The 6 Stages of Accessibility: Middle Stages of Disease

For many, dealing with the changes that come with a progressive disease diagnosis can throw life as planned off course.

The initial prognosis for a progressive disease is usually very well explained; however, as physical condition changes and worsens, needs change as well. Providing the equipment that will take care of needs now and in the future is critical to maintaining quality of life throughout the progression of the disease.

Understand the Diagnosis and Prognosis

Often the complexities of a diagnosis are more than a client can absorb while in the doctor’s office. As you begin to work with your client, make sure you get a clear picture of the situation. There are a multitude of resources available to assist in you becoming an expert in the condition of the client. Begin by asking real questions. Empathy is important in each of these situations, but for the proper recommendations on equipment, use a questionnaire to assist in determining what is needed. Agencies that represent specific diseases have resources to help you ask the right questions and be the expert that your client needs you to be.

Make the Right Recommendations

Recommending the correct equipment will ensure that your client’s needs are taken care of on a long-term basis. Research on a specific diagnosis will keep you on the right track. In your repertoire of products, make recommendations that efficiently take care of the condition that your patient has developed. Watch for additional symptoms that may develop such as:

• Bladder or bowel incontinence
   
• Eye problems
   
• Falls and dizziness
   
• Fatigue
   
• Freezing
   
• Pain
   
• Restless legs syndrome
   
• Skin and sweating problems
   
• Sleep problems
   
• Speech and communication problems
   
• Swallowing problems
   

With each of these symptoms, additional care may be taken to ensure your patient’s safety. For example, sleeping problems may lead to increased attempts to get up during the night. Patients with limited mobility may be prone to slips and falls or falls related to trying to get out of bed. Full evaluation of the bedroom for sturdy nightstands, or devices to assist in getting in and out of bed are very important. A bed rail or similar device is an important tool. Simple additions of motion sensing night-lights and even electric beds are great recommendations. Each room can provide its own challenges so make sure that a full evaluation is conducted. CEAC and CAPS certifications are important tools to train your staff, and the utilization of tools such as the Live at Home Pro APP make you the expert.

Maintain Ability to Do Basic Functions

One of the major issues that tends to cause rapid deterioration for clients is the loss of their independence and ability to do daily functions. One simple area is eating. As daily eating becomes more of a chore, individuals may opt to simply skip meals and in turn begin to suffer from lack of nutrition. There are two basic areas that need to be addressed in this category aside from making sure that there is sufficient food available.

Food Preparation

Some basic considerations for food preparation as diseases reach the middle stages and mobility becomes more limited is the ability to reach into cupboards, get the utensils, pots and pans and then begin preparation. Above-counter cupboards can be very difficult to access, and items that are in the back of cupboards can be even more of a challenge. Some basic design changes that can make the kitchen more accessible include lowering the cabinets or installing devices that will lower the items in the cabinets. Creative solutions for cabinets can be found with companies such as Rev-A-Shelf, making even the higher cabinets accessible. Having shelves that pull out to easily access the back of the cupboards is also an important addition.

Utensils that are easily usable are important during food preparation. Another point for consideration during the preparation process is access to the appliances. Often kitchen accidents occur when someone is reaching over the top of a stove to adjust the burners or reaching to the back of the sink to turn the water on or off. Burns and falls are two of the most common injuries and can result in major and even life threatening complications for your client. During the modification of the kitchen area, make sure that the controls for the appliances are on the front and easily accessible. General Electric has a good selection of appliances that are designed to meet ADA standards, as do other major appliance brands.

Food Consumption

Preparation of food is only part of the challenge in one’s independence. Once the food is prepared, the client must be able to consume the food. As mobility decreases, the ability to use standard silverware may be a challenge. Some basic recommendations may help increase the ability of a client to eat, and in turn help maintain their nutritional levels.

Start by using an insulated dish to keep food at the right temperature for slow eaters. As the client eats, a point of frustration can be food sliding off the plate as attempts are made to get the food on a utensil. Using a hi-lo scoop plate can eliminate this concern. Using a rocker knife for food cutting and easy-to-hold utensils will assist in the utilization of the utensils. Drinking from a nosey cup can eliminate the need for bending the head back to drink and can eliminate spills from drinking. All of these combined with the use of a non-slip surface, such as Dycem, will keep the plate and utensils from sliding off the table. Many of these items are inexpensive and easy to find, making the process simple for your client.

Keep on the Go

As mobility decreases, one easy trap to fall into is having your client stay home all the time. When someone gets to the point that the only time they leave their home is when they go to the doctor or the hospital, it very much adds to their stress and decreases their mental outlook on life. There are many aids to keep them mobile, so providing them with the tools needed is very important. Whether mobility needs require a cane or walker or a motorized mobility device, utilizing aids to daily living assist in maintaining independence as well as keeping a patient mobile and active. Ranging from devices such as aids to help close the door or put on a seatbelt, to using a device to help turn the key in the vehicle or a handle to help you stand when getting in and out of the car, these devices keys to allowing accessibility and mobility and keep your client on the go.

Accessibility and mobility are key aspects to the overall quality of life as an individual faces diseases that reach the middle stages of severity. Provide the recommendations that your client needs that will ensure no additional injuries or complications result and will assist in providing the best quality of life possible.

This article is the fifth in a six-part aging-in-place case study series. Each segment will focus on a particular aspect of aging-in-place. Read other articles in this series here.