How to Make the Most of Wheelchairs

According to NHS figures, there are 1.2 million people using a wheelchair in the UK. With two-thirds of these using them regularly, there is a growing requirement for accessories to enhance them. Probably the most important of these are wheelchair ramps. Their correct installation makes areas of the home and outside much more accessible.

Ramps to negotiate door thresholds can be key pieces of access equipment. Installing these in doorways greatly improves wheelchair access. Most thresholds only provide a barrier of a couple of inches in height. Still, this can be enough to cause problems if you are using a chair or a wheeled walking aid.

Thresholds typically require ramps providing a slope on either side. Rubber or flexible plastic is a good material for the job. Modular units offer a good choice for this situation. These have small parts which fit together to create the desired height and width of the ramp.

These are great for wheelchairs, as well as for someone using a walking frame with wheels, or a rollator. Many modular ramp systems are quite heavy, preventing them slipping or sliding out of position when in use. The rubber versions have high friction with the ground, useful if they are on a hard surface.

Even for relatively small obstacles like thresholds, it is important to ensure that the ramp is not too steep.

Away from small threshold ramps, there is a huge range of more substantial wheelchair ramps available. These are great for steps, curbs and rough ground. Most modern ramps are aluminium because of its relative light weight and resistance to corrosion.

Many ramps have a high-friction rolling surface, to minimise the risk of slipping. Using textured plastic or an abrasive pattern in the metal itself are common methods.

While suitable ramps are among the most useful wheelchair accessories, there are a host of others which can enhance the equipment. Clothing made for wheelchairs is one area which has seen great strides in recent years.

Weather Protection for Wheelchair Users

For those living in the UK, dealing with changeable weather is an every-day consideration. Luckily there are now many specially made garments for wet weather. These range from poncho style rain coats, to fleece lined all-in-ones, offering head to toe protection.

Garments like this are available with or without hoods and with a choice of inner lining. Depending on the weather forecast, there is clothing for every eventuality!

Mobility scooter rain macs are typically of the poncho variety. Often these stretch out in front of the user, covering the handlebars and controls. This prevents them getting wet, along with the hands of the user.

They usually have a see-through section, allowing the user to see the controls.

Some people prefer leaving their mobility scooter or wheelchair outside the house rather than bringing it in. To protect it from the elements, a waterproof cover is a good idea. It is important to securely fasten any cover to ensure it is not a risk from blowing away in the wind.

Other creative wheelchair accessories help personalise them. Colourful hubcaps are available in various designs, for example. These clip to the spokes of the wheels. Colourful transfers are also great for brightening-up the paintwork.

A ‘wheelybrella’ is another clever product which helps keep the rain off. These are essentially umbrellas which have clamp on the end of a flexible shaft. This fixes to the back of the wheelchair, allowing the hood of the umbrella to open above the user.

A wide range of bags can fit to various parts of a wheelchair or mobility scooter. The most popular are those which attach to the backrest or pushing handles. They usually adhere using simple straps, which fasten with Velcro or popper catches.

Available in various sizes, these bags are ideal for visits to the shops. Side bags are also available which strap to a wheelchair’s armrests. It is important to note that many of these are not suitable for chairs with large rear wheels. Instead, they are for assistant-propelled ‘transit’ wheelchairs with small rear wheels.

Other popular ‘extras’ for wheelchairs include trays which attach the armrests. These fold-down out of the way when not in use.

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Measures to Avoid Pressure Injuries

Issues arising from staying in bed for long periods can be significant. For those recovering from surgery, or living with certain disabilities or illness, one may be at risk of pressure injuries. Usually called pressure sores or ulcers, these cause discomfort and pain.

Sites of the body where bone has only a thin layer of skin tissue are most at risk. These include ankles, knees, elbows, hips, heels and the tailbone. Often these areas become inflamed before the skin breaks.

Sustained pressure restricts the blood vessels supplying the skin with nutrients and oxygen. This pressure damages the flow of blood cells, leading to localised skin death. This manifests itself as a pressure sore.

There are four grades of pressure ulcer. Symptoms range from reddening of the skin, through to wounds which penetrates right through the various layers of skin. In the most serious cases, the lesion may be as deep as the underlying bone or muscle. If left untreated these sores can become infected and lead to secondary problems.

