Introduction
Mobility – it is only really possible to appreciate what mobility means if your ability to move around freely is reduced, then it takes on a whole new meaning.
Living with someone who is partially disabled gives me an insight into the kind of issues that people with disabilities have to deal with. When you are able and sure footed there is no real understanding of the disadvantage of not having full mobility of your person. Besides which nobody is particularly interested unless it concerns them directly. We all take it completely for granted when everything works as it should and we get on with living our lives concentrating on making money, raising a family, having a good time and other such normal everyday activities. In fact quite often we don’t even like to see people who are disabled and struggling because it makes us aware of our own vulnerability which reminds us of our mortality. Next time you see someone who is in a wheel chair, notice your own reaction to that person, and be aware of how you avoid eye contact and carefully get out of the way. People who use wheelchairs often say how people they meet will talk to the carer and ignore them as if they are stupid as well deaf.
Early Disability Aids
The first type of disability aid that most people will be familiar with is the walking stick. For some, it will be something to make them feel more steady on their feet when they suffer some impairment in walking. If a person has a broken leg or hip then crutches for a period of time will be needed and later a stick until full mobility returns. When I broke my hip I found the most frustrating thing was that I could not carry a cup of tea from one place to another so I improvised with a trolley on wheels which I could push along. When you have to use two arm crutches as I did to get about, there are no arms left to carry anything. For non spilling things you can use a bag to carry your things in which can be attached to your crutches, but not cups of liquid. Recently when visiting my husband in hospital I watched while the nurses unpacked a Zimmer frame on which they attached a plastic box with a tray for a lid. It was fixed like a basket on a bike. The patient had to practice pushing it along, and I realised it was because he lived on his own and needed to be able to transport things but couldn’t manage without two handed support. These types of early aids are common for people as they get older and lose their youthful mobility because of age related problems. They are also required for those who have suffered accidents and injuries so that temporary mobility is affected.
Independence
One of the major frustrations for people becoming disabled is their loss of independence and freedom to be able to do what they want, when they want. If a person becomes disabled after years of normal living and independence there will be a great deal of frustration and a need to make adjustments to the new situation. However, whatever the disability experienced there are a vast range of aids to help people live as independent a life as possible. Whatever the level of disability there is a need for mobility to maintain independence.
In the Home
When suffering loss of mobility or normal functioning whatever the reason, the first task is to create safety and functionality in the home where the level of disability determines the type of support needed.
One of the first things to consider is the quality| degree| level of comfort while resting. Correct support in bed and while sitting in a chair will allow the muscles to relax properly so that the body will function as well as possible. There are a range of Orthopaedic beds which allow for many different positions from lying to sitting and the best examples are the hospital beds where you will find electronic buttons to change the position of a patient with ease. Chairs can also be found that will allow for different positions and even a vibrating and massaging function incorporated into the frame. A friend of mine had a chair specially made which reclines, vibrates and massages in three different places and also tips forward when you want to get out for ease of standing up. When we visit we all want to have a go in it because it is such good fun.
The next test when disabled, is the function of toilet, bathing and dressing. There are a huge range of aids to chose from such as commodes and other toilet necessities, grab rails for showers and baths. My mother is severely arthritic and cannot get into the bath anymore, so she has a seat which lowers and raises her in and out of the bath. There are also walk in baths and then specially adapted showers with stools and slip mats to aid the sufferer. Also because my mother is partially sighted she cannot read the numbers anymore, so she has a set of talking weighing scales.
Having managed the getting up, washing and dressing as well as maybe a good rest in the special chair, moving around the home will be next on the agenda. Depending of the level of incapacity it might be that a simple walking stick or Zimmer frame will support mobility. As well as grab handles in the bathroom, handles can be mounted alongside entrance doors and steps to help with negotiating different levels. Just because people suffer some sort of disability it doesn’t mean that they want to leave their homes, but when they live in a house and have stairs to negotiate then the use of a stair lift is a wonderful invention. Severely handicapped people may need a wheelchair in the home which requires a lot of space and maybe wider doorways to accommodate it.
The next activity for independent living is food preparation and dining. Standing can be a problem so a high stool to perch on might of value. Otherwise do as much preparation as possible sitting at the kitchen/dining table. If a person has a problem with holding cutlery and kitchen utensils, there are specially adapted items with larger handles for ease of use. With arthritis in the wrists, lifting items such as kettles and saucepans can be a problem, but there are available cleverly designed kettle and teapot tippers for ease of pouring. Using a food processer and electric gadgets will save a great deal of time and effort when preparing meals. Another simple aid which my mother found very useful is a grabbing stick or ‘Reacher’ that picks up items to save bending down.
For disabled people who want to get out and about the mobility scooter has proven to be a godsend.
Maintaining the home is sometimes difficult for a disabled person. Obviously there are washing machines, dryers and dishwasher to aid with tasks in the home but you can also get remote control vacuum cleaners that are radio controlled with a joystick or key pad such as for toy boats and aeroplanes. Long handled brushes and dusters help with hard to reach corners particularly the microfiber dusters that attract dirt and dust to them.
