Mobility Equipment Supplies

Bathrooms at home usually need adaptation if an elderly or disabled wants to stay in the house and remain independent. Ensuring bathroom access and safety may require room customizations.

Falls often happen as people get in or out of the bathtub. Non-slip suction mats or non-skid tub liners or stickers can help prevent falls and provide firm footing.

Grab bars around the tub are a must for safety. These bars should be institutional-grade and installed according to the manufacturer’s directions for firm and solid support.  Using towel rods in place of them is strongly discouraged. Improperly installed bars, as well, will not support a person who loses balance.

Various types of bars and poles are available from plumbing supply companies. The type, number, and positioning of supports depend on:

• The wall space around the tub;
• The wall structure;
• The plumbing arrangements; and
• The disability of the person using the tub.

Two kinds of grab bars are often needed at the bathtub for the disabled or elderly:

1. For use in getting in and out of the tub from a standing position;

2. For use when lowering and raising the body to and from a seated position in the tub.

U-shaped bars are available in 12- to 40-inch lengths. They may be installed vertically or horizontally to a wall.

A vertically placed U-bar, attached to the side wall at the foot of the tub, allows safe entry and exit. Note that the foot of the tub is the end where the water faucets and drain are located. This vertical bar should be about 32 inches long, and placed near the edge of the outer tub.

Horizontally placed support bars are best for lowering and raising the body to and from a sitting position in the tub. A 12- to 15-inch bar may be placed at the foot end of the tub and a longer one along the back wall.

Diagonally placed grab bars are not recommended because the hand may slide; and if footing is not secure, falls are more likely to occur.

If the tub is free-standing at both ends, like in most older homes, and the end wall is too far for grab bars to be secured, a vertically placed pole on the access side of the tub may be used. This pole should be about 1.5 inches in diameter and extend from floor to ceiling. Place it between 1 foot 3 inches to 1 foot 6 inches from the end of the tub, close enough to the access side to reach from a sitting position. It also can be used to grasp with one hand while operating the water controls.

Angle bars from the back wall or behind the tub to the floor, with wall posts, may be used when one or both tub ends are enclosed by a wall. This is useful for persons needing to use both hands to enter and exit the tub.

A variety of portable seats, chairs, and benches are also available if sitting on the bathtub floor is difficult or impossible. One seat has side flanges that adjust to fit any bathtub. Inside-the-tub chairs with backs for greater comfort are also sold in the market today. An inside/outside transfer bench with adjustable legs allows the person to sit on the bench that extends outside the tub then slide to the inside of the tub.

Any chair or bench must have non-slip rubber tips and should be safe and comfortable. When using this type of seats in the tub, a hand-held shower head is preferable to use.

An angle bar attached to two walls provides support while standing, and also aids in sitting and rising from a bath bench or chair.

If the shower floor is slippery, non-slip suction mats or rubber silicone treads should also be used there.

A non-skid bath mat on the floor outside the shower is a necessity.

The standard 15- to 17-inch height of toilet seats creates a problem for many people, especially those with arthritis, hip, knee or back problems. Elevating the seat 5-7 inches more will give better leverage in regaining a standing position.

There are several types of removable and permanently fixed raised toilet seats available in stores. For a more permanent raised toilet, a plumber can put the stool on a wooden platform made to fit the toilet bowl base. If you are building a new bathroom, consider a wall-hung toilet that can be hung at any height.

A portable bidet for cleaning the perineal area without hands or paper may be attached to any standard toilet bowl. It is electrically powered with a mechanism for spray washing with warm water and drying with a flow of warm air. This promotes independence for persons with very limited hand/arm functions.

Grab bars around the toilets are a must. Many types are available, and the choice will depend on:

• Available wall space near the toilet;
• Nearness to other fixtures in the room; and
• Needs of people in the household.

If you have a physical limitation, we recommend you consult a physical therapist or a housing specialist to help you select and recommend placement of grab bars and other accessories for safety in the bathroom. If you are unsure of your wall structure, or do not have proper tools or skills, we suggest you hire a carpenter to install and/or make the new adaptations.

And for the latest bathroom and toilet aids for the disabled and the elderly, visit www.doability.co.uk.

In my previous article, I focused on how medical organizations from around the world try to reduce harm from falls in their own facilities on a macro level. Now I am going to delve on more practical advice on how to reduce the incidence of falls within our homes or workplace.

