How Learning to Adapt To Disability Can Take Time and Courage

Many people talk about the psychological impact disability has on their lives. One big factor is how they mentally frame their condition and their self-identity. For someone used to living an able-bodied life, learning to adapt and change the way they see themselves and their place in the world, can be a challenge.

Many people find it hard coming to terms with using tools for routine tasks. These might include the simple job of walking from A to B, or even using the bathroom. Some feel a sense of shame that they require help, while others feel exposed to the judgment of others. Overcoming these feelings may take time.

Often there is a temptation to shut oneself away from the world. The idea of using aids like crutches, walking sticks, rollators or wheelchairs is hard to accept for many. Using something like a disabled shower seat in private is one thing, but using a walking frame in public is another matter.

Some disabled people resist the advice of occupational therapists about tools which might assist them. This is usually because they don’t want to draw attention to their disability, they feel embarrassed, or they do not want to invite questions. This can be especially true for a young person.

Walking using disability aids will on occasion lead to questions like “what have you done to yourself?” or “had an accident?” If the truth is in fact that you have a chronic illness or disability which may involve a long story to explain, this may not be welcome.

Many in the community feel it is important to be as visible as possible, in order to gradually normalise disability. By doing this, they argue that it will in turn become less of a talking point and reduce the ‘gawp factor’, hated by so many.

Getting Used to Questions

Julie lives in Hove and developed a spinal condition in her early thirties which meant she could no longer walk unaided. Initially her physio suggested that she use a walking frame. This she did in the privacy of her home, but was resistant to it in public. She did not like the idea of having to explain her situation as she found it distressing and repetitive.

While she could rationalise that she should not feel ashamed, Julie did not enjoy such conversations and would go to great lengths to avoid them. It took nearly a year to have a change of heart. It was only after many discussions with close friends and online with people in similar situations, did she realise that for her, there was a greater good involved.

Although she still disliked the idea of going out in public, she knew that unless she adapted, she would not make the most of her life. In private she made the change far more readily. She started using a disabled shower seat and installed grab rails around the house. She also used a walking frame with wheels to move between rooms.

These changes made a big difference to her mobility at home. As a result, she gradually realised that it was the lesser of the evils to use equipment in public as well. The disabled shower seat, for example, greatly improved her comfort in the bathroom.

A rollator was the first of a series of mobility aids Julie began using outside. This is a simple and robust wheeled walking frame made for outdoor use. As I young woman, it does invite questions, but overall she knows she is better with it than without it.

The rollator has become routine and others are familiar with seeing her with it. It has become a part of her daily life and she no longer fears its use.

Another problem surrounding disability is the inconsistency of its effects. For example, many people may need a wheelchair or mobility aids on some occasions while not at others. When using disabled parking bays, this can cause issues.

If a third party sees someone parking in a disabled bay and walking away from the car, it can lead to accusations. This is all part of the wider misunderstanding in society of the nature of disability.

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Think! Are You Doing Enough For Disabled Customers?

Accessibility for visitors to commercial premises is critical in today’s competitive world. With one in five of the UK’s population living with some form of disability, it makes sense to take the matter seriously. Luckily there are measures you can take to ensure disabled people are able to enjoy your facilities in comfort.

A Wheelchair Ramp for Steps?

If there are steps leading up to the premises or on the shop floor itself, a ramp might make sense. Creating instant accessibility for wheelchairs is both logical and potentially inexpensive. Depending on the space, various types of wheelchair ramps for steps are available.

Remember that some wheelchair users will be pushing the wheelchair themselves, so make sure you fit the correct length of ramp. The longer it is, the less steep the gradient will be, making it easier to climb.

With limited space, it might be difficult to fit a fixed ramp. Instead consider the various options for portable models on the market. Telescopic ramps are available which close down to half their length when not in use. These ‘channel ramps’ come in pairs. They have raised edges which prevent wheels from sliding off to the sides.

Suitcase or folding ramps are a more suitable option for commercial settings. These ramps are available in various lengths and are easily stowed away when not required. Most modern units are aluminium, because of its low weight and strength. Again, choosing a model with raised edges it sensible, as it reduces the chance of an accident.

Carefully consider the weight bearing capacity of any ramp before ordering it. Remember that it needs to carry the weight not just of the wheelchair and its user, but also that of the person pushing it.

