If you are receiving Medicare benefits you can expect to see changes if the Affordable Care Act(ACA)/Obamacare is repealed. When the Affordable Care Act/Obamacare was first enacted it added enhancements to existing Medicare benefits.
- The ACA significantly decreased the number of uninsured. A repeal of the ACA would once again increase the number of uninsured passing that cost on to hospitals, doctors, other providers and patients including people on Medicare. Expect an increase in Medicare Part A and B deductibles and copayments.
- The ACA added Preventive Services at no cost to you. If the ACA is repealed, expect to pay for your annual Well Visit, PSA Test, Mammogram and flu and pneumonia vaccines, among many others.
- The ACA has been lowering the cost of the doughnut hole. If the ACA is repealed it means the return of the doughnut hole. For those in the doughnut hole they may have to again pay 100% of the cost of their prescriptions, as they did prior to the ACA.
For more information:
National Associations of Area Agencies on Aging:
Kaiser Family Foundation:
Shots and vaccinations aren’t just for children.
The following information is from the National Institute on Health and Aging
Shots for Safety
As you get older, your doctor may recommend vaccinations—shots—to help prevent certain illnesses and to keep you healthy.
Talk with your doctor about which of the following shots you need. And, make sure to protect yourself by keeping your vaccinations up to date.
Flu—short for influenza—is a virus that can cause fever, chills, sore throat, stuffy nose, headache, and muscle aches. Flu is very serious when it gets in your lungs.
The flu is easy to pass from person to person. The virus also changes over time, which means you can get it over and over again. That’s why most people (age 6 months and older) should get the flu shot each year.
Get your shot between September and November. Then, you may be protected when the winter flu season starts.
Pneumococcal disease is a serious infection that spreads from person to person by air. It often causes pneumonia in the lungs, and it can affect other parts of the body.
Most people age 65 and older should get a pneumococcal shot to help prevent getting the disease. It’s generally safe and can be given at the same time as the flu shot. Usually, people only need the shot once. But, if you were younger than age 65 when you had the shot, you may need a second one to stay protected.
Tetanus and Diphtheria
Tetanus (sometimes called lockjaw) is caused by bacteria found in soil, dust, and manure. It enters the body through cuts in the skin.
Diphtheria is also caused by bacteria.
It is a serious illness that can affect the tonsils, throat, nose, or skin. It can spread from person to person.
Both tetanus and diphtheria can lead to death.
Getting a shot is the best way to keep from getting tetanus and diphtheria. Most people get their first shots as children. For adults, a booster shot every 10 years will keep you protected. Ask your doctor
if and when you need a booster shot.
Shingles is caused by the same virus as chickenpox. If you had chickenpox, the virus is still in your body. It could become active again and cause shingles.
Shingles affects the nerves. Common symptoms include burning, shooting pain, tingling, and/or itching, as well
as a rash and fluid-filled blisters. Even when the rash disappears, the pain can stay.
The shingles vaccine is a safe and easy shot that may keep you from getting the disease. Most people age 60 and older should get vaccinated, even if you already had shingles or don’t remember having chickenpox. Protection from the shingles vaccine lasts at least 5 years.
Measles, Mumps, and Rubella
Measles, mumps, and rubella are viruses that cause several flu-like
symptoms, but may lead to much more serious, long-term health problems, especially in adults.
The vaccine given to children to prevent measles, mumps, and rubella has made these diseases rare. If you don’t know if you’ve had the diseases or the shot, you can still get the vaccine.
Side Effects of Shots
Common side effects for all these shots are mild and include pain, swelling, or redness where the shot was given.
Before getting any vaccine, make sure it’s safe for you. Talk with your doctor about your health history, including past illnesses and treatments, as well as any allergies.
It’s a good idea to keep your own shot record, listing the types and dates of your shots, along with any side effects or problems.
Shots for Travel
Check with your doctor or local health department about shots you will need if traveling to other countries.
Sometimes, a series of shots is needed. It’s best to get them at least 2 weeks before you travel. For more information, visit the Centers for Disease Control and Prevention website, www.cdc.gov, or call the information line for international travelers at 1-800-232-4636.
