Recently I wrote on SCI, TBI, ALS and other neurological disorders. In these blogs, I mentioned modified functional independence. I discussed how a person can stand, walk, commute in a car, go up and down the stair with limited or no active use of his or her extremities. These all come with the help of technology and use of assistive devices.
If you are an occupational therapist, you know how the use of assistive technology or adaptive devices can change a person’s quality of life. So the whole psychology of a patient! This is not only important for a person’s well- being but also a necessary requirement for many patients with limited social help.
As exciting as this sounds, let me tell you that home modifications are expensive, and takes a long time. Depending on the insurance, it may take years to go through the process of getting approval to actually build it in the house. Yes, we are talking about building something in the pre-existing house. So regardless to say, the type of home, built of the home as well as other scenarios like the type of the walls and ceiling are crucial here.
Home Modification options for Transfer:
Few of my previous articles, I discussed how to achieve functional independence to perform daily activities. But what about transfers or ambulation? If a person has some degree of active range of motion, a clinician will try to use one of the transfer techniques described here.
When none of these works, a clinician will start thinking and recommending different modes of transfer. This can be with the use of some type of lifts. There are lifts available that attach to the ceiling of the room. A cognitively intact person can operate the lift independently with a remote with some basic training.
Home Modification Options for Car Transfer:
A person can transfer into the electric or motorized chair. There are two options to get in and out of the car independently. First is to have a ramp installed in the back of the car (at the trunk side). A person can get in the car with the ramp and commute independently. Of course, he or she will need someone to drive the car. Many transport companies including Uber has a wheelchair van now. This van can accommodate a power chair as a well manual wheelchair. This way a wheelchair-bound person can go anywhere independently.
The other option is to fit the motorized chair directly into the passenger seat. This is usually in the front seat. This specialized power chair can be used for mobility after a person is out of the car as well. So a person is not performing any transfer whatsoever. Just put yourself into the front passenger seat!!
When a person is able to perform some degree of transfer, a clinician may recommend different adaptive devices. Some of these examples include a transfer board, slide board, pivot disc, transfer belt etc.
Home Modification options for Ambulation:
With tracks attached to the ceiling and a harness, a person can perform some short distance ambulation. This helps a cognitively intact person who has some independent functional use of upper extremities but has weak lower extremities.
Different companies have their names for this kind of track systems. All types basically do similar things. With the use of a harness, a person’s body weight is suspended to the ceiling. With the use of harness and ceiling, a person takes few steps in the kitchen to heat his cup of coffee or walks from kitchen to living room to sit on the sofa!
Home Modification options for Stair glides:
This is another cool technology that helps many patients. Many patients can perform short distance ambulation but cannot perform the stairs. The reason being there is a different contraction and muscle work involved in stair performance. That is where stair glides come into action. A person sits in a chair, which is a battery operated. As the name suggests, the chair glides up and down which is usually attached to the railing of the stairs.
As I mentioned earlier, home modification takes a long time and a good amount of planning. For insurance to pay for such kind of modifications depends on, the type of injury, the prognosis from the injury as well as the severity of the injury. There are special federal and state grant options available for this kind of home modification. Below are few sites that can guide you through the special grant and waiver program.