Remember too that the weather may cause the ramp to get wet and slippery. Ramps are available with non-slip surfaces. Abrasive patterns are either milled into the surface of the metal, or textured plastic layer is present, both doing a similar job.

If you are a shop or café owner, it is vital to let customers know that a ramp is available, so signpost it clearly. Also, ensure staff are aware of where any portable wheelchair ramps for steps are and how to use them safely.

Toilet Facilities for Disabled People

Suitable toilets are a must if you want to be accessible for disabled people.

They need support rails fitted internally and have a step-free wide doorway. An alarm system should also be in place. This is usually in the form of a chord-alarm attached to the ceiling for emergencies.

The height of the sink should also be at a level which makes it easy for use by someone in a wheelchair. The disabled toilet room needs to be larger than a stand toilet cubicle. Manoeuvring a wheelchair is not easy in a tight space, so this requires thought.

Official UK building regulations have a document (commonly known as Doc M) for disabled toilets. It lays out the specific requirements for a disabled toilet. These include minimum dimensions, necessary support rails, sink height and other factors. The disability aids included within the Doc M remit are widely available to buy. In some cases packs are available containing every piece of equipment needed to comply with the regulations.

The Shop Floor

On the shop itself, think about the width of the gangways and if there is space to fit a low level counter. Walkways for able bodied people may be too narrow for a wheelchair.

If it is a large shop there may be different floor levels. Ensure that any steps have a ramp within easy reach, be it fixed or portable. Make sure too that your staff are well informed and trained in how to use the ramps safely.

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Using Underarm Crutches Correctly and Safely

If you are recovering from an injury or have a condition which means you need to use crutches, it is vital that know the correct techniques involved. Misuse can lead to accidents or secondary injuries. While using aids like walking sticks is intuitive, crutches require more thought.

Underarm crutches seem simple designs, but care is necessary when using them. These models have a horizontal bar at the top which fits under the armpit. Two vertical tubes meet at the bottom, were a single shaft makes contact with the floor. At the height of your upper thigh, there is second horizontal bar, one which the hands rest.

People use single crutches in the same way as walking sticks. Usually this is by employing the crutch on the opposite side of the body to the injured leg. If you are using a pair of crutches, you may need to think about how to use them correctly depending on the nature of your injury.

Crutch Height

The first thing to consider is the height of the crutches. Adjust them using the ‘button-clip’ in the single vertical shaft in the bottom sections. It allows setting of the length as desired. To select the correct size for you, the horizontal pad which fits under the armpit should have around two inches of clearance above it.

In other words, this pad should not fit tight against the armpit. If it is set to high, it applies pressure to nerves under the arm, which can cause pain and secondary injury. A good way to test if the crutches are the correct length, is to make sure you can get two fingers into the gap between your armpit and the horizontal pad. Once fitting correctly, one’s arms should bend slightly at the elbow.

Do not hold the crutches too close to the body. Instead, angle them slightly outwards, so there are a few inches between the outside of your foot and foot of each crutch.

Depending on the nature of the injury, different techniques might be necessary. There are two general categories: partial weight bearing and non-weight bearing.

Partial Weight Bearing Situations

If your injured leg is able to take some weight, move the crutches forward by a step length, then move your bad leg forward. Lastly, bring your uninjured leg forward.

To climb steps or stairs, place your toes an inch or two away from the first step. Place your balance on the two crutches before stepping up with your good leg. Then bring the injured leg and crutches up to join it. Repeat this for each step.

When going downstairs, bring the crutches down to the lower step so your weight is going through them, followed by your bad leg. Lastly, bring your uninjured leg down to join it.

Non Weight Bearing Situations

For people whose injury means they can’t put any weight on one of their feet, there is a different technique. Use small steps, don’t over-reach going forward. Ensure the body weight goes through the hands and forearms, and avoid resting on the armpit pads.

To move forwards, all one’s body weight should be on the good leg, before moving both crutches forward by one step length. Then transfer your body-weight onto the arms and the crutches, before moving both legs forward together. This prevents any pressure on the injured limb.

To climb stairs, move your feet close to the first step. Slightly bend the injured leg so that your toes don’t trip on the step. Shift your body weight towards the step and step forward onto the first step with your good leg. Straighten this leg and in the same motion bring both crutches up so that they are level with it on the step.