For More Information about Shots and Vaccines
Centers for Disease Control and Prevention
National Heart, Lung, and Blood Institute
National Institute of Allergy and Infectious Diseases
National Institute of Neurological Disorders and Stroke
For more information on health and aging, including free brochures about shingles and flu, contact:
National Institute on Aging Information Center
P.O. Box 8057
Gaithersburg, MD 20898-8057
To order publications (in English or Spanish) or sign up for regular email alerts about new publications and other information from the NIA, go to www.nia.nih.gov/health.
Visit www.nihseniorhealth.gov, a senior- friendly website from the National Institute on Aging and the National Library of Medicine. This website has health and wellness information for older adults. Special features make it simple to use. For example, you can click on a button to make the type larger.
National Institute on Aging
NIH…Turning Discovery Into Health®
Illinois Aging Network Alert
A weekly report on the impact of the state budget crisis on Illinois seniors and community programs on aging
From I4A – Illinois Association of Area Agencies on Aging
Week of June13, 2016
Contact: Joy Paeth 618-222-2561 or Jon Lavin 708-383-0258
When Will Reason Prevail?
This morning several Directors of Illinois area agencies on aging informed the Illinois Department on Aging that they have developed plans to close down their region’s community senior services network this summer. This information was provided during a phone call where the Department explained that federal funding would stop after reimbursements covering the month of June. Unless there is a court order or an enacted state appropriation, no federal funds will be processed for July, August or September. Not all area agencies on aging are in the same situation this summer (AgeOptions would not have federal funding for community based organizations, but will continue state funds for home delivered meals, about half of the meals, if the Court Order continues into July, August and September). It is clear that many of Illinois’ 230 community senior service agencies will desist operations without federal support.
The biggest problem is that the federal dollars are in jeopardy that come from the U.S. Department of Health and Human Services – Administration for Community Living under the U.S. Older Americans Act. The federal appropriation is on a fiscal year that begins October 1, 2015, and concludes September 30, 2016. Under Illinois law, that funding will end on June 30. The Department stated that June reimbursement will come through in early July and then no additional funding is anticipated following that date unless there is a Court order or a state appropriation.
Federal Older Americans Act resources require state match. That match is combined with federal funds to process payments under the Beeks Consent Decree for meals. Home Delivered Meal funding alone is problematic since it may not be used for administrative purposes. Area agencies administer the court ordered dollars with their federal dollars and state match under Planning and Service Area Grants to Area Agencies on Aging. Not a penny of Planning and Service Area Grants has been provided this year.
Without the federal and state funding, there will not be a viable Aging Network. Federal law requires that the Illinois Department on Aging send the federal and state matching resources to the 13 designated area agencies on aging for distribution to community service provider agencies. It may not be proper under federal guidelines for the Department on Aging to send the court-ordered Home Delivered Meal funding directly to community agencies. Those agencies have contracts with area agencies on aging, and no contract with the Department. This is a legal, moral, practical, administrative and human mess! When will reason prevail and Illinois act responsibly to pass an agreed budget with adequate resources to meet its legal obligations under the Illinois Constitution?
If no federal dollars are released and no state administrative support to area agencies on aging is provided, the high stakes game of chicken being played out by elected leaders will result in the loss of independence, health and lives of older persons. It is time for politics to be put aside and for leadership and governance to prevail.
Distributed for I4A by:
“Traditional” and “non-traditional” medicines are often at odds with one another, and have been ever since the scientific method took hold in the Renaissance. In general, that has served humanity well. Science has slowly and steadily teased out the true causes of disease and their treatments, and pushed aside the myths and fabrications of pre-evidence-based health care.
But now, I believe, it is time for reconciliation. Rather than butting heads, “establishment” practitioners and technologies need to collaborate with so-called alternative or allied health providers. Doing so will deepen the care narrative and improve patient experiences.
