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Stay at Home Solutions blogs on topics such as aging in place, universal design, adaptive equipment, home modifications, accessibility, durable medical equipment, legislation, and caregiving.

Posts in power wheelchair
Aerosmith Wants You to "Walk-er This Way"!

Have you ever thought about the possibility that you might need to use a walker someday? A walker is a type of mobility device used to help your balance. Other types of mobility devices are canes, rollators, wheelchairs, and scooters.

Unsplash

Unsplash

You may have a fleeting moment of insight that you’ll need something like that as you age. But you don’t give it more thought than that.

I bring up mobility devices today because they can be REALLY REALLY difficult to use at home.

Why?

Because your home is not set up to allow you and another object to seamlessly move around.

You’ve got the coffee table too close to the couch. The door frames are 27 inches wide. Your chest of drawers is 12 inches away from your side of the bed. I could go on forever!

You didn’t set up your house for a mobility device because you didn’t think you needed more room.

That’s okay! You and every other person on the planet has done the exact same thing. Now’s the time to make some changes!

I’m here for you! I think about mobility devices constantly because I’ve worked with many people on how to do what they need to do at home with the space they’ve got. I lovingly bring up the nitty gritty details on how to move around your home with your device to make sure you can live your life safely and comfortably.

Let me share what I did for one of my clients, Marge (names have been changed for privacy purposes!).

Marge had a terrible year. She was in the hospital for over a month and went to rehab for three months prior to going home. Before the hospital, Marge was able to walk around in her apartment and community with no problems. However after being sick for such a long time, she did not regain the strength in her legs to confidently walk like she used to.

Unsplash

Unsplash

Marge’s thoughtful son saw his mother push herself in a manual wheelchair over high pile carpet flooring in her apartment. He heard Marge talk about how sore her arms were from pushing herself from her bed to the bathroom at night and how difficult it was to move around her furniture.

To make life “easier”, Marge’s son bought her a scooter to use in her apartment.

Little did Marge’s son know, scooters require a wide turning radius to allow the user to turn 180 degrees or less. On the market, the “best” scooter could turn with a 38” radius. This makes scooters terrible for homes because people typically place furniture under 38” apart meaning there is NO room for scooters.

What ends up happening is scooter users need to drive forward and reverse a lot when navigating their homes. This requires a skilled driver to avoid scratching walls, door frames, furniture, or running over people!

My point is very FEW people do well with scooters inside of their homes.

Scooters make moving in living rooms impossible! Photo by Unsplash

Scooters make moving in living rooms impossible! Photo by Unsplash

So what did I do for my dear friend Marge?

When I met with Marge, I assessed her physical abilities while getting on and off the scooter and her driving skills. I also looked at how she did using her manual wheelchair. Comparing the two devices, I noted that Marge was more safe and independent getting in and out of her wheelchair than the scooter. Marge did not bump against her furniture or walls in the wheelchair. She did hit a door frame and recliner while using the scooter.

I told Marge I did not recommend she use the scooter in her home. The scooter increased her chances of serious injury if she used it in her apartment.

I gave Marge a couple of options:

  1. Remove the high pile carpet and replace it with low pile carpet or another type of flooring like laminate. This requires less effort for a wheelchair user to get around.

  2. Use a power wheelchair. Power wheelchairs need 20 inches or less turning radius, depending on the skill of the driver.

The downside to power wheelchairs is the price. They can cost as much as a car and are just as lethal if the driver does not have good driving skills.

Medicare will SOMETIMES pay for the cost of a power wheelchair, but they need excellent medical reasoning and documentation from your doctor, an occupational or physical therapist, and a third party mobility device supplier. For instance, Marge would need to show she had a drastic decline with her physical status to qualify for a power wheelchair through Medicare.

If Medicare does pay for the power wheelchair, then you are SOOOO lucky! All you have to do is wait several months for receipt of your power wheelchair, which is very difficult to do since you probably needed the power wheelchair for everyday living already!!!

Good mobility device companies usually offer a loaner power wheelchair to rent while you wait for your power wheelchair though. Keep that in mind!

In Marge’s case, she had the funds to purchase a standard power wheelchair to use in her home and community. I trained Marge how to drive the power wheelchair and get in and out of it. We set up her charging station within reach of her bedside table to plug in the power wheelchair at night.

Unsplash

Unsplash

I was happy to see Marge’s gleeful expression while she zipped around her apartment. Her son looked relieved when he saw Marge move around without taking off the door frame.

Sometimes, you need an objective eye to show you previously unknown options. Marge’s son was trying to help his mom the best way he knew how.