When going downstairs, hold the injured leg out in front of the other by a few inches. Then bend forward and put the feet of both crutches on the step below. Once balanced, step down with the good leg. Repeat this process for each downward step.

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How Small Changes Can Make A Big Difference In The Bathroom

Specialist bathroom tools are useful for people living the issues old age can bring. Routine tasks like washing, using the toilet or brushing one’s teeth can become difficult. Luckily, there are plenty of bathroom aids which offer assistance.

Support Rails or Toilet Frames

Using the loo is one such example. Back problems, arthritis and a host of other conditions make it hard to stand up from a sitting position. To deal with this, it is sometimes possible to have a support rail fitted next to the toilet. This helps the user sit down and stand up. These usually require fixing with screws but some suction rails are available, if the wall tiling is suitable.

If this isn’t possible, a free standing toilet frame does a similar job. Some models are adjustable in width to cater for a variety of toilets and surrounding space. Essentially, these are support frames which reduce the strain on the person’s body as they raise themselves from the toilet seat. They are a popular choice because they do not require permanent fixings.

Helping with Hand Weakness or Arthritis

Arthritis in the hands and upper body may make it painful to use a conventional lever flush on the toilet. Push button flushes are easier on the hands and modern mechanisms are both reliable and cheap.

Hand arthritis can also make it painful to hold narrow items like a hair brush or toothbrushes as the plastic digs into the palms and fingers. For those in this situation, increasing the size of the handles makes them more comfortable and easier to control as desired.

Fitting special foam tubing to the grips increases their diameter. Although these foam grips are usually for kitchen cutlery, they work just as well for bathroom tools like a toothbrush. For many, simply increasing their grip-size make them much less painful to use.

Non-Slip Items

If one lives alone in old age, a fall can lead to serious problems. Thus taking steps to reduce the possibility of this happening is a sensible thing to do. The bathroom, with its hard and often slippery surfaces, can be dangerous.

Conventional bath and shower mats make smooth surfaces less slippery. These bathroom aids usually have suckers on the base which prevent them moving around on smooth tiled or enamel floors.

Non-slip strips are also available which do a similar job. These are stuck to the floor of the bathtub or shower cubical, providing a high friction surface. This reduces the chance of slipping in bare feet, even when wet.

Sitting Down in the Shower

A shower chair might also be a good option for a cubicle or wet room. People with certain disabilities find it more comfortable to sit down while they take a shower. A seat which is suitable for a wet environment is ideal. These have fast-draining textured sitting surfaces along with non-slip feet. They are also made of non-corrosive materials.

A shower chair will usually be very lightweight, with aluminium legs and a plastic seat. Non-rusting screws, which won’t create unsightly marks in the shower tray, fix the chair together. It is important to make sure the chair you choose fits the cubicle floor. Check the footprint measurements before ordering.

Remember that in many cases the shower chair might require moving in and out of the cubicle as and when needed. This is particularly true if one is sharing the bathroom with other people. This means it should be as light as possible, without losing stability.

Ensure you choose one with non-slip feet. The feet, known as ‘ferrules’, are a critical safety feature. They make it much less likely that the chair will slip, even under the running water of a shower.

Bending down to scrub one’s feet and toes is difficult with certain disabilities or chronic conditions. There are various long-handled tools with scrubbers or sponges on the end, which help. Another option is to fit an upturned scrubbing brush to the floor of the shower. These attach using suckers and provide an excellent means of scrubbing the soles of one’s feet.

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Wheeled Mobility Aids

Mobility aids with wheels are key for all sorts of tasks around the home. If someone struggles to walk unaided, they are perfect for a number of situations. Injuries or conditions which affect the ability to walk impact millions of people in the UK, leading many to seek equipment which might help.

While sticks and canes offer useful support for walking, sometimes they are not enough. Stability can be an issue and if the person’s balance is also impaired, standard sticks can be dangerous to use. This is especially true if the individual concerned lives alone.

Suffering a fall can result in serious injuries, particularly to elderly people. Fractures occasionally lead to infection and other secondary medical conditions. Those living alone are vulnerable to falling and possibly having no way of raising the alarm.