Traditional medicine is based on scientific discovery. Where once, the ill and infirm would pay good money for Dr. Smith’s Magic Elixir only because Dr. Smith said it work, science helped determine if Dr. Smith’s cure-all really did cure all – or if the alcohol in the magic elixir just made you not care.
However, it is dangerous to think that science itself is a magic elixir. Scientific discovery is still fraught with bias and poor study design. And alternative medicine may not be alternative at all, just based on older teachings that, though not scientifically proven (usually because there is no money to be made by studying them), may be just as valid.
As we all know, patients have been returning to some of those teachings in droves over the past few decades. Take chicken soup. Grandmothers have been touting the healing properties of chicken soup for generations, and a recent study proved your grandmother was right. It really is a time for both the old and the new.
We also need to look at how we got to modern medicine. What was left behind may have been due to political or religious pressure rather than science. The use of silver in medicine is a good example. Once a common remedy in the physician’s black bag, it became too expensive with the advent of photography. Maybe we might come back to it?
In all things there needs to be a balance. Healing cannot occur without a compassionate understanding of the power of the mind. We cannot underestimate that power. I am disappointed that traditional medicine has called this “the placebo effect.” That demeans and diminishes this important healing power rather than really using the mind’s ability and desire to cure the body to its fullest advantage. After all, “science” has proved that 30% of people will have a beneficial effect from a treatment if they believe that it will help. Having healthcare that is in alignment with our belief system is important for that reason.
That’s why I believe we need to add allied health to our practices. We also need to do it right. I am not advocating moneymaking “medi-spas.” I am advocating for the use of real healing massage, real counseling about optimizing diet and exercise, real skin and body care that checks for moles along with providing facials. We need healing foods, healing music, healing movement.
I also believe that we need healing therapies that are specific to our individual heritages. Before humanity was so mobile, it was fine for local and traditional medicine to address those local or regional illnesses. But today, our culture is no longer local. It is multiethnic, multicultural and global. We should have – in fact, we need – care that reflects that diversity of needs and beliefs. We need care that is specific, not one-size-fits-all.
This is not to say that we should embrace all allied health practitioners out of hand. I think we should work with those who have proven their worth over time, culture and, yes, scientific inquiry. There is still a lot of bad, incorrect and downright dangerous information out there, and patients have access to it in unprecedented ways. Doctor Google has been wonderful because it allows patients to feel they have more control, to get a variety of opinions and multiple sources of data. It allows them to ask smart questions, to learn the language, to be involved and to process. However, in the Internet age of the three minute YouTube video or 140-character Tweet, they don’t get the whole story. There is no filter, no expert to confirm to them if that bump on their nose really is –according to whatever source they stumble upon – a spider bite, a pimple or cancer. That is why we must work with allied, alternative practitioners, not against them.
I also advocate for educating these allied health professionals in how to look for diagnostic clues, so that they can then alert the patient/client’s physician. Think about this: A massage therapist likely sees more of the patient than the primary care physician, and is thus more likely to notice darkening of the skin, loss of eyebrows, skin tags, varicosities, joint pain or other signs of disease.
So let’s make use of it. Let’s add chicken soup back to medicine.
AgeSmart Community Resources would like to thank Dr. Teresa L. Knight for this month’s article. Dr. Knight is the CEO at Women’s Health Specialists of Saint Louis.
Pneumonia vaccines are designed to prevent disease caused by various serotypes or strains of the bacteria streptococcus pneumonia. The recommendations for use of these vaccines recently changed, and what to do can sometimes be confusing. The Centers for Disease Control and Prevention (CDC) revised their recommendations for pneumonia vaccines in August of 2014. While I find discussing the vaccine very interesting, if you do not, just skip to the last paragraph of this blog, and you will have the basic facts you need to know!
First, let’s talk about pneumococcal disease, a serious infection that can cause pneumonia, meningitis, and bloodstream infections. Each year about 1 million adults in the USA get pneumococcal pneumonia, and 5-7 per cent of those die from it. The death rates are considerably higher for those over 65 years of age. The symptoms of pneumococcal pneumonia can include high fever, chills, cough, shortness of breath, chest pain, and disorientation. This type of pneumonia can progress to a serious infection very rapidly. While antibiotic treatment is often successful, the best treatment for this problem is to prevent it. There are about 90 serotypes of streptococcus pneumonia identified, but only a few of these cause the majority of serious pneumococcal disease.