When a patient is bedbound following an operation or because of chronic illness, they are most vulnerable. Fleece pads for the heels, ankles and other parts of the body are available. These act as cushions, reducing the risk of sore development.

Someone using a wheelchair might benefit from a pressure relief cushion. They are available in different depths and dimensions to fit most chairs. Various types are available, ranging from foam based units, to those which are air-filled and require inflation.

Some cushions have pockets of gel within them. These have weight distributing qualities which ease stress on the body. Often the main part of the cushion is foam, with gel section or sections within it.

Another design is the ‘nodular’ pressure relief cushion. These have nodules or pockets filled with air, foam or gel, which allow air to move in between them. As well as their pressure distribution properties, this air circulation is great for keeping the backside cool.

Other Useful Equipment if You Are Spending a Long Time In bed

Getting dressed unaided is another problem encountered by people with restricted mobility. Stroke often leave people with reduced dexterity in certain parts of their body.

This may make it difficult to put on and take off clothes. While in many cases one might need a carer to help, there are tools which make it easier to dress oneself. ‘Dressing sticks’ for example have a hook and loop on the end and are useful in a variety of ways to aid the user. They are especially useful if you suffer with inflexibility of the upper body.

Other devices help with putting on socks and shoes. While these require practice, they do work for many people.

An overbed table is another piece of equipment which is useful if you’re spending prolonged periods in bed. These are height adjustable so they can be set to suit most beds.

Similar to those found on hospital wards, they have legs and feet which roll or slide under the bed, positioning the table top above the bed-covers. When not in use, they are easy to roll out of the way.

Great for books, laptops, meals and drinks, an overbed table is a great piece of kit if you’re stuck in bed. Some can be set to tilt at an angle of your choice, which can be good for tablet screens or open books and magazines.

Many have a ridge extending around the edge of the table top. This prevents objects from sliding or rolling off onto the floor.

Be careful to ensure that any overbed table you choose has the correct weight capacity for its intended use. The models found in hospitals tend to be more robust than domestic versions.

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Design of Disability Equipment Changing for the Better

The design of rollator walkers is an exciting area of change. New models have better wheels, lighter frames and smoother folder mechanisms. Because most people using this type of equipment tend to be frail or have limited mobility, all of these developments are significant.

Moving On From ‘Bone Shaker’ Walking Aids

Gone are the days of heavy units made of steel. While these were stable, their weight made them both difficult to control and for many people, almost impossible to lift. Disability aids of the 1970s and 80s were frequently ‘bone-shakers’. They rattled down pavements with hard, tiny wheels, heavy frames and frequently had no brakes.

Larger, softer tires have made a big difference. These absorb impact and make a walker a smoother to use. Usually the tires a solid varieties, rather than pneumatic versions found on bicycles.

Many people take their rollators on buses. This means lifting them on and off the bus at either end of the journey. With steel framed models, this is very hard and may need help from a third party.

Weight Counts!

An aluminium framed rollator walker is a different matter. These are lighter and much easier to lift. So whether it is travelling by bus or simply transporting the rollator in the boot of a car, the process is much easier.

Weight has long been a key issue for a variety of disability aids and heavy materials make a poor choice for walking sticks, for example. In the old days, the only readily available metal vaguely suitable was steel, but this was both heavy and prone to rust.

Wood or Metal Walking Sticks?

For many years, wood was the only realistic material for a walking stick. While it remains popular today, aluminium has also become a realistic choice. Aluminium tubing is both strong and rigid, making it great for walking sticks. Unlike steel, it is also light in weight and does not rust.

Metal walking sticks have an advantage over wood because they are adjustable to fit the user. A pin-clip system is common, allowing a lower tubing section to be set at the desired length. While wooden walking sticks adjust in length simply by sawing them down, many people prefer the metal option.

Rubber Feet Don’t Slip!

An important extra part for either wooden or aluminium walking sticks is the ‘ferrule’ at the bottom. These are rubber or plastic feet which make the stick less likely to slip when in contact with the ground. These are particularly valuable when it has been raining.

Ferrules are also required for crutches, along with other disability aids like shower chairs. Anything which involves metal tubing rubbing against hard flooring needs a ferrule to create friction.

