Assistive Devices to Help the Joys of Daily Life

[Guest guest]

Arthritis is disabling to many people, but fortunately, we have obtained

recognition of our needs in the Americans with Disabilities Act (ADA) passed

by Congress in 1990. ADA includes many components, but a major effect is to

make public places more user friendly for you. This means that curbs will be

leveled to get rid of steps, and ramps or elevators will be available near

stairs.

Many devices also exist to help us, but before we review them, let me mention

that the most helpful device is your own creativity. The American College of

Rheumatology (ACR), in cooperation with the Lederle Laboratories, publishes

an annual self-help guide, Sharing Innovations (P.O. Box 585, Summit, NJ

07902-0585), a compilation of creative ideas from people with arthritis.

Robin May, a judge who has suffered from RA for more than twenty years, notes

that not a day goes by that she doesn't look for ways to make an activity

easier. For example, she wears a carpenter's apron around the house, filling

the pockets with items that she'll need during the day, thereby avoiding

unnecessary trips up the stairs. In addition, the pockets free her hands to

hold onto the railing of the stairs. Another idea is to use a textured rubber

soap mitt in the shower to prevent dropping the soap.

Here's an example of individual creativity once seen at a Japanese

restaurant: The waiter saw a woman with arthritis of the hands having

difficulty with her fork. He folded a piece of cardboard, placed it between

the ends of two chopsticks, and secured the ends and cardboard with a rubber

band. The result was a pair of chopsticks with a spring, easily squeezed

together to hold food. So use your own creativity to protect joints, conserve

energy, reduce fatigue, and make life a little easier.

A Review of Devices

I reviewed the most frequently ordered items from several large catalog

companies and interviewed a few medical equipment store managers and

arthritis doctors. The catalog companies included the Sammons Preston Catalog

(1-), Sears' Health Care (1-), which marks the items

that can be reimbursed by Medicare, and J.C. Penney's Easy Living Fashions

(1-). The Arthritis Foundation and the Arthritis Health

Professionals Association, P.O. Box 7669, Atlanta, GA 30357-0667

(1-) has many educational pamphlets and videos about how to live

better with arthritis.

To introduce you to the major helpful devices, the following sections are

arranged by activity. For each section, there is at least one name and phone

number. This does not mean that they are the only places to obtain help, as

there are literally hundreds of catalogs, but you do need a name and phone

number to call as a starting point for assistive equipment.

Hand Tasks: Writing, Phoning, and Hygiene

Perhaps the single most important concern to most of us is working with our

hands. You need to remember, though, that if you are looking for assistive

devices to help you with hand motions, pick products that use as few hand and

finger joints as possible to reduce pain. The ACR pamphlet Sharing

Innovations notes: " Remember, make the product or task fit you -- don't fit

yourself to it! "

For writing, there are many devices for holding pencils and pens more

effectively. For example, enlarged holders that fit over the pen make

grasping easier and less painful. For a steadier hand, Sammons Preston has a

Steady Write pencil and pen. Battery-operated pencil sharpeners are also

useful.

If you use a computer, wrist and hand rest attachments for your keyboard are

a must also. Sammons Preston has an extensive selection of computer aids for

disabled people.

If you read a lot, book holdrs are necessary to reduce fatigue in the hands.

The Sammons Preston Catalog offers an amazing assortment of holders for

reading in bed, in a chair, or at a desk.

Telephoning can be a real chore, not only in dialing but in holding the phone

to your face. Consumer Communications (1-, 2001 Rte. 46,

Ste. 310, Parsippany, NJ 07054-1315) has a catalog to answer your special

problems. The devices mainly help hearing- or speech-impaired people, but

they also assist motion-impaired people. In addition, the company has 600

local AT&T Phone Centers to help you with any individual problems. (Call

1- for the location of one near you.) There are amplifiers and,

of course, speaker phones to eliminate fatigue of your arms while cradling a

phone to your ear. You can also try a large-number keypad that requires

minimal pressure to dial.