When it comes to safety at home, it’s best to consult a professional like me to help you find the perfect solution that fits you. I helped Marge find ways to live at home safely and independently. She doesn’t need a caregiver to push her in the wheelchair. She can take herself to the bathroom or living room or dining hall. Marge is her own person living happily in her home.

What do you want to know about making your home safer? What have you already done to prepare yourself for the future? All I know is you better do it before you need it!

How to Pay for Home Modifications or Repairs
Pexels

Pexels

Hello, my dearest friends! Let’s talk about the biggest hurdle to overcome when you’re thinking about home modifications or repairs to your home: money.

Many people I talk to say, “I don’t know if I can afford you.” I completely understand the dilemma. You want to make changes in your home, but your bank account isn’t too sure you can handle that. You know home modifications can help you stay safe and independent in your comfortable abode.

You’re right, home modifications are a key ingredient to keeping yourself OUT of a nursing home. But paying for them can be tricky!

I am a firm believer in thinking you don’t need to spend a ton of money to make your home safer! Unfortunately, I do run into certain problems that require more extensive home modifications as part of the solution. A common example of this predicament is when people need to use a wheelchair or power wheelchair and they cannot fit through the bathroom door.

The truth is that home modifications are an investment for you and your lifestyle. And like any investment, you need to buckle down and think about your options before making a decision.

An investment in knowledge pays the best interest.

-Benjamin Franklin

Pexels

Pexels

To help you make the best financial decision, I created a page devoted to financial resources on my website. This page is specific to the Kansas City area; although a lot of resources pertain to residents statewide in Missouri and Kansas.

My biggest passion is to help you live at home for a lifetime. I am a huge advocate of looking into every possibility for people to remain at home if that is their wish. Click here to see how happy Mrs. B is with her home modifications!

My zest + the power of research = Home Modification Financial Resource

I am excited to have this resource available for you because it can be confusing to figure out what financial supports exist! If you want to learn more about a particular resource, just click on the link highlighted in red. Or you can contact me to answer your questions!

I covered financial supports like: Medicaid, grants, loans, tax credits, long term care insurance, life insurance loans, resources for veterans, and Kansas City area community organizations. The focus is on financial assistance for home modifications. Please note that home modifications include home repair, household items, and equipment in addition to structural changes to the home, like building a ramp.

People ask me often if Medicare will pay for home modifications. The answer is “No”. Medicare will help pay for medical equipment with a doctor’s order, like a hospital bed. You have to pay a twenty percent copay for the medical equipment.

As of right now, there is legislation for the Medicare Advantage plans to cover simple home modifications in 2019, like grab bars and shower chairs. If it goes into effect, many people will benefit from simple fixes to their bathroom or main entryway at home.

If this legislation passes, please ask an occupational therapist on where the best placement is for grab bars in your home!!! Occupational therapists have the medical training to look at your overall needs compared to a contractor or handyman’s skills to install your equipment. Your home modifications will go smoothly if you have a team that includes an occupational therapist and a contractor!

The worst anecdote that comes to mind is of a woman, Betty, I met in a nursing home. (Names have been changed.) Betty started to notice how difficult it was to step out of the tub shower in her bathroom. She felt like her foot slipped on the floor of the tub while she picked up her other foot to step over the ledge. Betty would reach out her strong left hand to hold on to anything to steady herself. She knew it wasn’t safe to hold onto the jiggly towel rack, but she didn’t have any other choice.

Betty didn’t want to fall, especially in the bathroom! So she called a handyman to come over and put in a grab bar to feel more steady. She paid the handyman with her own funds and no financial support. With the grab bar in place, Betty felt more comfortable with taking a shower again.

Maybe Betty could’ve benefited from this? Photo by Pexels

Maybe Betty could’ve benefited from this? Photo by Pexels

When Betty was stepping out of the shower, she felt her foot slip again. She quickly reached across her body for the grab bar with her strong left hand, but it wasn’t enough. Betty slipped and fell over the tub ledge onto the bathroom floor and broke her hip.

It’s awful when home modifications, like putting in grab bars, doesn’t work out well for people like Betty. The effort and money she put in to install the grab bar to provide her safety did not turn out as planned. If she had an occupational therapist on her team, her money would not have been wasted. An occupational therapist would have helped Betty create a solution customized to her needs.

Don’t be like Betty. Be informed about making the best financial investment for you and your home! Look through this list of financial resources for home modifications. Find an occupational therapist to help you in deciding what home modifications are going to be right for you! Talk to friends and family about contractors they have hired in the past. Read this article on how to find the right contractor.

In the story above, Betty tried to prevent getting injured in her bathroom. She did a great job being proactive and recognizing she needed help. But Betty didn’t realize she needed an occupational therapist to look at the big picture for her tub shower.

I am happy to assist you in creating a team that is committed to help you stay at home! Planning home modifications in advance is much better than needing them right after an injury or illness. You need to do it before you need it!