Ferrules vary in quality. It is important to ensure it has an internal metal disc which fits against the foot of the walking stick. This is especially vital for aluminium sticks. If this disc is missing, the tubing will rapidly cut through the rubber of the ferrule as the stick is in use. Once the tubing comes through and makes contact with the ground, it is likely to slip against the surface.

Special Handles Spread the Weight!

Another important component for walking sticks is the handle itself. With most wooden sticks, this is quite narrow and can dig into the palm of the hand. This is likely to cause pain as time goes on, especially in those with arthritis of the hands.

Most aluminium models have ‘ergonomic’ handles, shaped to fit the grip of the user. These spread weight evenly, making them more comfortable to use.

The same applies to a rollator walker. It is now common to find models with anatomically shaped handles, making it comfortable to use the walking aids for longer periods.

Most wheeled walking aids collapse down so they can be easily stored or transported in a car or on public transport. Down the years, the mechanisms have improved. Because those using these devices tend to have limited strength, this is a valuable advance. Now, many of them fold up with a simple gentle pull of a lever.

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‘Takes Steps’ To Find the Right Mobility Equipment

Modern mobility aids can make a big impact in some people’s lives. There are many different types available, including a wide range of walking aids. If you have limited mobility through injury, illness or disability, you may find there is something out there which is just right for you.

Crutches, walking sticks, walking poles are all good examples of commonly used aids. On top of these, wheeled walking equipment like rollators are also available. All these devices help with your balance and provide support as you walk. They can help when you are walking inside or outside the home.

Select the Correct Size
 

It is important to make sure you choose a walking aid which is the right size. Consulting an occupational therapist should always be your first port of call. In terms of sizing, as a general rule of thumb, the walking stick handle should be the height of the crease of your wrist, when your arms hang down to your sides. It is the same when you are choosing a walking frame for use at home.

This also applies to the height of the handles if you are using a rollator for outdoor use. It is important to ensure that a rollator is the correct size for you. If it is too small, you will find yourself stooping forwards. This puts pressure on the back.

If the rollator is too large or the handles too high, the user’s shoulders may hunch upwards, which can lead to shoulder or neck pain. Most models have adjustable handles, so they can easily be set to the correct height.

Rollator Wheel Size and Brakes
 

Four wheeled and three wheeled walkers are widely available. The most stable models are those four wheels. But the three-wheelers can be slightly easier to manoeuvre and are usually more compact.

Larger wheels on rollators tend to be better if you need to climb kerbs regularly. Wheeled walkers for indoor use usually have smaller wheels. Modern models have 360 degree swivelling wheels, providing excellent control.

Most rollators have brakes. In most cases these are similar to those found on bicycles. Before making your choice, ensure that you have the finger and hand strength to operate them.

While the mechanisms are usually lightweight, if you suffer from arthritis in your hands, it could cause issues.

Most brakes are lockable. This means you can engage them, remove pressure and they will not disengage. This is a useful safety feature designed to make sure the rollator does not roll away on its own!

Locking brakes are also good if you want to have a rest and use the rollator as a seat. Four-wheeled mobility aids like this tend to have an in-built seat between the handles. Usually there is a back-rest fitted too.

Many of the seats flip up to allow the rollator to collapse down, either for storage or to go in the car boot. Others feature a wire basket underneath the seat, great for small bags of shopping.

Other wheeled mobility aids include substantial items like wheelchairs and mobility scooters. Some people only need this type of aid at certain times. They may find that for the longish journey to the shops they use their scooter, then get out and walk around the shop itself.

They may be able to do this without help, or possibly with the aid of walking sticks or crutches. Some bags for wheelchairs and scooters have special high pockets on the sides made to hold crutches or sticks. The bags usually attach the back of the chair and many are of substantial size, great for food shopping. Side fitting ‘pannier’ style bags are also available. These fit to the arms of mobility scooters, providing extra carrying space.

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How to Aid Recovery After Joint Replacement Surgery

The UK’s National Health Service (NHS) is conducting more knee and hip replacement operations than ever before. Surgery in many cases provides ageing people with greatly improved mobility. But joint replacements are major undertakings and inhibit one’s range of motion in the period following the operation. In the initial weeks and months of recovery, the individual may need help to aid mobility.

