What I have observed is that people without physical limitations often do not appreciate how difficult simple everyday tasks can be to someone who is physically compromised. Many times a small modification can remove an obstacle. By presenting these examples of problems and solutions, I hope to raise awareness of problems and inspire people to look for answers.

Problems/Solutions:

Doorways openings are too small/Offset Door Hinges - The obvious answer is through construction - widen doorways. There is a cheaper, less disruptive approach. Offset door hinges will give you an extra 2 inches with very little effort and cost.  Offset Door Hinges

Turning round doorknobs/Levered Doorknobs - Round doorknobs can be difficult for people with limited grasp. With a lever, all you need to do to open a door is to push down on the lever. You can replace all the doorknobs in the house with levered ones but this means changing locks and that can get expensive. An alternative approach would be to put conversion lever attachments over existing round knobs. Locks would not need to be changed and the cost would be less with this problem solver.  Door Levers Attachments

Standing from a seated position/Furniture Risers or a Lift Chair - Standing from a low level can create problems for someone with limited leg strength. By raising the seat to a higher level, it takes less effort to stand, possibly making the task achievable. Furniture Riser can raise the whole chair from 2" to 5". Another option would be a Lift Chair. These chairs automatically lift the seat of the chair with the push of a button. Chairs online begin at about $600 and go up. My online purchase saved me about $300; I paid $600 when the suggested retail was $900. Shipping was free. An additional feature in many of these electronically operated chairs is that they also can recline with the push of a button.  Furniture Riser or Lift Chair

Turning Faucets/Automatic Faucets - Normal aging, a stroke, arthritis, or some other medical problem may cause the simple, everyday activity of turning a faucet to be frustrating.  An utomatic faucet can be mounted to your existing faucet. Simply run an object under the faucet and your water comes on automatically. It will then stay on until you move from under the sensor.  Automatic Faucet

Grasping and turning a small switch/Touch Lamps - Limited grasp caused by arthritis or other health problems can make the activity of holding a small object like a light switch and turning it difficult. A touch lamp can be operated by coming in contact with a metal surface on the lamp. You can buy new touch lamps or just put a Touch Lamp Converter into your existing lamps.  Touch Lamp Converter or Touch Lamp

Opening widow coverings/Motorized Window Blinds - Do you, a friend or relative have a dark house because the blinds were never opened? Sunlight can work wonders on a person's psyche making this an important problem to fix. The inability to reach the controls to operate window coverings is a very common problem. It is not unusual for furniture to block access. With motorized blinds, you use a remote to point and click to open or close blinds. A cheaper fix for those who can reach controls but find it difficult to turn wand controllers is to buy blinds where pulling a cord opens or closes the blinds.  Motorized Blinds

Getting over thresholds when using a wheelchair/Wheelchair friendly threshold - Your normal door threshold has a small hump so there is not a gap between the bottom of the door and the floor. Unfortunately, a wheelchair user must be very careful that both wheels hit the hump at the same time or the chair will rock, threatening a collision with the door frame. You can replace the raised threshold plate with a flat one but then must put a weather proofing strip on the bottom of the door to close the gap. This item is available at most hardware stores.

Getting out of bed/Bed Handle - For people with the problem of getting out of bed independently, a bed handle may be the solution. This bedrail gives a person something to pull up with, helps them turn in bed, or can provide support when standing. It is only about 1 1/2 feet long which is shorter than a normal bedrail. This short rail is not effective for keeping someone in bed, however, it provides something to grasp while being short enough to allow someone to swing their legs over the side to stand.  M-rail

Many times only minor changes are necessary to bring an obstacle down to size. The first step to problem solving is to recognize the actual stumbling block. Once identified, consider whether an alternative approaches would help you reach the goal.

The Renaissance Fair was something Annie looked forward to every year but this year she would have to skip it.  There was just too much walking and her medical problems had progressed as expected, limiting her endurance.  Maybe it was time for her to accept her limitations and put that aspect of her life behind her, OR maybe not.

