dictionary peculiar to him and his needs.

Communication Devices

hands-free cursor
Text-to-voice application on iPad
All of these special needs devices are adaptable to seniors, as well as those who are physically disabled.

This one, SmartNav, allows you to use the cursor without using your hands. The 'mouse' is a 'dot' that you can place on a cap, or on a pair of computer glassess, that works as a beam and moves the cursor across your computer screen.
Phones, clothing, cushions, head support, 
Assistive technologies can range from devices that make work, ADLs or play much easier.
Mobility issues, transportation, navigational issues, access barriers, clothing, glasses, hearing problems, there are many barriers to living life to its fullest.

I think the labelling is the most difficult concept for seniors to get over. It took my mother 10 years to convince my grandmother to get a hearing aid. It took me 15 years to convince my mother and father to get
them. Mom learned to lip read, or ignore what you said, or agree continually. Dad shut down and spent his days reading.
Speed dial using family photos

Barriers to using assistive devices
I like the term 'Assistive Devices', because many of us are not disabled. Most of us are physically, socially, environmentally or emotionally challenged in one way or another. I've worn glasses since grade 4.
  • Stigma is a huge barrier. 
  • Issues with batteries, or breakdowns cause 50 - 70% of assistive devices to be abandoned.
  • Lifeline, emergency buttons, are often forgotten by those who wear them, in the panic of the moment, or the desire not to cause problems. 
  • Dementia causes patient to be unable to figure out the function of a phone or a TV Clicker. My father phoned us 8 times one day, having phoned the front desk of his retirement home, not realizing that they had been to his room to try to help him. 
  • My father kept fiddling with his hearing aids, and broke them several times (repairs = $500/fix) until he finally lost them. Both of them.

Games and activities

Many enjoy Wii, or card games, when shuffling becomes difficult.

Bathroom assists
Grab bars, tubs with doors, commodes for bedrooms, shower benches.
Commodes can be a great way to allow the client to have some control.

The big issues with the bathtubs you can walk into: you must sit in it and wait for it to fill, and you must sit and wait for it to drain, with the risk of being cold. The other barrier: they cost about $5000 CDN.

The issue with grab supports like this
- you cannot close the shower curtain.
This tub, parents of infants love, too!

Toilets need to be 48 cm (19" high) for easy transfer from wheelchair to toilet. The supports you can put onto a toilet often do not permit it to be flushed easily. You can purchase a regular 48cm toilet for your home.
Centre-wheel drive


Mobility Devices
a light footstool  - perfect solution
It took us forever to convince Dad to use his walker. These are for old, sick people! Once he could manage it, he had balance issues, and would fall over on his walker.
For some, using the toggle switch on a motorized wheelchair requires a steep learning curve. It requires patience, coaching, and experience!
Ramps are a perfect solution for many.

Walkers can have no wheels, two wheels, or three, with or without a seat.

A simple device, a footstool, helps a senior get in and out of a high van more easily.
She drags herself with one hand using the railing
What I find, in my experiences, is that many items meant for young kids, have begun to be adapted for use by those who are ill, frail, or otherwise physically challenged.

Impossible to power it with only one hand.
One barrier, that the engineers have not yet figured out, is how to make a wheelchair that can be moved by the client using only one hand. I have many clients who have had a stroke, and drag themselves about, using handrails, as they cannot use one hand, and coordinate it with one foot.


Mechanical Lifts
Patients at home, in LTC or hospital, can be designate a 1-person or 2-person lift. In this situation, it is important for the caregiver, as well as the care recipient, to relax, accept the help, and for the caregiver to know her limitations. My husband had 2 years of physiotherapy after lifting my Dad back into bed. Dad was begging him to be allowed to go back to bed. The personal support workers (PSWs) were very busy and were not available at that moment. This is especially true for volunteers who are not supposed to lift a client alone.

Medication Reminders
This is a big issue. The blister packs are terrific for those with mild issues.
Unfortunately, those with dementia or addictions, are not good candidates. There are machines that will offer the pills at the right times, some take blister packs, but at $500, they often do not work for those with dementia.

Monitored Automatic Pill Dispenser MD.2

Developed in the USA, marketed by e-pill Medication Reminders. High capacity allows the machine to operate without reloads for up to 30 days.

My father was adamant about taking his pills at exactly the right time. He fretted over which ones to take, when, and perseverated on the issue, phoning me often. For those who are so profoundly impaired that they cannot manage to understand when to take pills, they require human supervision.

Comfort or Safety
Both of us in my house have back issues. There are many back supports available.
What do you suppose he is thinking?!
We are careful to choose furniture properly, and to use it wisely. Slips in the tub will set us back months. The great risk for seniors are falls. 

Much is written about preventing falls, but many choose to take risks, as well.

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