Sitting Down and Standing Up

One key issue in post-op recovery is using the toilet or bath. The process of sitting down and standing back up again can be particularly difficult after hip surgery. The stiffness and immobility associated with the recovery period is significant.

Many people choose to have support rails installed in the bathroom. Positioning them next to the bath and toilet makes the most sense. In addition to this, a disabled toilet seat may make a difference. Some seats are available which raise the height of the WC. This means there is less distance to travel from a standing position to a sitting one and vice-versa.

A standard toilet seat usually has a height of around 16 inches from the ground. Many raised units increase the sitting height by two, four or even six inches. Lower padded seats may fix the existing seat with some kind of strap. Larger units which give a raise of more than two inches, fix to the toilet bowl itself.

Turn-clamps typically attach the seat to the WC, providing a firm sitting platform. It is vital that these clamps are tightly adjusted, making the overall unit stable and safe.

For those living with the stiffness of a new hip or knee, this makes a big difference. Losing one’s range of motion can come as a shock and it is important to take steps to adapt.

Another type of disabled toilet seat features a cut out section. Usually made from firm padded foam, these seats are comfortable to sit on. Sometimes these have the same basic shape as a standard toilet seat. In other cases there is a cut-out section at the font, allowing easy access beneath the body. This makes for easier personal cleansing.

A more specialist cut-out raised toilet seat has a large section missing on one side. This design is for people who are unable to bend their leg and must keep it straight. The straight leg fits into the cut-out area, allowing them to use the toilet.

Another type of seat has arm supports fitted to it. These project upwards on either side, providing two handles which the use can use to lift themselves up or lower themselves down onto the seat. These substantial units fit securely to the toilet bowl itself. A loosing fitting could create imbalance and lead to injury.

These raised seats are ideal of the user has limited range of motion in the lower half of their body, but good strength in the upper body.

Sitting Down at Shower Times

Elsewhere in the bathroom, a shower chair or bath board fitted across the bathtub may help. If standing for the length of the shower is difficulty, a sitting platform could be the answer.

Ensure that any shower chair you opt for is suitable for wet conditions. This means non-rusting parts and drainage holes in the seat. Non-slip feet are also important. These prevent damage to the shower floor and also guard against accidents.

Folding seats are available which collapse back against the wall of the shower cubicle while they are not in use. This makes them excellent space savers and they often an ideal solution if more than one person uses the shower. Because they bear the whole of someone’s weight, it is important a qualified tradesman installs them. They will take into account the types of fixing required and assess the wall for suitability.

A free-standing shower chair on the other hand, will usually have an aluminium frame. This is a lightweight metal and less likely to corrode than steel. In most cases it is easy to move these chairs in and out of the cubicle as required.

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Think About Alternatives When Using The Toilet Becomes Hard

Toileting aids used outside of a conventional bathroom play a part in the lives of many people in the UK. Certain physical conditions reduce mobility, making using the WC more difficult. Fortunately there are options to make life easier.

Commodes

In these circumstances, a commode chair might be a useful piece of equipment. For those spending extended periods in bed, it may become a routine-use item.

Before deciding which one you need, consider carefully the space you have available. As they tend to be next to a bed, it is wise to measure the area to ensure it is adequate. Many models are available with discreet designs, blending in with the room’s existing furniture.

Some commodes are foldable and easily stored away in a cupboard when not in use. Usually this type has a steel or metal frame with plastic components. Make sure you select one which is easy to clean.

Bear in mind that in many cases you will need someone to help you fold and unfold the chair. This person will also need to empty and clean the commode pan after use.

Many people need a carer to assist you in getting on and off the commode. It is important the commode chair is stable through this process. Transfer boards are useful to bridge the gap between bed and chair.

Think too about the height of the bed. In terms of its compatibility, it is helpful to ensure it is not unusually high or low. Grab rails fitted next to it may in some cases make patient transfer an easier process.

A commode chair can be an essential piece of kit if you find yourself unable move upstairs at home. Reduced mobility can make staircases serious obstacles. Some in the elderly community find the first floor of their house is impossible to reach, forcing them to sleep downstairs.

