summit on at reuse and emergency management for fema …€¦ · houston, tx successful strategies...
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Summit on AT Reuse and Emergency Management
for FEMA Region VI May 1 and 2, 2012
Houston, TX
Successful Strategies Innovative Partnerships
Futures Planning
Assistive Technologies: What are we talking about?
Jamie Arasz Prioli, RESNA ATP Assistive Technology Professional
[email protected] 215-204-5974
Assistive Technology Device
“any item, piece of equipment, or product system, whether acquired commercially, modified, or customized, that is used to increase, maintain, or improve the functional capacities of individuals with disabilities.”
From Public Law 108-364, the Assistive Technology Act of 1998, as amended. Retrieved 3-2-09 from http://www.resnaprojects.org/nattap/library/laws/pl108-364.pdf
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Low, Mid and High Tech
Assistive Technology Devices
• Low Tech: Inexpensive, easy to learn, readily available, can be “off-the-shelf”, easier to make/maintain/replace
• Mid-Tech: May cost more, require some training, have special design, may need power source or other support
• High-Tech: Higher cost, need specific training to learn, may require on-going support, often customized
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The Technology Pyramid
Low
Mid
High
The Scope of Assistive Technology
• Communication
• Seating and Positioning
• Power Mobility
• Manual Mobility
• Mobility Aids
• Assistive Listening
• Vehicle Modification
• Leisure/Recreation/Play
• Worksite Modification
• Home Modification
• Learning Aids
• Environmental Controls
• Vision Aids
• Self Care/Activities of Daily Living
AT Device Categories
• Communication (e.g., picture/letter board; simple electronic communication device)
• Computer Access (e.g., screen magnification software, alternative keyboard/mouse)
• Daily Living Aids (e.g., large-handled utensils; long-handled shoe horn)
• Environmental Adaptations (e.g., ramp)
• Hearing (e.g., TTY; Personal Amplification System, Amplified Telephone) 7
AT Device Categories
• Mobility, Seating, Positioning (e.g., cane; walker; manual wheelchair; transport chair; shower chair; raised toilet seat)
• Recreation, Sports, Leisure (e.g., adapted golf cart; adapted trike)
• Vehicle Modifications, Transportation (e.g., vehicle lifts; wheelchair tie-downs; hand controls)
• Vision (e.g., magnifier; CCTV)
My “kids”…Savanna, Chip, Maddy and Toby
What’s this?
A. Cat toy
B. Sock dressing aid
C. Gardening tool
D. A glove with missing
fingers
E. I have no idea
What’s this?
A. Reacher
B. Grabber
C. Lifter
D. Slingshot
Leg Lifter
http://www.dynamic-living.com $9.00
What’s this?
A. Ball with screw & hole
B. Child’s toy
C. Something I put cat treats in
D. Writing Aid
What are these?
A. A cat collar
B. A broken cup
C. Tools to help me eat and drink
What’s this?
A. Mats
B. Dycem
C. Paper
D. Cat hair
picker-upper
Dycem…or use shelf liner!
http://www.dycem-ns.com/ $25.00+
Favorite Discount Store…..$1-5.00!
What’s this?
A. Soft frisbee
B. Flat pillow
C. Swivel seat
D. A cat bed
How do I decide what assistive
technology is needed?
Requires consideration of the:
PERSON + ENVIRONMENT + TASK What activity does the person want to do?
What skills are needed to do the activity?
What skills does the person have to do activity?
What supports exist to help learn a new way?
Where is this activity done and under what conditions?
How do I decide what assistive
technology is needed?
Need to know:
1. Activities – FUNCTION!
2. Assistive Technology Devices and Services
3. Environments
AND
Individuals and Their General Characteristics
Mobility and Seating Devices
-Canes -Shower Chairs -Walkers -Raised Toilet Seats -Crutches -Wheelchairs
…are a few examples of mobility AT devices.
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Other AT Devices Helpful to Shelter Residents
For Positioning & Transferring needs:
• Portable patient lift
• Transfer board and pivot transfer disc
For Environmental Adaptation needs:
• Portable ramp (12 inches [1 foot] ramp run length for every 1 inch of ramp rise)
New User of a Mobility Device (Due to New Injuries/Limitations)
• Until a qualified assessment and doctor’s prescription can be obtained for a permanent device, use AT devices found through your state AT program or reuse.
• New device user should move slowly to retain balance & safety until proficient.
• Ensure device fits size (height & weight) requirements before using – NEVER use an AT device that does not match size and need as it may result in more harm than good.
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Canes
Offset Handle Quad Cane, Adjustable
Forearm Cane / Crutches
Canes
Tourist Handle Single, Adjustable
Cane Usage • If weak and need a little support, use
single prong cane.
• If injured and need more assistance keeping your balance, use a quad cane.
• Proper Positioning: – Top of cane should reach crease in wrist
when standing with arm hanging slightly bent.
– Elbow should bend a bit when holding cane.
– Hold cane in hand opposite of injured side. 29
Walkers
Sure Lever Release™
Single Release
Dual Release
Rollator
Walker Usage
• For more stability, a walker is used in place of a cane or crutches when there is a more significant problem or when a knee or hip has been broken/replaced.