There are now electronic devices to open letters, lick stamps, and place the

stamps on letters. Many catalogs and several upscale gadget stores such as

the Sharper Image have them. Scissors are always a problem if it hurts your

hand to squeeze. Spring-assisted scissors have oversize handles, allowing the

user to use the whole hand. One brand, Fiskars, has a layer of

shock-absorbing plastic cushion covering the handles. The Arthritis

Foundation recommends cordless and regular electric scissors among many other

types of helpful devices. More than 100 ergonomic kitchen and garden utensils

are manufactured under the trademark Good Grips. They all have long handles

and large grips. Oxo International (1-, ext. 11) has more

information or visit kitchen and houseware stores, most of which carry these

products. The Ulu knife has the handle on top. By using a rocking motion you

can cut without having to hold your wrist in an awkward position. The Ulu

Factory (1-) manufactures the Ulu knife. The Zip Away plastic bag

opener easily slits open packages containing chips, pretzels, and other

snacks. It is available from the Sammons Preston Catalog (1-). A

childproof cap opener, Medigrip, has a large surface so you can turn

childproof caps easily with the palm of your hand. Polymedica Healthcare

(1-, ext. 1) can provide names of retail stores that carry this

product.

Eating, Drinking, and Cooking

Most catalogs and books have sections on aids for eating, drinking, and

cooking. They offer several kinds of cutlery products that are lightweight

and maneuverable, featuring proper handle angles for distribution of

pressure. Combination cutlery is a combination fork/knife and spoon/knife.

Weighted style cutlery provides proper balance for users with limited

strength. Another style of cutlery is designed to be used with the thumb

opposite the index finger. Lightweight angled style cutlery has 45- and

90-degree angles for forks and spoons to make eating easier for both right-

and left-handed users with limited elbow or wrist motion. Household knives

have handles like pistol grips to economize effort by transferring the

cutting power from the arm to the center of the knife. If you prefer, you can

also find in books and catalogs puttylike materials that can be molded to

your hand to make gripping utensils easier. These are recommended by many

workers in the field.

Consider also an electric can opener. To open bottles, you will have to try

the many types to see which one works best for you. An interesting one to me

is the OpenUp electric jar opener in the Hammacher Schlemmer catalog

(1-) that twists lids off in seconds and attaches to the wall; it

has a cone-shaped grip with up to five times the twisting power of a normal

hand. In short, you will find many kitchen aids in these catalogs, and so you

will need to review them to see which ones help you.

Getting Dressed

Numerous catalogs offer adaptive clothing for persons with disabilities. Most

are devoted to women's clothing. J. C. Penney's Easy Living Fashions offers

fashionable clothes that use Velcro instead of buttons or zippers for

closure, soft elasticized waists, and sturdy fabric pull loops to give more

leverage. Jackets and tops have roomier armholes for easier sliding on and

off.

You can also find undergarments that have front openings and closings using

Velcro or hooks as closures. One-size stretch bras offer another option to

fasteners and hooks. Some undergarments offer zippers that can be zipped with

one hand.

Many catalogs offer dressing aids that include large and small buttoners and

unbuttoners, zipper openers, dressing sticks with garterlike clasps to hold

clothing in place while dressing, apron hoops, and sock or shoe aids. The

apron hoop is a bendable piece of plastic that springs back in place and is

ideal around the waist to hold pants or skirts in position. A major

improvement in the past several years has been the elastic shoelace that

allows you to slip your shoes off and on without having to tie or untie them.

Many other shoe manufacturers now make Velcro straps to fasten shoes as

another option.

Bathing and Hygiene

If you are limited in function, pay a visit to a medical equipment store to

see items in the bathroom category such as tubs and toilets. Alternatively,

the Sears Health Care catalog offers some selections, but when I visited a

Sears store, I found that they refer you to the catalog and do not have a

special section for health care.

Grooming and bathing aids such as comb holders, special curved brushes,

safety rails, seats for the tub, Interplak electric toothbrushes, special

squeeze containers for toothpaste, and special nail clippers are also

available.