I recently had a discussion with a neighbor who is a Physical Therapist.  She has a blanket rule that she never recommends handicapped scooters.   Her thinking is that a walker with a seat provides the same support and helps keep the user active.  I would contend that her approach is a "one size fits all" way of thinking.  Coming from a position of a person who actually has a disability, I think this approach limits the opportunities available to physically challenged people.  For me, because of fatigue due to multiple sclerosis, I had very limited endurance.  My scooter helped me live a more active and independent life.  If I paced myself, it was amazing what I could accomplish.  An often overlooked benefit was that the independence that it allowed me did wonders for my self image.

I used a full sized scooter with a lift to get the scooter in and out of my van in one piece.  With the lift, I only had to be able to walk to the back of the car and push the lift buttons to remove or insert my ride.  Not having these aids would have severely compromised my independence.  I was able to do my own grocery shopping, which is something I would never have accomplished if I was required to walk up and down all those aisles.  This aid allowed me to take a plane trip alone and brave a five hour, solo trip by car.  In order to continue exercising my legs, I did not use the scooter in the house.  My scooter helped me to expand my world and allowed me to continue activities outside my home.  I am not saying do not push yourself to be as active as you can, but when you have come to a wall, do not automatically discourage aids that will help you overcome obstacles.  (Because my needs have changed, I now use a power wheelchair.

Consider the source of advice when purchasing mobility aids. The motivation for that advice could be self-serving.  As an example, I present the following actual occurrence.  I met a man walking with a cane who was waiting for his new power wheelchair to be delivered.  He wanted mobility assistance when any distance was involved.  The store selling the mobility equipment advised him to get a power wheelchair saying he might eventually need it and his insurance could possibly not cover a chair and scooter.  I doubt a power wheelchair met his needs. It would be too difficult to transport and not available when he really needed it away from home.  I believe this recommendation was based on the store's motivation to maximize profit by selling a $5,000+ wheelchair instead of a $3,000+ scooter or even a lightweight scooter for less than $1,000.

With this incident in mind, I want to provide information that will help you determine what is right for you.

MOBILITY EQUIPMENT TO CONSIDER:

Manual Wheelchair - This is easier to transport than any of the power equipment.  Power equipment is so heavy that you may be limited in your access to some buildings.  If there is no access ramp, a manual wheelchair can be rolled by a helper backwards up a few steps.  An additional consideration is that a manual wheelchair takes upper body strength and will help you maintain that strength.  But, if upper body strength is a problem, maybe a power wheelchair is the correct option.

Power Wheelchair - If you cannot move a manual wheelchair independently, consider a power wheelchair.  The pros are that a power chair can easily maneuver around furniture and will turn on a dime with the simple movement of a joystick.  Cons are that if you stop trying to use your muscles with everyday living, these muscles will get weaker and atrophy. An additional consideration is that a power wheelchair is very heavy and may limit your accessibility to some areas.  If someone has limited body strength, and poor ability to improve that strength, this may be an option that gives them a fuller life.

Transport Wheelchair - This wheelchair does not have the heavy side wheels.  It is good for getting from point A to point B if you have a helper to do the pushing.  Without the side wheels, the chair is easier to transport but also cannot be self-propelled.  Several models of manual chairs have side wheels that can be removed to make them easier to transport.

Rollator - This is a walker with a seat to use as needed for rests. Many models have a basket or saddlebag to help carry things.  With this equipment, many people can obtain the mobility support needed and still exercise muscles to prevent wasting.  Of course, it would be much easier to transport then power equipment.

Full-sized Scooter - A full size Scooter has its advantages over a lightweight one.  With a car lift, the scooter can be put into your vehicle in one piece.  No assembly or disassembly is required.  Quick stops are easy, adding to independence.  The extra expense and the fact that these lifts are permanently installed are a disadvantages.   When traveling in a vehicle other than your own, taking your scooter requires disassembly and assembly of heavy parts.  These scooters come in 3 or 4 wheel models.  The 4 wheel models are not supposed to tip easily whereas, three wheel models have a smaller turning radius.