Risk assessment provides a useful framework when tackling accidents caused by trips, slips and falls. Here is a five-step approach for this:

1. Look out for anything that may cause an accident. It could be objects lying around the floor like toys or rubbish; a wet floor; or basically, the proverbial banana peel that can cause people to slip.

2. Identify and decide who is at risk. It could be young children, the handicapped, or the elderly.

3. Take preventive measures, like doing repairs or renovations, making sure the area is regularly cleaned and cleared of any obstruction.

4. Keep a record of what you have changed. Now this one is a bit of a stretch to expect at home, but for commercial establishments and public places, it is certainly necessary.

5. Continually monitor your living space or work area. This is more of a continuation of the first 4 steps. It wouldn’t be effective if you just stop at recording and don’t follow through, so there has to be constant monitoring.

Now here are more practical tips to prevent the incidence of falls:

- Keep pathways clear. Arrange your furniture in a way that it allows easy movement, and not serve as an obstruction. Clean pathways and remove any unnecessary clutter, like boxes, telephone cords, and loose wires from high-traffic areas. Make pathways that are wide enough for plenty of people to use, to avoid possible collision.

- Provide ample light. Make sure areas like hallways and stairways are well lit. Have rechargeable emergency lights and flashlights handy in case of power outages.

- Safeguard stairways. Keep stairways in good repair. Make sure all stairways have sturdy railings and that steps have a non-skid surface.

- Secure rugs and flooring. Secure loose rugs and carpets with tacks or a slip-resistant backing. Repair frayed carpet and loose floorboards. Avoid small throw rugs as much as possible.

- Keep your bathroom safe. Install grab bars in your shower or bath and near your toilet. Use non-skid mats in the shower or bath.

- Keep necessities handy. Store supplies, clothing, dishes, food, and other everyday items within easy reach.

You can improve your general well-being, and help reduce the risk of trips and falls by keeping yourself active and healthy. A good way to make your muscles stronger and to improve your balance is to have a regular exercise and a proper diet. You do not have to go to the gym to remain active. Simple tasks, like gardening, regular house work, and walking can boost energy levels and improve coordination and balance.

Exercise is very important for older people since they are more prone to falling.

*** For all your disability equipment needs, visit www.doability.co.uk.

I am no stranger to minor accidents at home and outside. Slips, trips, and falls happen to a lot of people of all ages, from all places, and in all walks of life. These would sometimes lead to injuries which would require hospitalization, or at least a visit to the nearest doctor.

What a lot of us do not realize is that these falls happen to patients in the hospitals and medical facilities, too. There is nothing worse than injuring a person who is already sick, and the cause of such injury is the person who is supposed to be taking care of the patient, like the doctor or nurse. It is like adding injury to an existing injury.

Patient safety has been constantly one of the most pressing challenges in the health care industry, and a significant part of patient injuries come from falls while confined in the hospitals and nursing homes. Reducing harm from falls is becoming one of the top priorities of hospitals and health care organizations around the world. Patients, regardless of age, fall. While certain risk factors are common in younger people, falls are most likely to occur in older patients and they are much more likely to experience serious injuries. A significant number of falls result in injury, or even death, costing millions per annum for immediate health care treatment alone, not to mention the additional costs of rehabilitation and social care. In addition to these financial costs, there are additional costs that are more difficult to quantify. It not only includes the obvious distress, pain, injury, but also loss of confidence and independence to the patient.

There are lots of researches and reports around the internet on patient safety, specifically on how to reduce harm from falls, but it seems that there is not one single guide for all. What is apparent is that non-profit organizations from countries like the UK, Sweden, Australia, Canada and the USA are at the forefront when it comes to these initiatives with The Institute for Healthcare Improvement IHI in Cambridge, Massachusetts providing the main thrust. In the UK, there is Patient Safety First Campaign sponsored by the National Patient Safety Agency, the NHS Institute for Innovation and Improvement and The Health Foundation. In Australia, there is the Australian Patient Safety Foundation. While in Canada, there is the Canadian Patient Safety Institute.

The approaches are varied, localized, and sometimes isolated depending on the case. But what is common is the need to recognize these harms, identify patients prone to falls, record, monitor, and measure these incidents to be able to come up with actionable plans. These are for more organizational solutions though. Ultimately, it all boils down to the care and dedication given by our doctors, nurses, and caregivers that would spell a big difference.

