When looking for an assistive device, keep in mind what support you will need and when you would use it. Will you need your assistive device temporarily or for the foreseeable future? Don’t let price sway your opinion. Buying a cheaper product will give you cheaper support. On the other hand, the most expensive is not always the better one. Compare your needs with durability and stability. Most of all, find a device that feels right to you.
Folding walkers are used by those who have poor balance but are still able to walk, or anyone who needs to take part of their weight off their legs. Folding walkers can be adapted with wheels or small plastic skis so that you can push the walker rather than lifting it between steps.
Rollators are usually equipped with a basket or back and have a seat to sit if you or the person you are caring for gets tired walking. These devices typically have four wheels so they move easily and a breaking mechanism. Careful assessment by a therapist is required to ensure that you or your loved one can use this device safely, as it may tend to get away from you.
A transport chair may be appropriate for someone who is able to move over short distances, but has trouble getting around over longer distances. As a caregiver, you will be required to push the chair, however sitting it in this chair for long periods of time is not recommended. This chair is relatively lightweight and can fold up to fit in the trunk of most cars.
This category incorporates many different types of wheelchairs, from a standard folding chair to ones that tilt and recline. Most have removable footrests and height-adjustable arm rests. As with shoes, chairs come in many shapes and sizes and it is important to have one that is specifically fitted. A chair will generally last approximately five years before requiring replacement, although this may vary depending on the wheelchair and how much it is used. A change in a condition may necessitate an earlier change of chair.
Cushions and back supports
Many different types of seat cushions and back supports are available. It is rare for a wheelchair to be prescribed without a cushion because cushions are important for comfort and to help prevent some medical complications such as pressure ulcers. You can expect a cushion to last between two and five years, depending on the materials it is made from and its use.
A scooter is a great way to increase outdoor mobility and independence if you or your care charge are able to walk within their home, but struggle with outdoor mobility. If the scooter is being stored outside, it needs to be located in a secure, sheltered location with easy access to an electrical outlet. Consider discussing your options for storing and charging the scooter with the therapist or sales representative prior to purchasing the scooter.
A power wheelchair may be most appropriate for anyone who is unable to ambulate in their homes and cannot propel a manual wheelchair. Different types of controls are available for driving the chair, ranging from joysticks to head controls. The therapist will be able to determine the safest way to drive the chair and whether this type of device is appropriate.
Power wheelchair with power dynamic positioning
Thisis a power wheelchair equipped with power tilt and/or power recline. These functions allow clients to change the angle of the seat and back to enable them to change their position in the chair. This type of equipment is often recommended for those who need a power wheelchair, but have also lost their ability to shift their weight or reposition themselves.
Bathroom safety equipment
Many falls happen in the bathroom and often result in injury. Investing in bathroom safety equipment (e.g., raised toilet seat, commode, grab bars, bath bench) if you or your loved one has decreased mobility may help to prevent falls.
Raised toilet seats fit on top of the bowl to raise the sitting surface, making rising from the toilet easier. A bath seat or bath bench goes inside the bathtub or shower and can give a seating option while bathing. The height can be raised, again making rising easier. Also, a commode can be placed by the bedside to avoid having to get to the bathroom in the middle of the night.
The importance of grab bars cannot be over stated. We often try to hold towel racks, soap dishes or vanities for support and balance. These devices are not designed to support a person’s weight and are likely to give way.
Home accessibility modifications
For those with decreased mobility, some modifications to improve accessibility both outside and within the home may be required. A folding ramp may be an appropriate temporary solution to negotiate a few stairs at the doorway. A stair glide should be specifically designed if the staircase has a curve to it.
Many other home modifications are also are possible. A therapist can complete an assessment to determine the adaptations needed and help with getting cost estimates.
Therapeutic support surfaces (powered and non-powered)
Therapeutic support surfaces are either placed on top of the bed mattress or take the place of the mattress altogether. This type of device is often prescribed for people at risk of or who currently have a pressure ulcer. Check the manufacturer’s warranty information to determine the expected lifespan of the equipment.
Transfer and repositioning equipment
The ability to move from one surface to another—from the bed to the wheelchair, for example, or from the wheelchair to the commode—is critical to keeping our aging adults in our home environments. Many different pieces of equipment (e.g., ceiling lift, sling, repositioning sheets) are available to assist with these transfers and repositionings. Ceiling tracks with a sling can provide a lift, without having to store cumbersome equipment.
Adapted van and other vehicle modifications
An adapted van may be required for traveling long distances. A variety of modifications can be made, including driving controls, ramps, lifts, lowered floors and tie-down systems. A therapist specifically skilled in vehicle modification can be helpful in determining the most appropriate modifications.
The funding available and the processes used to access such funding vary greatly by province. In some cases, devices may rented or obtained from a loan cupboard. Once again, a therapist is an indispensable resource in helping to identify possible sources of funding and whether rental or loan equipment is available. Some sources of funding are listed in the sidebar; however, this is not an exhaustive list.
Many of us have extended health insurance. It is critically important to read the documents that outline the specific coverage. There are quite a few policies that will contribute to the purchase of one wheelchair or have a limited amount of funding available each year in this category.
Future needs should be considered before accessing this funding. For example, if your or your loved one has a deteriorating illness and currently needs a manual wheelchair but will likely require a power wheelchair with power dynamic positioning in the future, it makes sense to “save” the insurance funding for the more expensive piece of equipment.
It is important to budget for assistive technology, but also for a therapist’s assessment. Involving a therapist in the process of obtaining equipment will ensure that clients receive the most appropriate equipment, have access to potential sources of funding and have appropriate consideration given to both current and future lifestyle and needs.
Linda Norton, MSCH, BSc, OT, OT Reg (Ont), is the Rehabilitation Education Co-ordinator with Shoppers Home Health Care.