Ramps Make Public Areas Accessible For Wheelchair Users

For many people, walking substantial distances outside of the home can become difficult in later life. Using mobility equipment like walking sticks, crutches, walking frames and rollators can be the answer. But for others, it is simply impossible to get from A to B without using a wheelchair.

This may be because they have a physical condition in their legs, feet or hips which prevents them from walking. Or it could be down to a lung condition which means they quickly run-out of breath. For younger people, using a self-propelled chair might be the answer. These require physical fitness and upper body strength to propel unassisted.

These chairs have large rear wheels which require pushing by the user in order to make them rotate. In order to protect the hands and improve grip, most people using self-propelled models wear special gloves. These wheelchair accessories prevent injury and ensure that the user can turn the wheels without pain.

Most attendant propelled wheelchairs have lightweight frames. The lighter the chair, the easier it is to maneuver.

Ramps for Wheelchairs
 

Kerbs, steps, steep hills and other obstacles are problematic for self-propelled wheelchair users. While many modern shops have good wheelchair access, a high percentage of public locations remain inaccessible. Solid, fixed ramps remain a rarity.

Attendant propelled chairs are for people who are unable to push the wheels themselves. Usually these models do not have larger rear wheels. Most have handle-brakes which the attendant can use to stop or slow down the chair.

Both types of wheelchair typically fold-down when not in use. This makes it easier to transport and store them. Often wheelchairs pack into the boot of a car, so it is important to choose one which collapses down to the required size for the space available.

Wheelchair accessories like ramps are available in various sizes and lengths. To ensure maximum safety from accidents, many have non-slip tread on the rolling surface. This improves grip both for the wheelchair user themselves and their attendant, if they have one.

As with the wheelchair itself, wheelchair ramps often need to be lightweight and collapsible for easy transportation. If the ramp is a broad single unit, this usually mean it needs to fold down the middle. In transit, it can lay on the floor of the boot of the car, with the wheelchair itself put on top of it.

If the ramps are the ‘channel’ variety, they fold-down in one of two ways. Channel ramps typically come in two narrow sections which either fold in half like broad ramps, or collapse on themselves using a telescopic action.

There are two main advantages of channel ramps. One is that they feature raised edge sections which prevent the wheels of the wheelchair rolling off to the sides. The second is that each ramp is relatively light, making it easier to put in position than a single, broad unit. Because they are in two pieces, they are also more convenient to store. When in use, care is necessary to ensure an even distribution of weight on each unit.

Some ramps are available which fold-down to such an extent that they fit into a bag which hangs on the back of the wheelchair. This means the ramps are available as and when required.

Still, many wheelchair users still prefer a single-piece ramp. If made from rigid material, one-piece ramps provides a solid, reassuring feeling. Steel ramps provide the most rigid surface, but are heavy, making them less popular than they used to be.

Fibreglass is one option as an alternative material because it is relatively lightweight and waterproof. In recent years, aluminium has become the material of choice for wheelchair ramps. This metal is light but rigid enough to support the wheelchair user’s weight without too much flex.

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Aids to Help Someone Rise from a Sitting Position

There are many disabilities which lead people to require new pieces of equipment in order to maintain their quality of life. There is an increasing variety of products available. One common problem is losing the ability to get up easily from a seated position.

Getting Up From and Armchair
 

A lot of people struggle with the simple act of getting in and out of an armchair or sofa. This can be because they have lost strength in their back or another part of their body. This may be because of a long-term disability or a temporary illness. They may also be recovering from an operation.

Riser cushions are simple disability aids which push the user up from a seated position, or lower them as required. These are available with electric or hydraulic power. These either react to the weight placed on them by multiplying it, or they work by a button controller.

Some electrically controlled armchairs are able to tip forward at an angle. This provides the user with great support as they rise to their feet, reducing strain on their back.

A simpler solution is to raise the height of the armchair. This decreases the distance of travel required in order to sit down. This is achievable in two ways. The first is to raise the overall height of the chair by adding special feet underneath it. This can lift the height of the seat by anything up to six inches.

The second is to insert a very deep and firm cushion to the seat itself.

If neither option appeals, there are special support bars available. These fit to the next to the chair and provide a solid support, allowing the user to pull themselves up to a standing position.