Tripods, Tetropods and Walking Frames

Tripod or tetrapod walking sticks provide options if a standard walking stick is not stable enough to be safe. These have three or four legs and offer greater stability than traditional sticks. Even when made of lightweight aluminium, the drawback with these walking aids is that they are comparatively heavy to use.

For the elderly, this can be a problem, so they instead look to more substantial aids.

Walking frames are a great way of getting around the home. These are available with wheels and are usually made of lightweight materials, so are easy to control after some practice. Some come equipped with on-board storage, so you can easily carry objects from room to room. These storage devices are sometimes called walking frame caddies.

If you have narrow corridors, consider the width of frame you require before making a choice. Some extra-narrow frames are available, which might be a good option in limited space.

For the kitchen or dining room, trolleys are a great way of offering support. At the same time they help transporting food and drink from the work surfaces to the table. Often they have shelves for this purpose.

These wheeled kitchen trolley typically have casters on each leg so are easy to manoeuvre. Equipped with four wheels, they are both stable and practical.

When outside the home, the most common form of wheeled walking aids are rollators. These have either four or three wheels and are great for trips to the shops. Four-wheeled models usually feature a basket and a seat.

The seat provides a convenient resting point if you need a break from walking. Usually a brake system will be in place which prevents the rollator from rolling while the seat is in use.

Some modern models look radically different to a typical rollator. They have sleek geometry and attractive colour schemes. Some have bicycle-staying lever brakes.

An Over Bed Table?

In the bedroom and over bed table with wheels can be a useful aid. These have legs which are nearly flat to the ground. Their small wheels are able to roll underneath the bed itself, positioning the table-top over the legs of the person in bed.

The same principal applies to an over chair table. Again the legs slide under the chair, allowing the table top to be accessible to the person sitting down.

Using an over bed table is convenient to allow eating and drinking, providing access to reading material, an Ipad or laptop. For those spending extended periods bedbound, they are a useful living aid.

It is important to check if the over chair table you are considering will fit the armchair or sofa you have in mind. Similar to divan beds, a small clearance gap under the furniture may cause problems. Make sure that you know the clearance the table requires in order for its legs to fit under the furniture concerned.

Sometimes models with wheels need more space in this respect than those without. Some designs don’t have wheels at all and the legs simply slide on the carpet beneath the chair. These models tend to require less clearance space.

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Reduced Mobility Can Lead to Prolonged Periods in Bed

Many medical conditions lead to people having to spend long periods in bed. While this may be necessary for recovery, it presents practical problems requiring solutions.

Equipment to Consider

If going to and from the bathroom is difficult and incontinence is an issue, products like bed pads, bed pans and portable urinals come into their own.

Pads of various types are available and offer different degrees of absorbency. They work by absorbing liquid away from the skin, protecting the user and the mattress. Many modern bed pads are disposable, but washable versions are still available. These are an economic option for long-term use.

Disability aids like bed pans are available, some with a ‘slipper’ design. These slide beneath the user’s body while they remain in bed. These are wedge shaped, making them relatively easy to position. While still somewhat uncomfortable to use, they provide an option if it is impossible to get out of bed at all.

Other more bulky designs of pan require more mobility to use. Realistically, all bed pans require someone’s help in order to dispose of their contents and keep clean for reuse.

Portable urinals are available with special openings designed for either a man or a woman. They usually have lids, make it easier to dispose of the contents of without spills. It is important to clean them thoroughly when in regular use.

Commodes are another option, but these require the user to have the capacity to move from bed into a chair. Various types are available, including those will look like regular pieces of furniture and blend in with the room.

Others have wheels, so the user can travel to the bathroom, if necessary. These models tend to look less like regular pieces of furniture but are practical and robust.

The impact of staying in bed for long periods with little movement can also stretch to pressure ulcers. Also knows as bed sores, these can be painful and difficult to treat.

Special pressure mattresses, cushions and pads are available to help limit any damage to the skin. Fleece bed socks, elbow pads and knee pads may also make a positive difference. They protect the skin in bony parts of the body, reducing the chance of sores developing.

Other handy disability aids for the bedroom are over-bed tables. These slide across the bed, providing a stable platform for plates, drinks or any other item the person needs. These tables are usually height adjustable and easy to wipe clean. Most models have wheels, while some have legs which slide under the bed. This type is useful for divan beds, if there is only a small clearance gap at floor level.