Accidents do happen but a lot of them can also be avoided with the right actions and presence of mind. For those that cannot be avoided totally, there are ways to reduce the harms and risks brought about by these accidents. While this is easier said than done, it is doable with a little effort and good luck.

The Centers for Disease Control and Prevention has recently published a study on the correlation of injuries related to walking aids and its proper usage. The study was conducted using ER records from 2001 until 2006. It was found out that that a total of more than 47,000 American senior citizens are sent to emergency rooms each year, with a third of this number requiring hospitalization.

Some findings of the study include:

• 6 out of 10 accidents associated with walkers and canes occur at home.
• People 85 years and older are more susceptible to fall-related injuries; the study shows that the chances of accidents involving walkers and canes increase with age.
• 33% of accidents involving walkers and 28% of accident involving canes required hospitalization.

This is rather alarming. Walking aids and other mobility equipment are created to assist the elderly and the disabled to keep them safe.

“Walking aids are very important in helping many older adults maintain their mobility. However, it′s important to make sure people use these devices safely,”" said Judy Stevens, Ph.D., the study’s lead author. “Walkers are often used by frail and vulnerable older adults; people for whom falls, if they occur, can have very serious health consequences.”

Now that even the walking aids that we rely upon to assist our elderly is questionable, what can we do about it? Are there other underlying issues we need to address to keep our elderly safe? Note that the study involved American senior citizens. From whom do we have to expect action on this matter? Social welfare? The health ministry? Or the manufacturers of mobility equipment?

What can we learn from the study?

From this study we can learn that having walking aids is not enough to assist the elderly. It is also important that they are provided with quality walking aids and are knowledgeable in how to use such aids correctly and safely. It is highly recommended that physical therapists provide counseling to teach the elderly, as well as their caregivers, how to properly use walkers, canes, scooters and other mobility equipment. Doctors and other health care professionals must also take time in ensuring that a walking aid or any other mobility equipment fits properly with the user’s stature.

A concern is raised.

The study was conducted with American seniors as subjects and findings show that the problem stems from incorrect usage of walkers and canes. However, one cannot help but surmise if the problem is also aggravated by the quality of mobility equipment. How can the quality of one brand compare with another? It cannot be denied that equipment with inferior quality contribute to accidents. However, we cannot prove anything without numbers or statistics. The study did not mention anything about the quality of walkers and canes and how it relates to the number of accidents relating to fall, but it remains to be something worth looking into, for the welfare of our elderly.

For a full copy of the study, visit the Journal of the American Geriatrics Society.

When we age, our bodies lose their strength and a house can, over time, become a dangerous place use this risk assessment safety guide to keep your elderly loved ones safe.

Improve indoor safety: even though you can’t prevent every fall, you can help reduce risk factors.

Here are a few ways to improve safety:

• Keep floors clear of clutter to avoid falls. The easier it is to move around, the less likely a person is to fall. Keep things within an easy arm’s reach.
• Well lit rooms make it easy to see whether the floor is clear of obstacles. Be sure to have flashlights on hand in case the power goes out.
• Safety railings: Installing grab bars and railings around the house can improve safety. Places that should have railings would include the bathtub and beside the toilet. Installing bed railings will stop your loved ones from falling out of bed.
• Non-slip mats: Placing non-slip mats under rugs, on stairs, and in bathtubs will improve traction.

Improving outdoor safety

It’s also important to be safe outside, but it’s not as easy to make modifications. If you hold your loved one’s arm while walking, you will be helping to ensure their safety. Sprinkle sand or salt on icy roads and sidewalks to prevent falls on slippery surfaces. A cane can help with navigation on uneven ground or other devices may be needed such as a walker.

What should be done if someone falls?

Despite all precautions, accidents occur; it is impossible to prevent all falls. If something does happen, keep calm.

Don’t panic, staying calm will keep your loved one calm. If they cannot get up, keep them warm by placing a blanket over them until the ambulance arrives.

It’s not always possible to prevent every accident or fall. Fortunately, most of these mishaps can be prevented. Home is where people spend most of their time, so it’s a key place to start with this risk assessment safety guide for your elderly loved ones.