Sitting Up in Bed
 

Those who struggle with getting to their feet may also find it hard to sit up in bed. Problems with back strength can lead to this problem.

Using disability aids like a ‘Jacob’s ladder’ can sometimes be the answer. This is lightweight rope ladder which attaches to the foot of the bed. When the user wants to sit up, they use the rungs to pull themselves up.

A more substantial item to do a similar job is a bed rail. These fit to the bedframe and provide a support rail. This enables the user to pull themselves into a sitting position without straining back muscles.

It is sometimes beneficial to raise the height of the bed itself. One option is by fitting special feet which fit to the bed’s legs, raising them off the ground. This works in the same way as for armchairs or sofas.

Using the Toilet
 

Just flushing the toilet can become difficult for people with certain disabilities. The solution maybe to get a push-button WC. As the name suggests, these flush with a single press and require little strength to operate.

For those who struggle with sitting down and standing up unaided, using the toilet is difficult. Raising the height of the toilet seat can help. High loo seats are available which fix firmly to the existing bowl. These reduce the distance of travel one requires in order to sit down or stand up.

Grab Rails
 

Another simple way to provide support when getting up from a sitting position is to install grab rails. These fit to walls in positions where support is usually required. For instance, next to the toilet in the bathroom. If fitted correctly, they provide solid support for the user and provide a way to pull oneself up, limiting stress on the back. Grab rails are essential aids for many people living with disabilities in the UK.

In-Car Disability Aids
 

Getting out of a car seat is difficult for many elderly people or those suffering with disability. Using a specially fitted handle which attaches to the door frame is one helpful solution. It provides an excellent point of support, enabling the using to pull themselves out of the car and onto their feet.

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Using Walking Aids After a Knee Injury

Following knee surgery, Lisa required various pieces of rehab equipment on her way to recovery. While skiing in France, she was dismounting a chair-lift when a child crashed into her. The child was skiing at high speed, knocking Lisa from her feet.

Lisa did not see the approaching child so did not have the chance to brace herself. Because of the child’s height, the main site of the impact was the outside of Lisa’s knee on her left side. The child was wearing a rigid helmet which contacted the side of the knee directly.

The result was serious trauma to the joint. After an airlift to hospital, doctors diagnosed knee-ligament damage. Lisa’s uninjured right leg enabled her to use crutches for mobility after two days in hospital.

 

After flying back to the UK, Lisa had a scan on the knee showing damage to two main ligaments. There were tears to both the ACL and MCL. Her injuries were similar to those commonly found in footballers and rugby players.

These injuries would in the past have brought careers to an end, but developments over the last 20 years mean that they are successfully treated. Some footballers can return to playing within a year of surgery.

In Lisa’s case, there was some doubt as to whether an operation would be wise at all. There are some risks associated with it, but in the majority of cases the individual regains full functionality of the knee. As she does not play impact sports on a regular basis, she is not at high risk of a similar injury.

Following more assessments, doctors recommended an operation to repair the knee. While waiting for the surgery, the NHS gave Lisa a leg brace. This wrapped around the leg and prevented it from flexing laterally while allowing it to bend as normal. In turn, this stopped the damaged tissue receiving further lateral stress.

Because the knee still felt weak, Lisa continued using walking aids. She also used crutch accessories in order to spread the weight evenly through her hands. Pads slipped over the plastic handles were beneficial, cushioning them and improving pressure distribution. This meant that Lisa was able to travel for sustained periods to and from work.

Lisa had two operations on her knee to repair the damaged ligaments. Immediately afterwards, she was unable to walk unaided for a period of weeks. In the first few days, she needed a wheelchair.

After the accident, she had used only forearm crutches. After the surgery, Lisa used ‘Axilla’ models. These fit into the armpit and look something like old-fashioned pirate-style walking aids. These bear the user’s weight through the hands, armpits and shoulders. Conventional modern styles tend to focus weight through the forearms. Both designs are lightweight and easy to carry.

Lisa found that alternating between the two styles reduced the stress on her body and aided her recovery. When the ‘elbow’ versions because uncomfortable, she switched to the Axillas, and visa-versa. She also found crutch accessories like fleece padding could fit into her armpit and improve comfort.

