The Survivor Newsletter: Summer 1999

DOES YOUR HOME NEED A CHECK UP TOO?

From our New Zealand Correspondent:

If you have a condition such as Polio which has worsened over the years due to the onset of associated physical changes, perhaps now is the time to examine whether you have a disability or a handicap. Chances are, if you haven’t done anything to change your environment or the way you do things over the years to make allowances for your disability, then you may well be handicapped much more than is necessary.

As an Occupational Therapist currently working with seriously injured folk, I am constantly amazed at how common sense and a couple of judiciously chosen pieces of equipment or a basic housing alteration can make that shift from being handicapped – (disadvantaged by environmental obstacles) to being merely disabled – (having a long term medical condition).

If your condition has been complicated by the onset of osteo-arthritis and increasing chronic pain you owe it to yourself to take a step back and examine what you can do proactively to control what is happening to you.

For a start take a good look at your home. Whereabouts is it giving you trouble? Look at the list of points below and ask yourself if they effect you and if the answer is yes, do something about it!

Front door steps

Too steep? Need a rail? Need two rails? What about using an alternative level access entrance instead. A ramp is not always a good idea for those using crutches or a walking stick unless it has a very gradual gradient. Specially formulated non-slip plastic paint on steps is a good idea.

Floor surfaces, Internal space.

Slippery or damaged vinyl, loose mats, wrinkled carpet? What can be removed or replaced to make mobility safe? Does that side table have to be in the passage? Even though the lounge suite has been in a certain place for years consider changing its position to increase the space for safe walking. Remove extra furniture if it is not used.

Step up shower cubicle

Need a rail? What about a flip down shower seat or a shower stool or chair and a non-slip mat. Hand held showers make life very easy. Level access showers are only necessary for those needing to use a wheeled commode.

Taps / Basins

Tap turners are okay but installation of a central easy-to-use lever tap is preferable. Is the basin too low? Have you tried sitting on a stool while using the basin? Are you holding onto the basin while transferring? It would be better to use a properly installed rail.

Toilet

Is it too low. Think about a rail or a toilet frame surround which you can push up on with both hands. A raised toilet seat can also be useful to make getting on and off the toilet easier. They come in various heights and are easily obtained from hardware stores.

Bath

Are rails required? Do you need assistance in and out now? There are excellent battery powered hydraulic bath seats available now which effortlessly lower the user into and out of the bath. Expensive but worth considering if soaking in the bath is a good way of relieving pain for you. The usual bathboard and bathseat can help but you need to be reasonably strong and pain free to use them properly. Of course ceiling hoists and floor standing hoists are options for those who are severely disabled.

Bed

Too low? Too high? Too soft or too hard? A good mattress is essential for pain relief, pressure area relief and postural support. Think hard about treating yourself to the best possible mattress you can afford. It’s a great investment. Failing that a specialist pressure relief Dacron topper pad is a nice addition for comfort. Do you need bed raisers ensure the height of the bed is just right for you when getting on and off or a bed pole to help you shift yourself around? Once again the more expensive option of an electric height adjustable bed with head and foot raise is a fabulous solution for chronic pain as it is multi-adjustable. (If you have a Porche in the garage you might be able to afford this too!)

Internal steps and stairs

Perhaps the time has come to put in an extra rail here and there to ensure safety around the house and check that the floor coverings are suitable. Do you have to go upstairs twenty times a day or can you organise yourself better than that? Are you brave enough to consider moving downstairs permanently?

Kitchen layout

There is so much to consider here. Height of the work tops, accessibility to the drawers and cupboards and the sink. Carrying hot and heavy items around the area. Use of oven and hob. Do you need a small trolley to reduce walking around? What about an extended Easi-Reach pick up stick . Do you need to sit down at a work surface when preparing food? What is causing you a problem in this work space? Take some time to think laterally to find a solution. If you spend a lot of the time in the kitchen it really is worth getting the layout right. Ask your Occupational Therapist to help with the design.

Armchairs

A reclining armchair is a must if pain is a major problem. Preferably an electric remote control chair which gives you many choices of position at the flick of a switch. Some models bring you up to a semi standing position which makes getting in and out easy. Failing that, put your favourite armchair up on chair raisers to make it easier to get in and out of and make sure you have a lumbar support roll and check that the seat cushion has not sagged over the years. Put your legs up on a foot stool which supports you under your knees as well as under your feet.

The list above assumes some level of ambulatory ability with crutches or a walking stick or walking frame.

If you are in a wheelchair your needs are even more specific, ramps and level access showers, internal circulation space, door widths, correct height kitchen benches are things which should have been sorted out for you when you got your chair. If they weren’t or you have moved house since you got your chair, consider having the Occupational Therapist around to do an ergonomic check on your home. It may be annoying when an outsider points out something glaringly obvious which you didn’t pick up but still, why suffer when there are solutions out there? When you actually live in a house it can be hard to be objective because you simply get accustomed to living with the problems.

You owe it to yourself to find out what is available and what you are entitled to under the Health System and what you ought to consider buying privately as an investment. An electric recliner armchair or an electric bed may be considered luxuries to some but if they result in better pain control then they could be worth every hire purchase penny. However if you are seriously keen to get this specialist equipment do ask for professional assistance first. You may need to trial a variety of items to identify what suits your needs best.

Meg Daly Dip COT

Occupational Therapist