Lightweight Scooter - These scooters dissassemble into 4 or 5 lightweight pieces and can be reassembled within minutes.  Because they are so easy to transport, you have more flexibility when using a friend's car, taxis, or when traveling.  If you will be alone and making frequent stops, a full-sized scooter and lift may be preferable.  Lightweight scooters cost less than $1,000 and may be covered by your insurance. I helped my nephew obtain one through his insurance, but be prepared to commit time and persistence.

When choosing the right mobility aid, you need to take into consideration:

• *  Your current ability
• *  Expectation for future ability
• *  Whether or not you will be using this alone or with assistance
• *  Cost and insurance benefits
• *  The degree of independence you hope to achieve

Choosing the right mobility equipment is an important consideration. I am not suggesting you give in and choose the equipment that makes mobility so easy that the muscles you have go to mush.  On the other hand, used wisely, these aids can help you live a more independent, full life.

Memory problems first showed up for me on my job when I had a case I needed to present to a supervisor. This supervisor was the type of person who had no patience if you were not clear and succinct in your presentation. In order to explain what happened with this client, I needed to recall various dates crucial to the outcome of the case.

My dilemma required a little creative problem solving and what I did turned a negative into a positive. I created a document with a chronology of events with dates and descriptions. There were a lot of dates to remember which almost took up a full page. I kept one copy for myself and gave one copy to the person receiving the report. My presentation went better than I had anticipated. My “cheat sheet” helped me stay on track with no worries about flaws in my recall. In fact, this technique helped those listening to follow my story better. I left my supervisor shaking his head in appreciation.

I have used this trick with doctor’s visits. With the assistance of these written notes, I can relate when symptoms first began and my response to treatment without having to worry about memory lapses. By putting things in writing, I do not have to worry that the listener might miss an important point.

An unanticipated benefit is that these little brain exercises seem to be helping to train my brain to work more efficiently. I feel I am sharper and quicker in thinking than ever before. They say there are a lot of unused brain cells…maybe this will put a few spare ones to use.

I love this story and want my website to encourage this type of thinking,

ATTITUDE

Author unknown

There once was a woman who woke up one morning, looked in the mirror, and noticed she had only three hairs on her head. Well," she said, "I think I'll braid my hair today?" So she did and she had a wonderful day.

The next day she woke up, looked in the mirror and saw that she had only two hairs on her head. "H-M-M," she said, "I think I'll part my hair down the middle today?" So she did and she had a grand day.

The next day she woke up, looked in the mirror and noticed that she had only one hair on her head. "Well," she said,"today I'm going to wear my hair in a pony tail." So she did and she had a fun, fun day.

The next day she woke up, looked in the mirror and noticed that there wasn't a single hair on her head. "YEA!" she exclaimed, "I don't have to fix my hair today

Attitude is everything.

• Be kinder than necessary, for everyone you meet is fighting some kind of battle.
• Live simply,
• Love generously,
• Care deeply,
• Speak kindly

Life isn't about waiting for the storm to pass. It's about learning to dance in the rain.

There are so many glucose monitors on the market, that it is difficult to determine which one would be best for you. The following is a link to the American Diabetes Association’s recommendations on how to choose a glucose meter.

http://clinical.diabetesjournals.org/cgi/content/full/20/1/48

Several websites will bill insurance but make sure they are billing the discounted price. I have found that merchants use the full price when filing insurance. You're not really saving anything when they do this. To save money with your insurance copays, purchase the item at the discount price and then you file for insurance reimbursement. First check with your insurer to find out their requirements. Companies may require pre-authorization or a physician's prescription for the item.

When putting a permanent ramp outdoors, keep in mind a visible ramp may advertise to the bad guys that a vulnerable person lives in the house. Put the ramp in the back of the house rather than the front. Better still, build it in the garage where it cannot be seen with the garage door closed.

For a permanent ramp, codes usually require a foot of ramp for every inch of drop. By this I mean if the platform is 15 inches from the ground you will need a 15 foot ramp. This will help prevent the ramp from being too steep and putting a wheelchair occupant at risk of falling out of their chair.

The following URL will take you to a directory of adaptive clothing website.

http://www.makoa.org/clothing.htm