She then underwent a long period of therapy in order to rebuild strength around the knee. After surgery, Lisa had a feeling of uncertainty towards the strength of her knee. The exercises suggested by the physio gradually worked her left leg, slowly improving its strength and Lisa’s balance. Learning to ‘trust’ the knee again was an important part of the process.

A key piece of equipment through the rehab process were walking aids. Without their use, she would have needed a wheelchair. Without an adapted home, fitted with ramps, she would also have required a nurse or carer.

The knee brace, while effective at limiting the range of motion of the joint, did not provide enough support to allow Lisa to walk unaided. For the first six weeks after her operation she required crutches and later, walking sticks.

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Choosing Correct Equipment If You Have Limited Mobility

Using special equipment can make a significant difference to a person’s quality of life in old age. As one’s flexibility and strength decreases, routine tasks become more difficult. Using the bathroom or even getting dressed without help can feel like huge mountains to overcome. While in some cases this can lead to the need of a carer or nurse, using mobility aids can delay this for a long period of time. Independence is something most elderly people value highly, so their use is becoming more popular.

Assessing someone’s degree of ‘mobility’ is a first step towards picking the correct equipment. In the strictest sense, it means in relation to the ability to walk unaided. If they can, how far? The individual may need a mobility scooter, a rollator or simply a walking stick when out and about, but be fine unaided while at home. Support rails placed in useful places can provide resting points and provide a sense of security.

For people unable to walk for any sustained distances, using mobility scooters, wheelchairs and even stairlifts may become part of everyday life. Lightweight walking frames with or without wheels are also popular. Correctly adapting the home for their use is critical. Fitting ramps for thresholds up short flights of stairs is a common home modification.

Particularly in old age, ‘mobility’ relates to the question of hand and general body dexterity. This is a question when assessing if a person may benefit from the use of mobility aids. Are they able to bend down and put on shoes or socks? Do they have the flexibility and strength in their hands and fingers to do up buttons or zips? Are they flexible enough to reach over their shoulder to pull-over the arm of a shirt, for example? Selecting the correct aids for the elderly people who are facing these issues is vital.

Reaching and Gripping Aids

Devices are available which extend the person’s reach, reducing the need to stretch. These including reaching aids or grabbers, which have a trigger on the handle and grasping jaws at the other end. Other items make it easier to put on socks, while the classic long-handled shoehorn helps with shoes.

In the bathroom, restrictions on one’s mobility can cause everyday problems. Washing can be hard when it’s difficult to reach certain parts of the body. Long-handled bathroom tools can help. Wide hand grips which attach to toothbrushes make them easier to control for people with a tremor.

The process of getting in and out of the bath can also cause difficulty for those with reduced mobility. Installing bath steps to reduce the height of the bath can help. Inside the bathtub itself, a bath seat may also be of benefit. Its use reduces the height which one has to raise one’s body to get in and out. A bath seat often has suckers on the base, meaning it will not move around, even under water. A non-slip sitting surface reduces the chance of accidents.

Using standard kitchen-ware can also become challenging. Many elderly people develop tremors, making the use of utensils difficult and sometimes dangerous. Strength in the fingers may also lessen, making it difficult to prepare food. Devices like push-button electric tin openers or items which grip food for cutting are useful.

Many elderly people enjoy gardening and here too mobility aids are available to help. Some individuals may struggle to kneel down and stand up unaided. Gardening ‘kneelers’ with support handles make this process easier.

Garden tools with special grips are also effective. These usually have handles which are set at such an angle that reduces the amount of strength required to use them. These grips are also broader than on normal tools. Again, this feature is of benefit for people with a weak grip or hand tremors. Most find the enlarged grips make the tools easier to control.

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How Cushions Help the Fight to Prevent Pressure Sores

Spending long periods of time sitting in the same position can lead to pressure sores. Using appropriate cushioning guards against the condition. Elderly people or those in rehab from illness or injury often have to spend much of their time in bed. In some cases, patients may be unable to get out of bed at all.

Those with paralysis in all or some parts of the body are especially at risk of pressure-point related injuries.

People with other disabilities may also be in a position where they need to sit down, possibly in a wheelchair, for much of the time. This may result in localised skin and soft tissue damage, usually where there is a bony part of the body. Areas at risk include the elbows, heels and bottom of the spine.