Home Accessories and Housekeeping

One of my pharmacist friends tells me that he uses a product called Easy Dose

pill splitter from Apothecary Products, Inc., 11531 Rupp Drive, Burnsville,

MN 55337 (), for splitting pills for customers who are unable to

cut the pills. This item is not expensive and is easy to use, so you might

get one for yourself. The same company sells an Easy Dose pill crusher that

has a spoon in the well and a round metal crusher that is pushed onto the

pill.

Sammons Preston has a pill-cap opener to make it easy to open those

ridiculous child-proof plastic bottle caps if a grandchild is not around to

do so. The same catalog has a large selection of doorknob turners, scissors,

special brushes for all kinds of housework, and key holders and turners. A

plastic product called Dyna-Form-It, used right out of the can, easily molds

into customized grips on almost anything and is particularly useful for

combs, keys, eating utensils, and doorknobs.

Many people also like reachers, one of the most frequently used home

accessories. These are long rods with open-jaw pincers on one end to grasp an

object and are usually made of aluminum or stiff plastic with pistol-like

handles and trigger designed to allow you to squeeze the trigger and securely

grasp and hold onto objects. People with arthritis find them useful because

it is painful to bend over to pick up something or too dangerous to get on a

stool or ladder to reach up high. Many catalogs have extensive models from

which to choose.

Mobility Aids

Canes, crutches, walkers, wheelchairs, and tri-wheeler power chairs are the

principle mobility aids for people seriously affected by arthritis. Canes are

probably the most commonly used aid-to-daily-living devices. If you have a

problem with one leg, the use of a cane to take some of the weight off that

leg improves mobility and reduces pain. It is important to remember that the

cane is held in the hand opposite to the painful leg. When walking, the cane

is extended when the bad leg is bearing the weight of walking. This may seem

too obvious, but people often use a cane on the same side time after time.

The height of the cane is also important; it should be long enough that your

elbow is almost straight when you are leaning on it. A single rubber-tipped

cane is the most commonly used. Equipment store managers told me, however,

that most people buy a quad cane. This is a cane with a pod of four tips,

which provides greater stability when walking. The cane comes in two styles,

wide and narrow. The narrow size has the tips closer together in the pod so

that walking up stairs is easier. There is also a tripod cane, which is not

sold as often.

You may need crutches when both legs have problems or one leg has such pain

that weight bearing is undesirable or impossible. Sometimes you can use only

one crutch, but usually two crutches are better. If your hands are painful,

use the platform crutch, which has an arm-rest forearm support that allows

easier motion. Crutches should be carefully measured by a qualified person.

Your elbows should be barely bent when you place your hands in the hand grips

and are bearing weight. The underarm pads must be lower than the underarm,

and you must not lean on the crutch when walking. Your hands must bear the

weight. Be sure to have a rubber tip on your crutch point to prevent you from

slipping. In the catalogs already mentioned a wide variety of crutch

accessories are available.

s can help many people who are too weak to support weight or who need

more stability. These devices have four legs, are built of lightweight metal,

and form a supporting frame around the user. The height of a walker must be

set so that the elbow is bent and able to pick up the walker to make the next

step. Most walkers have wheels in front and rubber tipped legs in back for

easier walking and maneuverability; four-wheel walkers are rarely used. Most

catalogs offer a variety of walker accessories, such as pouches to store

needed items.

Wheelchairs need to be individually fitted if you are going to require one

for a long time. The expertise needed cannot be provided by a catalog. You

will need to be properly measured and fitted at an equipment store. If you

can afford it, an electric wheelchair or tri-wheeler adds enormously to

mobility.

Driving and Transportation

In years past, people with serious arthritis were unable to get out and be

independent. Now quite a few devices are available to allow you to continue

independent living. Often the biggest problem is opening the car door and

turning on the ignition. Special devices are available to allow you to do

this. The Arthritis Foundation recommends the gas cap wrench. Gas caps on

cars turn more easily with the gas cap wrench, which provides greater

leverage for turning. The gas cap wrench is available from RAM products

(1-).

Don't let your arthritis prevent you from enjoying life. Whatever your

problem, you can most likely find a device that will enable you to continue

living a full and joyous life.