In most houses the bathroom is upstairs, which presents its own problems. In these circumstances, someone may choose to use a commode downstairs. For these situations, wooden framed models provide a good option. Many of these are attractive pieces of furniture which are not noticeable. A lid, doubling as a seat, covers the aperture.

Aids to raise the height of a toilet seat

People with many conditions associated with aging find it difficult to use the toilet. The reasons for this can be manifold, but the problem often boils down to difficulty in sitting down and standing back up.

There is potential to alleviate this problem by using equipment like support rails positioned next to the WC. These provide a stable hand hold for the user, increasing their sense of safety.

A toilet frame does a similar job of supporting the individual to access the WC. These move out of the way when not in use.

There are other methods to reduce the distance of travel which sitting down and standing up requires. A common one is the use of a raised toilet seat.

These devices fit either to the toilet bowl itself, or the existing seat above it. Some have clips which fit under the rim, while others have Velcro straps which attach to the seat.

Typically they are foam-filled constructions, with a wipe-clean outer layer. Others are hollow plastic shells, providing a more rigid platform on which to sit. Foam-filled varieties have adequate rigidity, but provide a slightly softer seat.

Both types of raised toilet seat reduce the distance required to sit down. In many cases this reduces the strain on the body, making the toilet easier to use. Most models are available in more than one size. Commonly, these devices can raise the sitting height of a toilet seat up to around five inches.

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Making Bathrooms Safe and Accessible For the Elderly

Adapting one’s bathroom for use in later life requires planning and an awareness of the options. Losing flexibility, strength or balance can all lead to issues. High quality equipment is now available which improves both safety and mobility. Sustaining independence in the bathroom is important to many people and selecting the correct aids can help.

Sitting Down in the Shower

A folding shower seat fits to the walls of your wet room or shower cubicle. They are stable when in use and save space by folding back against the wall when not required. It is important to fix the seat at the correct height, so make sure you think carefully before installation. In the UK, your occupational therapist should guide you in terms of its best position.

An OT should also be able to advise you on the positioning of any bathroom grab rails. Locate these at points which complement the folding shower seat. For safety reasons, it is crucial that a qualified tradesperson installs both the seat and grab rails. They need to understand the materials of the wall and the appropriate fixings. A poorly fitted seat or rail can easily lead to a fall and serious injury.

While less stable than a fixed folding seat, freestanding shower stools and chairs are also available. If this is your choice, make sure the floor of the shower is flat enough. Many shower trays have quite deep grooves or undulations, making them unsuitable for a freestanding shower seat. Again, your OT should be able to help you.

Accessible Baths

For people who still like a soak in the bath, special bathtubs are available. Many elderly people find it hard or even dangerous to climb in and out of a normal bath. Walk-in baths have a door cut into the side. One factor against this type of bath is that they require filling while the person is already in and the door sealed shut.

For many people making a conventional bath more accessible is a more practical solution. Stable bath steps can make it easier to make the step into the bath. These have non-slip stepping surfaces, reducing the chance of slipping in the wet.

A bath seat sits within the bathtub itself. These effectively raise the height of the bath’s floor, meaning less distance of travel for the user. Most seats have suckers on their feet which stop them slipping. A grab rail fitted to the wall immediately next to the bath may provide a valuable point of support when using either bath steps or a bath seat.

Some baths are available with an integral moulded seat at one end. While these do require more installation budget, they work in the same way as temporary seats, enabling the user to sit at a raised height.

Walk-in Showers, Baths, Lifts and Hoists

For people with severe mobility restrictions or reduced strength, hoists and bath lifts are available. These are substantial pieces of equipment and physically carry you weight in and out of the bath. An OT would need to assess you for this type of equipment.

A walk-in shower is another option, if getting in and out of the bath is difficult. These have shower trays which are level or almost level to the ground, meaning there’s no step as you walk in. Suitable internal grab rails work well in combination with this type of shower.

Easy-turn Taps

Controlling temperature and the flow of water on or off can also become hard if you have lost strength in your hands or fingers. Conventional taps may stiffen over time and become difficult to turn. Large single lever taps provide more leverage and are a good alternative.

If you live in the UK and have a disability or chronic condition preventing you using the bath, you may be eligible to get a grant to adapt your bathroom. Contact your local social services if you think you might qualify. An OT who is fully aware of your situation would be able to advise you in this area.

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