Other items available for people who have some level of limitation may be lever type handles for taps to make them easier to use. If a person has lost their grip there are special items to open cans, bottles and jars. Because my mother is partially sighted she has large buttons on her telephone and speed dialling so she can stay in touch with her family who are spread far and wide. She can order goods by phone which means with such aids she is able to retain her independence and stay in her own home. It seems that whatever the disability there is some clever invention to help overcome the problem.
Outside the Home
To enable a person who is disabled to live as normal a life as possible then aids outside the home are just as important as those inside. Wearing an alarm cord around the neck is a wise precaution so that if a person does get into difficulties while outside they can call for help. To be able to move around easily outside may only require a walking stick or a Zimmer frame for support but where mobility is more restricted, wheelchairs or electric scooters may be necessary. My mother used to love to garden but now the arthritis and osteoporosis has taken hold and her eyesight is impaired, she is severely limited in any activity outside. On a good day however she does have a garden stool which enables her to do some weeding and tidying of the flower beds. There are even wheeled seats for moving along the edge of flower beds when weeding. Long handled garden tools can be used to avoid bending or kneeling and raised beds will allow even wheel chair users to tackle the garden plot. Ramps may be installed to allow a wheelchair to move from one level to another, and sit-on lawn mowers are a possibility if you have a big enough lawn.
There is a relatively new product on the market called Flexiloc which is a modular system of tough polyurethane tiles that interlocks to form ramps of any size. It has the advantage of being able to run straight, turn corners, be used indoors or outdoors and has a good grip surface that is more comfortable than conventional surfaces. It can be used as a temporary solution where a permanent ramp is not possible and is easily dismantled to be reused again and again.
If a disabled person relies on a wheelchair then automatic gates and garage doors which open remotely is a big help. Cars or vans used for transporting electric scooters are usually specially modified vehicles with ramps or lifts to allow the mobility scooter to be loaded up. Sometime cars may have to be adapted to allow for the lack of functioning of particular limbs. My husband cannot manage the foot pedal movement required for gear changing so we have switched to an automatic car to enable him to still drive.
As the name suggests electric wheelchair mobility devices are powered by a battery and have to be recharged from an electrical power point each time they are used.
There is a huge range of mobility scooters available both new and second hand. The mobility scooter is mostly a four wheeled vehicle which travels between four and eight miles an hour. However for the electric scooter there seems to be more three wheeled versions which travel at a maximum of six miles per hour. The speed is determined on the weather, the terrain and riders weight. A three wheeled scooter is inherently less stable and unless greater manoeuvrability is required it is better to get the four wheeled variety. Some scooters can be completely folded up to go into the boot of a car. The scooter usually has a chair with arms mounted over the battery enclosure with handlebars like a bike for turning and controls in reach of the hands. They are very easy to operate and comfortable to ride. The chairs vary with the amount of padding and enclosed back, usually the more expensive the more padding there is.
As well as the open versions of mobility scooters there are enclosed ones to protect the passenger from rain and wind. These come with lights, windscreen wipers, full suspension, mirrors and lockable doors as with a car and can cover larger distances. I have seen them in my local area travelling along the road rather than on the pavement.
Home Remote Controls
Where an individual is physically unable to get about inside or outside the home the use of remote controls is a valuable aid. Being able to manage and operate your entertainment centre remotely is only one of the possibilities. The availability of remote controls for opening and closing of blinds and curtains, switches for electrical equipment such as ovens, lights, cooking appliance and washing machines, is a great help. For people who cannot easily answer the door there is a keyless door entry system designed to fit most latch locks which enable the elderly, the disabled and partially sighted who have difficulty using keys, to manage their security remotely.
One story I read in the paper a few weeks ago was of a young man who was so obese, in the region of forty stone, that he could not move out of his bed. He had an entertainment centre in his room remotely controlled and he ordered food online to be delivered to his house. There were three healthcare workers in attendance at all times to turn him in bed and see to his bodily needs; as well as people to cook for him the food he had ordered. He was waiting for a stomach operation to staple his stomach together to reduce his intake of food. And all this was paid for by the tax payer. My feeling was that if there was no one to take such good care of him he would soon lose weight because he would not be able to get about and eat all that food.
Having read that story I question the value of having remote controls so easily available, because the forced activity of getting up and out of your chair to change channels is at least exercise to keep your circulation going. However for people who cannot move around easily then remote controls are a boon I am sure.
Conclusion
For the babies who were born with a physical disability, may never know what it is like to be fully mobile and they may always yearn to live a normal life. For those who were once completely functional, when they become disabled they have to come to terms with their loss and face up to their own mortality. If the time comes when you are no longer able to do all the things you used to do, then be sure there are many creative aids to help you maintain as much independence as possible.