• Top of walker should match crease in wrist when standing straight.
• Arms should be slightly bent.
• Never hurry with a walker or push it too far ahead.
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Shower Chairs
Hygienic Backless
Hygienic with Back
Contoured (300 lbs)
Shower Chair Usage
• Ensure that shower chair is stable and set on a level part of the shower floor.
• Ensure that shower chair has the weight capacity to support shelter resident’s weight – most sold today have a weight capacity of 250-300 pounds.
• Use a shower chair with a back to support a weak trunk.
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Raised Toilet Seats
Raised Toilet Seat with Arms
All-in-one Adjustable Toilet
EZ Lock™ Raised Toilet Seat
Raised Toilet Seat Usage
• It is important to follow manufacturer’s safety instructions when installing attachable raised toilet seats.
• All-in-one (3-in-1 bedside commode) adjustable toilets can be used as a raised toilet seat, a shower chair, and a free-standing bedside toilet, since the legs are height-adjustable.
• Ensure that raised toilet seat is securely fastened or that one with legs is placed firmly on the floor for stability, centered over the commode’s existing opening.
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Manual Wheelchairs and Transport Chairs
Transport Chair Manual Wheelchair
Manual Wheelchair and Transport Chair Sizing
• Wheelchairs and transport chairs come in all different sizes: pediatric, standard, and bariatric (wider, more heavy-duty).
• It is very important to have a good fit – measure widest part of hips/rear sitting down and add one to two inches to determine width for wheelchair seat. (Standard is 18”, with anything wider labeled as bariatric.)
• It is better to have seat depth shorter, rather than longer/deeper, as this hampers leg circulation. (Standard is 16”-18”.)
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Wheelchair & Transport Chair Usage
• Always lock wheels when sitting down, getting up, or just staying put.
• If a seat belt is available, secure it.
• Footrests are a must, and elevating leg rests are advisable for people who need their legs raised.
• Manual wheelchairs are used by people with good hand and upper body strength.
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Wheelchair & Transport Chair Usage
• Manual wheelchairs should never be used for more than temporary or transportation purposes without an assessment by a qualified therapist and physician’s prescription.
• Transport chairs are used to push people who are weak or have no upper body/hand strength to wheel around alone.
• Transport chairs are for temporary transportation use only.
Power Scooter and Power Wheelchair
Power Scooter
Power Wheelchair
Power Wheelchair • Various methods for driving
• Joystick • Head control • Switches and/or
sensors
• Rear wheel drive • Front wheel drive • Center wheel drive
• More customized seating
for special needs
• Oxygen tank holders • Ventilator support
Other AT Devices Helpful to Shelter Residents
For Communication needs:
• Low-tech, handheld Communication Boards with pictures and/or letters
• High-tech AAC (Augmentative Alternative Communication) Devices
For Low Vision needs:
• Low-tech magnifiers with lights
• High-tech digital video magnifiers (CCTV - Closed Circuit Television)
• High contrast, large print, and Braille signage 45
Communication Devices vary from low-tech, static (unchanging) communication boards on which one can point to pictures or letters up to high-tech, dynamic display (interactive) electronic devices with audio output. These devices range from $10 to $15,000 (or more).
Vision devices also come in varying styles, sizes, and prices. For slightly low vision, one can use a low-tech magnifying glass. For extreme low vision, a CCTV (closed circuit television) or digital video magnifier is needed to read printed material. They range in price from $10 to $5,000+.
Other AT Devices Helpful to Shelter Residents
For Hearing needs:
• Assistive Listening Device (ALD)
• Strobe light-equipped fire/smoke alarm
• Captioned Phone & Amplified Phone
For Daily Living Activities needs:
• Large grip utensils & plate guards
• Button hook, dressing stick, long-handled shoe horn
• Furniture risers
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Hearing devices can be as simple as an amplified telephone to help with hearing impairments; a captioned telephone (or a TTY); an assistive listening device; a personal amplifier; and visual or vibrating alerts on alarms and alert systems.
Daily Living Aids can help someone with limitations to function more independently. Examples of daily living aids are adapted eating utensils, plates, cups, and furniture risers. Most of these aids are less than $20.
Positioning or transferring someone from a wheelchair to a cot, or vice versa, can be challenging. Usually a transfer board and/or pivot disc may be all the extra assistance one needs, but sometimes a portable patient (Hoyer is a brand) lift may be needed for more lifting help.
Transfer Board
Transfer Pivot Disc
Patient Lift
Environmental adaptations may improve access to buildings (with the help of a portable ramp) and also help control the surroundings such as lighting or appliances (with the help of an environmental control unit [ECU] which can be switch-activated, voice-activated, or even eye-gaze controlled).
Portable ramp Switch-activated ECU
(or EADL) Eye-gaze ECU (or EADL)
Considerations to keep in mind
• Use bariatric equipment for larger shelter residents (bariatric equipment is wider and more heavy-duty with a higher weight capacity).
• What is good for some may not be comfortable or good for others.
• Encourage and educate, never force AT usage.
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Questions?
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