Needs and opportunities in rehabilitation. Aids and the environment

Technology for People with Tetraplegia, Part 1: Accessing Computers

Computers have provided a means for people with tetraplegia to compete equally with able-bodied individuals, develop their intellectual and creative abilities and improve their quality of life. For this group of people to benefit from using computers, alternatives to the standard keyboard and mouse, and software to increase the rate of inputting data, are essential. This article describes ‘transparent’ alternatives to standard hardware and software. It discusses keyboard alternatives, point and shoot devices, switches, voice recognition, keyboard emulation and text acceleration packages. The importance of rehabilitation centres offering a comprehensive and up-to-date computer service is highlighted.

Commodes: inconvenient conveniences

OBJECTIVES

To investigate use of commodes and attitudes of users and carers to them.

DESIGN

Interview with semi-structured questionnaire of subjects supplied with commodes from Leeds community appliance centre.

SUBJECTS

140 users of a commode and 105 of their carers.

RESULTS

Main reasons for being supplied with a commode were impaired mobility (130 subjects), difficulty in climbing stairs (128), and urinary incontinence (127). Main concerns of users and carers were lack of privacy (120 subjects felt embarrassed about using their commode, and 96 would not use it if someone was present); unpleasant smells (especially for 20 subjects who were confined to one room); physical appearance of commode chair (101 users said it had an unfavourable appearance, and 44 had tried to disguise it); and lack of follow up after commode was supplied (only 15 users and carers knew who to contact if there were problems). Users generally either had very positive or very negative attitudes to their commodes but most carers viewed them very negatively, especially with regard to cleaning them.

CONCLUSIONS

Health professionals should be aware of people's need for privacy when advising them where to keep their commode. A standard commode is inappropriate for people confined to one room, and alternatives such as a chemical toilet should be considered. Regular follow up is needed to identify any problems such as uncomfortable or unsafe chairs. More thought should be given to the appearance of commodes in their design.

A regional survey of the housing circumstances of families with children experiencing intellectual and motor disabilities

Housing is an important aspect in promoting the home care of disabled children, but also one which is too often forgotten by professionals. The purpose of this study was to evaluate the housing conditions and the need for modifications, of 204 families with disabled children using technical aids. The housing condition of the families was good compared to average Finnish families with children. One hundred and sixty families had made no housing modifications, but 48 families had need for them, most often to bathrooms and toilets. The need increased with the severity of the children's motor and intellectual disabilities and the need to provide care in line with the number of technical aids in use. It is concluded that families with disabled children need more information on the possibilities for carrying out housing modifications, and that home visits by a case manager are important to evaluate environmental factors affecting the care.

Aids and adaptations for the elderly at home: underprovided, underused, and undermaintained

A random sample of 140 elderly people aged over 75 was selected from the age-sex register of an urban general practice to assess the provision and use of aids and adaptations in their homes. Many of the aids that the elderly had were faulty, including half of the walking aids and 15% of hearing aids, reading spectacles, and dentures, and up to half of the aids were not used. Yet despite this underuse there were many disabled elderly people who required aids for the bath and toilet. When screening of elderly people is carried out in general practice assessment of aids and adaptations should be included to see that they are provided where needed, are used, and are adequately maintained.