The skin damage, also known as pressure ulcers or bed sores, can take time to develop, but in some cases may form in a matter of hours. They result when there is consistent weight on a particular point of the body. Old people whose skin is fragile, may find they develop very easily. This often leads to pain and blood discharge from the sore.

Patients with reduced sensitivity may develop pressure sores without feeling any initial pain. These may include those on certain drugs.

If left untreated, these sores risk infection, leading to serious medical problems. It is therefore important to take steps to manage the issue.

The effect of standard bedclothes is usually inadequate. Nurses suggest using pressure cushions to relieve friction on the sites of the ulcers. Fleece padding can also be effective when applied to affected areas. Natural fleece or man-made varieties do a similar job.

Pads which attach using Velcro are available for specific parts of the body. Heel pads and elbow pads are popular. These are pieces of fleece or cotton with gel padding. Fleeces can make a difference, but frequently even these are not enough.

For sitting in armchairs or even when sitting up in bed, using a pressure relief cushion which actively guards against sores developing, could be the answer. They provide a soft barrier which reduces friction on the body.

Foam, Gel and Air-Filled Cushions

Various types of foam cushion are available, some with ‘memory’ properties which mould to the contours of the body. This often helps short-term comfort but can lead patients to ‘fix’ their position. Some foam cushions have a ‘nodular’ construction, allowing air to flow through the cushion, reducing heat and patient discomfort.

Gel-filled cushions are another popular choice. These disperse weight, increasing comfort and spreading the point of pressure. As with the foam filled models, many gel pressure cushions are nodular in their design, allowing as much air-flow as possible. This has the effect of keeping the patient cool.

Air-filled cushions can also be effective in some cases. These require inflation before use, and again are usually of a nodular design. These models are vulnerable to puncture, so it is crucial to take care of sharp objects when using them.

In addition to seat or chair cushions, various designs are also available as mattresses or mattress toppers. These are for patients who lie in bed without moving for long periods.

A wheelchair user will frequently need a pressure relief cushion. Being in a ‘fixed’ position in the chair, they are vulnerable to ulcers developing. Cushions are available in numerous sizes and depths in order to fit the user's chair.

Nurses stress that it is vital to spot the chance of a pressure sore before it develops. Once there, bandages and dressings can be difficult to replace, so the target is to avoid the sore in the first place.

There are four grades, or ‘stages’ of bed sores. Pressure cushions all come with advice to let you know which grade they are suitable for. Ideally, a doctor or nurse who has examined you first-hand should tell you which one to use.

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Benefits of Using Shower Seats for Elderly or Disabled People

Unassisted bathing and showering can become difficult in old age. Fortunately a range of aids is available which make it easier and safer. Simply getting in and out of the bath are tasks which can go from routine, to fraught with danger in later life. Fragile bones and impaired balance can lead to falls and bone fractures.

A fall for some elderly people is a dangerous, even life-threatening event. Broken bones or ligament damage can lead to long periods in hospital and the risk of infection and secondary illness.

Some people use steps and support rails fitted around the bath to make it safer to get in and out. This is a solution for many, but ideally a walk-in shower cubicle is widely regarded as the best long-term option. The drawback with this is that the person has to stand for the duration of the shower. Many conditions affecting the elderly make this very uncomfortable.

Seating in the Shower Cubicle

To overcome this problem, many people use a shower stool situated in the cubicle itself. Made from rust-proof materials, these provide an effective solution. They enable the user to sit down while showering, thus reducing the strain involved.

Without the high side of the bathtub to overcome, this option is easily the safest for elderly people. It reduces the chance of slipping and having a dangerous fall.

It is however important to choose the correct chair, seat or stool. Most of the best designs share some key features.

As the sitting area is going to be wet, it is crucial that it drains well. This means that it will need holes in the seat itself. Water from the shower then runs through the seat, reducing the chances of the user slipping when sitting in standing water.

The potential slipperiness of the floor of the shower is also an issue. Fitting non-slip feet to the stool can remedy this.

High friction plastic stoppers are ideal for this task. Old fashioned rubber feet perish over time because of exposure to water, reducing their gripping properties. They are no longer popular choices of material. Many modern plastics on the other hand, are waterproof and will do a great job as non-slip feet for shower seats for elderly.

