Let’s Talk Toilets!!

Seriously, let’s talk toilets. Face it, we all know that a poorly designed bathroom creates a scenario that could lead to a fall. Toilets, which every human being uses multiple times a day, are often squished into narrow and inaccessible spaces in a bathroom to make room for a shower and sink. Then forget how the door has to swing into that space as well!  

Unfortunately, one of the rooms that we use the most in our homes is often the smallest. Let’s tackle this potentially hazardous situation. There is much to consider.

Are all of the people in your home currently physically healthy? Are you in that aging population? Do you have people, parents or grandparents, visit your home who find the space challenging?

Toilet considerations:

  • What is the height of the toilet?
  • Is the toilet too close to a wall?
  • Are there grab bars nearby but not close enough for you? Or no grab bars at all?
  • Are you using a sink to assist with your sit to stand?
  • Do you feel like you are going to fall into the bathtub every time you get near the toilet?
  • Do you have adequate space to manage your clothing when you are using the toilet?
  • Are you having to twist to reach the toilet paper?
  • Men, would you benefit from a grab bar on the wall behind the toilet due to poor balance when urinating?
  • Do you find yourself pushing off the toilet seat or reaching for a door jam or counter to hoist yourself off the toilet?
  • Do you have visitors to your home who use a walker and have to leave the walker outside the bathroom and hold onto walls and counters in order to get to the toilet?
  • Is there space nearby to store/access items you may use in conjunction with toilet activities? Items such as toilet paper, pads, catheter supplies and more.
  • Can you safely walk to a toilet at night?
  • Do you dislike the add on raised toilet seats due to slipping, moving or too small of an opening?
  • Do you have added equipment in the bathroom creating a tripping hazard?
  • And the list goes on!

Occupational Therapists (OTs) who are Certified Aging in Place Specialists (CAPS) are THE profession to discuss toilets and toileting with. We are medical professionals and are not shy about discussing the tools to make this human “occupation” safe.  We look at bathroom design in a functional and comprehensive way in order to create an environment that works for you and your family. 

MEETING A NEED WITH VERMONT INGENUITY

Wait… WHAT? A pre-fabricated mobile unit that is already designed to accommodate physical dysfunction? Can this really be true? The answer is YES!!

Wheel Pad is a Vermont business that creates a product designed to do exactly this! They have designed and constructed a structure that is everything an Occupational Therapist dreams about for our disabled and/or aging population. Do you have a family member or friend that you would like to live in your home but you just don’t have the space? Keep reading!

Wheel Pad designs home attachments and backyard tiny houses that make any property a safe and cozy universally accessible place for people with mobility challenges. Their aim is very similar to that of Home Mobility VT however Wheel Pad units are prefabricated and designed to accommodate a changing family by attaching the units to your existing structure.

As a Certified Aging in Place Specialist Occupational Therapist my passion is helping people, families, discover options that make sense for their life circumstances. I assist with adapting a current home into a space that makes sense for the people living in the home but what if you have a family member that you would like to come live with you but you don’t have the space available? Do you have a parent or family member who isn’t appropriate or doesn’t want to move to an assisted living facility? Or a family member who had an accident or has a progressive illness and are in need of additional square footage due to equipment and needs?

Wheel Pad has two main products: The +Add PAD home attachment and the Personal Accessible Dwelling (Affectionately, The PAD) accessible tiny house. Both of these models exceed ADA specifications. They come with a track in the ceiling that is compatible with any lift on the market that can take you from the bed area to the bathroom. The bathroom itself is a full wet room to avoid transitioning in and out of the shower, and allows ample space for an aide if needed. The PAD also has an accessible kitchenette for more independent living. 

Wheel Pad also started our WheelPad Buyback Commitment for their smaller and more mobile units (depending on the type of foundation). Once you are finished using the Wheel Pad you can give them a call, and they will most likely purchase it back from you after a third-party appraisal. They do this so it can serve another family in need! So thoughtful and smart!

But they don’t just create utilitarian space! They have won awards for their designs. You can see more photos on their website: (www.wheelpad.com/photos).

Please contact Sherry at Home Mobility VT (https://homemobilityvt.com/) for a home evaluation to determine if this is a path you may be interested in pursuing. I will be happy to complete a home evaluation to help you determine if this is a feasible path for you and your family.

Lucky

Being an Occupational Therapist (OT) is more than just a job, it is who we are as human beings. It is a thought process that flows over into all aspects of our own lives. It’s the core of who we are as humans and we tend to practice what we preach!

One of the many descriptions of what an OT does as a profession is that we educate people on ways to participate in their activities of everyday life with their environment. It is our passion.