Many conditions which leave one bed-bound for long periods also have their effect in the bathroom. If the individual is mobile enough to reach the bathroom, it is important to correctly equip it for their use.

Getting in and out of the bath might be impossible, so a shower might be the only option. Even then it may become hard to stand up for its duration without support.

If this is the case, a shower seat might be the answer. They are available in fold-down or free-standing models with three or four legs.

A shower seat with four legs is usually much more stable. This makes them safer to use in a cubicle or a wet room. Non-slip feet on the base of each leg make the stool less likely to slip. Models which fold up against the wall are useful for saving space. They are ideal if the shower are is relatively small or used by other people.

It is important to select a shower seat designed specifically for use in the wet. These will have non-slip feet as well as non-rust parts, ensure stains do not become a problem. Most have easy-drain patterns on the seat itself, ensuring water rapidly runs away. This means the user is less likely to slip.

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Choosing Using Rollators or Wheeled Walkers

As people get older, they often require assistance doing the things they once took for granted. Using modern equipment to help makes sense for a number of reasons. Many products are now available which make life much easier and increase mobility.

Arthritis is a condition which affects millions of people in the UK. It causes stiffness and pain in the joints. Routine tasks like walking to the shops can become arduous if the condition affects your legs or hips. When using walking sticks or elbow crutches becomes painful, many turn to wheeled walking aids.

Under these circumstances, people often use wheeled walking frames called rollators, to help. These are available with either two or three wheels and offer a rolling support platform for the user.

Weight

Lightweight rollators are now available which are easier to steer and control than older models. When wheeled walking frames first came on the market some decades ago, they were usually made of steel. This made them both heavy and prone to rust.

Aluminium rollators are now the most common in the UK. This material is both strong, light in weight and much less corrosive than steel. Using it makes rollators practical and in some cases less expensive.

Weight is an important factor when choosing mobility aids. Rollators frequently require lifting on and off of public transport, so keeping their weight as low as possible is helpful.

Four or Three Wheels?

Safety and stability is another consideration. Four wheeled models tend to be the most stable. Distributing pressure to the four corners of the frame creates a solid platform. These four-wheeled walking aids often have an integral seat. Some seats offer a backrest made of padded material. This feature is useful if you need a rest mid-walk, something many elderly people are grateful for!

Three-wheeled rollators do not have a seat, but are usually slightly easier to manoeuvre. The downside is that without a wheel in each of four corners, they are less stable. Being generally smaller and lighter, some people prefer them because they are easier to lift.

Fold-Down Walking Aids

Ease of storage is also a factor when choosing mobility aids like wheeled walking frames or rollators. Most modern designs fold down to save space when not in use. They are usually easier to lift while collapsed.

When choosing a frame, make sure that it folds down to the size you require for easy storage. You might also want to consider if the frame has a clip which ensures it stays folded until manually released.

Hand Grips

Handles and grip materials vary from model to model. Some rollators simply have bare tubing, while others have plastic or rubber grips which offer great comfort. If the tube is bare, you can apply tape, similar to that found on tennis racquets, which improves comfort and grip.

If you are using the walking aid for substantial journeys, you might want to consider rollators with comfortable grips. Some rollators have ergonomic handles, shaped to the contours of human hands.

There are some walking frames which have forearm troughs rather than handles. People with severe arthritis in their hands often find these frames more comfortable. They reduce the stress and weight going through hands, diverting it instead to the forearms.

Your occupational therapist would be able to give you advice on the suitability of these special mobility aids.

Brakes, Baskets and Bags

Rollators for outside use all have brakes fitted so they do not roll down hills of their own accord! Some are similar to those you find on bicycles, operated by pulling a handle-lever towards you with your fingers. These provide the chance to slow down the rollator, if you find it is going too fast downhill.

Another common brake found on wheeled walking frames is the pressure brake. These lock with downward force. Unlike the lever brake, pressure brakes are either on or off and can’t slow the rollator down when it is moving.

On-board storage is another feature offered by most modern rollators. Usually there will be a basket under the seat on four-wheel models. Three-wheelers often have facility to hang a bag from the front.

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