For the seat’s frame, aluminium is the most popular choice for use in wet environments. It is strong and lightweight, making it easy to move in and out of the shower. Its non-corrosive properties further enhance its suitability.

An additional feature which some seats employ, is a back rest. These often make the sitter feel more secure than a simple stool.

Mobile Shower Wheelchairs

A disabled shower seat may need to be more substantial than the standard equipment available for the elderly. People with severe disability often require special wheelchairs in order to access the shower.

Building wet-rooms with smooth flooring from wall-to-wall, and under the shower head. This means a wheelchair can roll in and out without obstruction.

Regular-use wheelchairs are not suitable for this purpose. Shower wheelchairs made using appropriate non-rusting materials with perforated drainage seats are more appropriate.

In some cases, the wheelchair user may need nursing care to help them in the bathroom. Waist height shower screens protect the nurse or carer as they wheel the chair into the shower area, so that they can assist without getting wet themselves.

Another type of disabled shower seat is the wall-mounted variety. These work as fixed benches which stick-out horizontally from the wall, or they can fold flat when not in use. These collapse against the wall, so they do not take up much space. This is a useful feature, especially if the able bodied people use the same cubicle. It is of vital important to securely fix this type of seat to the wall.

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Development of Modern Crutches

Crutches have come a long way from their earliest designs to the comfortable, lightweight models we see today. Their purpose remains as pertinent now as it was when they were first used hundreds, if not thousands, of years ago. If you have an injury to one of your legs or feet, you need to reduce the weight the injury bears as you move around. This is where crutches come in.

The earliest forms of wooden crutches took the shape of simple long ‘T-Shaped’ walking sticks. The cross-bar of the ‘T’ would fit into the armpit of the user. This channeled the user’s weight through the armpits, shoulders and upper body, rather than through the injured limb.

The problem with this design was mainly one of balance. If someone’s weight was too far forward or too far back, it was easy to lose balance and fall over. The design of crutches therefore evolved to use a ‘V’ shape towards the top of the crutch, in order to combat this.

The ‘V’ shape resulted from splitting the wood and separating it as required. The two prongs of the ‘V’ required bracing at the top by the horizontal section fitting under the user’s arm. This meant that weight was more evenly distributed downwards, giving greater stability.

Another shorter horizontal brace towards the narrowest section of the ‘V’ would create a natural hand hold at about waist height.

This style of crutch is still in use today and known as an ‘Axilla’ crutch. While rarely made of wood, it still uses the excellent weight distributing properties of the ‘V’ shaped design.

It remained the most popular style of crutch until midway through the 20th Century. It was at that stage when people tried to find a design which provided less discomfort to the user.

The first modern ‘forearm crutches’ were first seen in the 1950s. As the name would suggest, with this design the user’s weight transfers mainly through the forearms. This reduces stress on the hands and under the arms.

This design also allows for greater adjustability. Both the lower shaft and the upper shaft can be set to the desired length. This makes these crutches suitable for people of various heights. They are now the most common crutches used around the world. The NHS in the UK prescribes the used of hundreds of thousands of this type of crutch every year.

Commonly known as 'elbow crutches' and made from aluminium, they feature a plastic cuff at the height of the top shaft, which wraps around the top of the forearm. A lower hand-grip sticks out horizontally just below waist height.

Padding for Crutches

A persistent problem with forearm crutches is that the longer you use them, the more pain they can cause to the user’s hands. Narrow handles, typically made of plastic, can cut into the hand with repeated use.

While the earliest crutches had no padding at all, some early wooden versions had leather pouches filled with horse hair. Built-in plastic filled with foam padding is now common, both for the handles and the under-arm weight-bearing parts. Crutches’ accessories like removable foam pads are also popular.

Another innovation is the development of ‘ergonomic’ handles. These have a specially designed surfaces which do not dig in to the hands. These wide, contoured handles spread weight across the palms, significantly increasing comfort.

These handles are particularly useful for those using crutches for prolonged periods of time.

Ferrules for Crutches

Early wooden models were prone to accidents caused by the foot of the crutch slipping on the ground. With the invention of new materials like rubber and plastic, special feet now fit to the bottom of the shafts, providing high friction and grip.

Other crutches’ accessories include metal spikes which fit to the bottom of the shaft, perfect for slippery, icy conditions.

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