China
Africa
Explore chapters and articles related to this topic
Caregivers in Patient- and Family-Centered Care
Published in Amy J. Litterini, Christopher M. Wilson, Physical Activity and Rehabilitation in Life-threatening Illness, 2021
Amy J. Litterini, Christopher M. Wilson
Cost is often a concern and a potential barrier in the acquisition of durable medical equipment, as insurance coverage can be limited or equipment access and availability in one’s region can be problematic. Routine equipment needs may be covered by private insurance and/or through one’s hospice benefit, but the type of item selected and actual costs covered are often determined by the agency providing services (e.g. custom, high-end items are generally not covered). The price and accessibility of a device ranges substantially based on the capabilities provided and the materials and procedures necessary in the construction. Furthermore, the expense also fluctuates based on items purchased over the counter versus those which are custom fit and ordered specifically for the patient. Additionally, constraints in one’s living space such as small sleeping quarters, narrow hallways and door frames, and inadequate or narrow kitchen and bathroom setup can also pose challenges. Particular attention should be paid to the correct installation of mobility equipment, such as grab bars, to ensure that they are, in fact, compliant with any legislative or regulatory standards (e.g. Americans with Disabilities Act) and installed into the wall studs for safe use.
Rehabilitation Engineering in the Workplace
Published in Raymond V. Smith, John H. Leslie, Rehabilitation Engineering, 2018
Raymond V. Smith, John H. Leslie
The solution — Horse demonstrated his ability to pull himself up into the bucket by doing basically a “chin-up”. Once inside the bucket, his long leg braces and the small size of the bucket afforded him enough stability to be able to perform the tasks required of him. Accommodations to his job and the truck enhanced his productivity enough to allow him to function fully as a lineman. Modifications made to the truck consisted of installing grab bars around the outside of the truck so that he would have something to hold onto when moving around (Figure 11). A pole was mounted on the rear bumper in order to hold the orange plastic cones commonly used to define the work space of someone working on a road. Once on this pole, the cone did not have to be handled for the rest of the day. The chocks for the wheels were dealt with in much the same way; they were tied to the side of the van and were always in a position to be used. Grab bars were installed on the bucket itself to make it easy for Horse to pull himself up. A heater was also installed in the bucket to minimize the risk of frostbite due to Horse’s sensory loss in his lower extremities (Figure 12). Horse’s original job was restructured; he was given tasks, such as splicing wires, that required him to remain at one pole for extended periods of time. This minimized the “setup” time required for each job. Commercially available hand controls were installed so Horse could drive the van independently. The cost of the modifications to the truck was approximately $3000.
Long-term discharge planning in traumatic brain injury rehabilitation
Published in Mark J. Ashley, David A. Hovda, Traumatic Brain Injury, 2017
Mark J. Ashley, Susan M. Ashley
Bathrooms should be equipped with grab bars around the shower/tub and toilet areas. Hand-held shower wands can be helpful for the physically challenged person. Bath benches that are nonslip and nonslip floor coverings for the shower/tub area and adjacent flooring should be considered. It may be necessary to remove glass shower door fixtures, both for access and safety in the event of a loss of balance. Bowed shower rods and curtains can provide extra space in the shower. Ground fault interrupt electrical receptacles should be installed in the vicinity of water, such as in bathrooms and kitchens, if not already present.
Home modifications and repurposing: perspectives on the accessibility, affordability, and attractiveness
Published in Disability and Rehabilitation, 2022
Linda R. Struckmeyer, Nichole Campbell, Carlyn Ellison, Sherry Ahrentzen, Sherrilene Classen
Participants noted how the affordability of home modifications served as a potential barrier for many individuals. Due to the expense of home modifications, both consumers and professionals expressed these concerns. An occupational therapist discussed offering less expensive options, even if the aesthetics are less appealing, in addition to standard solutions to help consumers offset cost. More specifically, alternatives to more costly grab bars that require supportive backing underneath the wall finish were discussed. Those included less expensive adaptive options such as installing grab bars into studs of the wall; adding a 2 × 4 on top of the wall’s surface to support the grab bar; or using medical-grade, suction cup bars, rather than those needing to be permanently affixed. The following quote from an occupational therapist illustrates this point:
Housing accessibility for senior citizens in Sweden: Estimation of the effects of targeted elimination of environmental barriers
Published in Scandinavian Journal of Occupational Therapy, 2018
Cecilia Pettersson, Björn Slaug, Marianne Granbom, Marianne Kylberg, Susanne Iwarsson
Referring to some of the studies included in these reviews [4,20], specific housing design features and environmental barriers (EB) such as lack of grab bars in bathroom and kitchen hindered safe and independent performance in ADL [21]. Lighting adaptation in these housing sections resulted in significant effects on ADL for people with visual impairment [22]. In another study [23], the authors reported that standard and personalized home modifications such as ramps, automatic doors, elevator/lift, and modifications in kitchen and bathroom were associated with less decline in ADL. Further, grab bars were the most prevalent safety features in shower/bathtub [24]. Another study reported that participants who got an intervention including home modifications and training in their use, instruction in problem-solving strategies, energy conservation, safe performance, fall recovery techniques and balance and muscle strength training had less difficulty than controls in ADL, with the largest reductions in bathing and toileting [25]. These studies contribute with knowledge of consequences and effects of housing adaptations at the individual level, but to date the potential impact of systematic approaches aiming for improved housing accessibility at population level is unknown. Moreover, as stated by Ahrentzen and Tural [4] the evidence base is not very strong due to methodological limitations. For example, sophisticated measurement scales are not used and there is selection bias and a large number of cross-sectional analyses. Therefore, more research is needed based on detailed measurements of environmental factors.
Clients’ Perspectives of the Effectiveness of Home Modification Recommendations by Occupational Therapists
Published in Occupational Therapy In Health Care, 2018
Guby Wai Chu Lau, Mong-Lin Yu, Ted Brown, Cassandra Locke
Niva and Skär (2006) found that modifications improved the overall accessibility of the home and allowed individuals to participate in outside activities. Oaks (2017) reported similar findings in a study of low-income older adults who received modifications to their homes. Likewise, in the present study, modifications increased participants’ home accessibility. One participant verbalized that the “ramps helped my wheelchair get into the house.” Conversely, the effectiveness of the modifications on the DOHM physical dimension of home could be limited (Aplin et al., 2013). This was reported by one participant who had a grab bar installed that was inappropriately positioned due to the physical structure of the shower, resulting in its non-use. Similarly, another participant declined the modification because “it would involve taking away part of the kitchen, unfortunately.”