What does this actually mean with regards to a Home Modifications OT? It means that we want to help you set up your environment in a way that will be easy and safe for you to use and enjoy comfortably, independently, and safely now and as you age.

I tell people all of the time, if we are LUCKY enough to get older, well, stuff is bound to happen. Unless you have a crystal ball you don’t really know what life is going to throw your way. Home Modification OT’s who are trained as Certified Aging in Place Specialists know that there are many things you can change to your home environment to help you be prepared.

You are you and your environment should and can be adapted to work for you! You should feel happy and relaxed in your home.

As we age many of us will eventually be diagnosed with an illness or injury that could progress and worsen with time. A Home Modification OT, because of our medical knowledge, can help you design your space in a way that works for you now as well as in the future.

Proactive decision making will help you be prepared when and if something happens. If you have your home set up now (proactive), with some basic modifications, you will have to be less reactive when/if something happens to you or a loved one.

Unfortunately, OT’s see this scenario too frequently. It is not at all uncommon for people to put off changes to their environment with the thought process of “oh, I’ll deal with that when I have to” or “I have been healthy so far, I’m good”. Then you fall and break a hip or dislocate a shoulder, or a more unexpected medical event happens. With this you go to the hospital and probably rehab. Before you can go home changes to your home environment will have to happen. The decision making of how to change your environment then frequently falls to family members making these decisions on your behalf. They are not likely to make the changes that you would have made proactively!

I am hopeful that after you read this article that you will reach out to an OT Home Modifications Specialist. We are in every state in the country. Help us to help you!!

Sherry Pidgeon, OTR/L, CAPS, ECHM, CDP

Home Mobility VT (homemobilityvt.com)

Phone: (802) 578-3440 or Email: sherrypidgeon@homemobilityvt.com

Transition Coordinator/ Occupational Therapist

As your loved one prepares to return home after time spent in rehab or the hospital, is their home ready for them? Is it set up appropriately to meet their needs? The burden of managing a patient’s care in our complicated healthcare system is felt most often by the spouse of the patient or the children of the patient. This responsibility can be very stressful for both the spouse and adult children who may still be trying to juggle work with caregiving. It can be almost impossible to manage if the spouse has their own medical issues that limit their mobility or have memory issues that make understanding and retaining information difficult. Here are some things to consider:

1) Are they a new cane, walker or wheelchair user? Is the space they will be living in safe for them to access with or without a new device?

2)    Is the walkway cleared to allow them to enter into their home safely? Will they face challenges getting in/out of the home from the car to get to appointments?

3)    Is the home well lit? Some minor changes can be made to keep an individual safer at night.

4)    Do they have the necessary equipment set up in the bathroom? Are you hearing terms thrown around like: DME, tub bench, grab bars and so on? Will your loved one benefit from having these items in place prior to them returning home?

5)    Will they be set up to live on the main level or will they have the need to access upper-level floors in the home? Will they be able to do this?

6)    Does your family member need to have the fridge stocked for when they arrive home?

7)    Is the family local or out of town? Is there the need to have professional help set up the environment? Re-arrange furniture (as minimal as possible so as not to disrupt accustomed routine but enough to allow for safe ambulation). Alleviate some of the caregiver stress and demand?

There are many things to consider when trying to help a person come home from the hospital, rehab hospital or a nursing home. Things that might not be in your wheelhouse. Or they are in your wheelhouse but you live too far away to help.

Home Mobility VT is prepared to help meet this need. I am an Occupational Therapist. I can evaluate the living space, make recommendations and follow through with helping your loved one through this important process. 

Wait, What? Pretty Grab Bars?

There is much to consider when deciding which type of grab bars to install and where to locate them. As you research online you may become overwhelmed with recommendations from Americans with Disabilities Act (ADA https://www.ada.gov/ada_intro.htm) and/or Universal Design (UD http://universaldesign.ie/What-is-Universal-Design/).

ADA became legislation in 2010 and “prohibits discrimination and guarantees that people with disabilities have the same opportunities as everyone else to participate in the mainstream of American life”. ADA regulations apply to all local, county, state and federal government agencies as well as privately run businesses with 15 or more employees. ADA does not apply to private residences.

UD: The term “universal design was coined by the architect Ronald Mace to describe the concept of designing all products and the built environment to be aesthetic and usable to the greatest extent possible by everyone, regardless of their age, ability, or status in life. (Wikipedia.org)

And because this isn’t enough to overwhelm you, one must consider the third alternative, Accessible Design (AD), a design process in which the needs of people with disabilities are specifically considered. (www.washington.edu/doit/what-difference-between-accessible-usable-and-universal-design)

All of these approaches are fantastic! They demonstrate the regulations and recommendations available to assist people designing spaces that are set up with independence and safety in mind. Grab bars are just one way to help make a home safer and there is no reason to delay installation until they are necessary!