If you know of a financial resource for home modifications that I did not list, please contact me! I would love to add it!

Look at My Garden Design!

I love gardening! As an occupational therapist, I feel delighted when my clients tell me they enjoy gardening as well. Since gardening is a great activity to stay healthy and strong, I like to help people figure out how to stay engaged in it.

I found that most of the time, people stop gardening because they can no longer access their garden beds at home. These people can not get down to the ground and stand back up. They find it difficult to walk on uneven ground in their yards. Reaching for weeds or tools on the ground can cause people to lose their balance. Nobody wants to take a tumble in front of the neighbors!

These gardening problems are caused by losing strength and balance over time as we age. When we stop doing certain activities, we lose the ability to participate in that task. Of course, I could tell people, “Just start exercising”, but in all actuality very few clients follow through on that suggestion.

Other hurdles to gardening include arthritis pain and joint problems. These two common complaints make my clients feel unable to resume gardening how they used to. So with these biological barriers blocking my clients from enjoying time outdoors with their plants, what am I going to recommend to them?

I wrote an article in May, “Easy Gardening Tips”, that focused on tool and self care recommendations when gardening outside. Today, I am going to go into detail about the physical changes you can make in your yard to access the garden easier!

Let me give you an example about my own garden. My husband and I want to make a raised 16'x16' garden bed for produce in our yard. We wanted to include a path in the garden bed to be able to walk and reach plants in the middle. Here is a picture of the design my husband created:

Design by Cole Lindbergh

Design by Cole Lindbergh

We call it a "Big Garden" because we are amateur gardeners, okay people? Sometimes I kill plants unintentionally, but I always love to try growing them.

To make the garden accessible for most people, I asked my husband to make the entry and garden path inside of the square 36 inches wide. This will allow plenty of room for any person with a walker or cane to come look at my plants or weed for me (for free of course). Anyone who walks will have no problem carting a wagon of tools around a pathway this size. My clients who find it difficult to lean and reach for items will like this type of design to avoid losing their balance.

The garden path width will also allow a wheelchair user to come inside, BUT this would be a very tight squeeze for that person when you include hand rims. Ideally, the width of the path would be 60 inches or have one spot that is 5'x5' to turn in any direction. My garden design works for people with smaller width wheelchairs and only gives them the ability to go forwards or backwards.

The other bone of contention is my power wheelchair user friends would not be able to come into the garden. They would need a 6'x6' turning space to safely navigate my garden without bumping into the bed walls. Power wheelchairs can often cost the same as a car! So we wouldn't want to accidentally damage my friend's mode of transportation!

Another thing to consider is how tall to make the garden bed walls. The minimum recommended height for raised garden beds is one foot for plant roots to spread. There is no rule for a maximum garden bed height, but be wary of the need to reach up too high to tend to your plants. For our purposes, we are going to make the bed walls two feet high. If that is too low, we can certainly add on to the wall height in the future. 

Building taller raised garden beds, like four feet high, will work better for people who feel pain while bending to the ground. I would recommend bringing a light stool in your garden wagon in order to sit and work on the plants. Sitting to garden conserves energy, limits pain, and improves your balance. You can also use a raised garden bed with legs that will give more room for your lower body while sitting to tend to plants like the picture below.

Costco

Costco

Lastly, it's important to think about the material to use for the garden pathway. For obvious reasons, dirt and grass will make it very hard for someone to walk or push a wheelchair in the garden. Mud is a mortal enemy to power wheelchairs and is incredibly hard to clean off of wheels!

You want the garden pathway material to be non slip and smooth for wheelchair users and people who use walkers or canes. The ability for a wheelchair user to access certain areas depends on their equipment and upper body strength. Some ideal materials include crusher run, concrete, or asphalt. Wood pathways are another option, however, you need to make sure they are sealed properly to avoid the pathway to become slippery when wet and to prevent the wood from breaking down from the elements.

Do not be tempted to put in brick or other stone pavers! They look really pretty, but cause unnecessary bumps for wheels. Also, I cannot tell you how many times I watched people with walkers get stuck in the spaces in between pavers and sidewalk cracks. Bumps and cracks on pathways can easily lead to falls in the garden. Again, we don't want the neighbors to watch us fall!

If you are interested in learning more about making gardens accessible for all, please check out Enabling Gardens: Creating Barrier Free Gardens by Gene Rothert. Mr. Rothert is a wheelchair user and gives first hand experience on how to make gardening available to people of all ages and abilities.

Everyone deserves to enjoy what they like to do, including gardening. If you or someone you know has a hard time with gardening, try some of these tips to get back outside! Comment down below if you have tried ways to make gardening easier for you!