Home Mobility VT strives to assist people who are living in either a home, apartment, or senior independent living apartment to improve their level of independence and safety. Grab bars are a great and relatively easy place to begin. When most people think about where to place grab bars they typically think of the bathroom, and this is not at all incorrect. We place grab bars in and around the shower, toilet and on open walls to improve bathroom safety. Keep in mind, however, that they can also be beneficial in other rooms as well such as the bedroom, kitchen and doorway areas such as out to the garage.

Home Mobility VT is a proud distributor for the beautiful Ponte Giulio bathroom products. On more than one occasion we have heard a client claim “We don’t want our home to look like an institution.” Ponte Giulio is an Italian company with colorful grab bars can either coordinate or contrast with bathroom décor. The vinyl coating makes them softer and warmer to the touch, they are easy to clean and have anti-microbial protection.

“Ponte Giulio manufactures Stainless Steel, Vinyl Coated (anti-microbial) and Designer style accessibility products for both your home and work place such as grab bars, shower seats, ergonomic sinks and accessible shower enclosures”.

DEMENTIA OR ALZHEIMER’S DISEASE HOME ENVIRONMENTAL TIPS

delighted senior father and adult daughter hugging in studio

LIGHTING:

  • Lighting should be soft, not bright however very well lit
  • Night- lights throughout rooms
  • Windows should be covered with blinds and open for natural light during days. Close window coverings at night to decrease glare.

BEDROOM:

  • Put all personal hygiene items in a locked drawer. Many hygiene items are poisonous, nail polish remover, perfumes, shampoos, nail polish, lotions. Position bed facing the bathroom
  • Use cards/colorful photo images to label contents in drawers/cupboards and doors
  • Pictures of your loved one from when they were young
  • Pictures of family with the names of the family members

    BATHROOM:

  •  Always have the SAME towels available and place them in same location for easy access
  • Use non-slip mats, *shower chair and *grab bars
  • Keep toilet paper in same location and within easy reach of the toilet
  • If the sink is white, consider colorful stickers to help it be visible
  • If the bathroom FLOOR is shiny it may appear WET which could lead to your loved one becoming anxious and move unsteadily when entering bathroom.  Change the floor or eliminate the shine. Avoid wavy lines, stripes or changes of color between rooms if possible.
  • Toilet: if identifying toilet is becoming difficult consider changing the color of the toilet seat to create contrast. Consider the height of the toilet and installation of grab bars for safety concerns.
  • Keep household water temperature at or below 120F

ALL ROOMS:

  • Remove all clutter and tripping hazards (cables/wires running across the floor)
  • Remove area rugs OR tape down edges
  • Keep a list of phone numbers with a photo of each person beside the telephone.
  • Mirrors: Often those with dementia become confused or disoriented seeing themselves (or the reflection of the environment) in the mirror. Cover or remove them.
  • Provide a daily “To do list” on a bulletin board
  • -leave doors open that your loved one are permitted to enter. Close other doors.
  • Use contrast colored wall socket and switch plates

Consult OT/Home Modification Professional for recommendations

Resources: National Council of Certified Dementia Practitioners and BrightFocus Foundation)

Fall Prevention

Balance and Fall Prevention

FALL PREVENTION STRATEGIES TO MAKE YOUR HOME SAFER: Make an investment in your independence!!

  1. Remove tripping hazards: secure (tape) or remove scatter rugs; tack down carpet if curling/puckering; use electrical tape to fasten electrical cords and phone charging cords to wall
  2. Clean up/remove all clutter (boxes/magazines/etc) from walking paths and stairs
  3. Store necessities (clothing, food, dishes) within easy to reach locations
  4. Adequate lighting: Keep your home brightly lit; use nightlights in bedroom, bathroom, and hallways; use glow in the dark/illuminated light switches; store flashlights in easy to find places in case of power outage
  5. Move furniture to allow for flowing traffic pattern
  6. Improve bathroom safety: grab bars, nonslip mat, shower seating, toilet modifications (seek out Home Modifications Specialist)
  7. Use non-slip surfaces throughout home: Bathtubs/showers, kitchen and bathroom floors, porches.

ADAPTIVE DEVICES: In addition to use of a cane or walker there are other assistive devices to consider. An Occupational Therapist/Home Modification Specialist is able to evaluate your living space and provide additional fall prevention strategies such as consideration of durable medical equipment (shower seating, grab bars, hand held sprayer); stair climbers, ramps or stair lifts; door widening strategies.

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