There are currently 2 pneumonia vaccines recommended for adults over age 65. The first is pneumococcal polysaccharide vaccine (PPSV23), commonly known as Pneumovax. This vaccine has been around for years, and is recommended as a routine immunization for adults age 65 and over. It protects against 23 of the serotypes of pneumococcus bacteria, and is usually given just once. There are special circumstances where a physician might advise a second PPSV 23, but that is not usually the case. About half the people who get this vaccine have mild side effects such as redness or soreness at the injection site. Less than 1% develop fever, muscle aches, or more severe local reactions.
The second pneumonia vaccine now available is Prevnar-13 (PCV13). As of August, 2014, the CDC recommends that all adults age 65 and over receive 1 dose of this vaccine as well. PCV13 protects against 13 serotypes of pneumococcus, and is quite effective against the serotypes that cause half of the serious pneumococcal infections in adults. Its potential side effects are similar to those of PPSV23.
The CDC recommends that PCV13 be given first if a senior has never had either of these vaccines. If someone has already had the PPSV23, the PCV13 can successfully be given later. These 2 vaccines should not be given together. Until recently, Medicare Part B would pay for only one vaccine, but the good news is that both vaccine doses are now covered as of February 2, 2015. It is important to note that PCV13 and PPSV23 must be given at least 12 months apart in order to have them be both effective and covered by Medicare.
Influenza vaccine can be given at the same time as either of the pneumonia vaccines, but they should then be given in opposite arms. If a person has had a serious reaction to a vaccine in the past, they should discuss with their physician the decision of whether or not to take the pneumonia vaccine. Keep in mind that pneumonia vaccines prevent only the types of pneumonia caused by streptococcus pneumonia, not all kinds of pneumonia, and they are not substitutes for a yearly influenza vaccine. The PCV13 and PPSV23 vaccines are available though many local health departments, immunizing pharmacies, and primary health care providers. If you have had 1 pneumonia vaccine, it is very important to know which one you had in order to know which one to get next.
Here is the bottom line. The pneumonia vaccines are quite safe, and they are very helpful in preventing potentially life threatening disease. They are recommended for virtually all adults age 65 and over. If you have never had a pneumonia vaccine, you should get the Prevnar-13 (PCV13) first, and then the Pneumovax (PPSV23) at least 12 months later. If you have already had the PPSV23, get the PCV13 at least 12 months later. Let’s work to prevent this disease rather than waiting to take our chances in treating it!
AgeSmart would like to thank Dr. Thomas Dawdy for this week’s blog.
Adaptive equipment are devices used to assist with completing activities of daily living. Bathing, dressing, grooming, toileting, and feeding are self-care activities that are including in the spectrum of Activities of Daily Living (ADLs). These devices can range from the most James Bond like electronic devices to something as simple as a piece of rope to pull a hatchback shut or an old tennis ball with a hole in it to hold a pen to aid in writing. Devices can be created or purchased but creativity can provide simple solutions and one need not look to the most modern gadget to achieve the end result.
This is just an overview, skimming the surface of what is available, do not be limited to the areas discussed here in finding inventive ways to complete a task.
People have different abilities and unique needs. Individuals who have physical disabilities in addition to sensory impairments often benefit from a variety of adaptations to routines, materials, and the environment. The following are examples of adaptive equipment and strategies that can be considered in order to help people with physical limitations be more independent with their daily living skills.
Before considering the use of adaptive equipment to promote a persons ability to eat independently, take a look at basic positioning. The Consumer needs to be as close to the table as possible. This will minimize the amount of food that falls into the lap and can discourage slouching, which can interfere with swallowing.
Therapists commonly recommend that positioning follow the rule of 90 degrees. This incorporates a 90-degree bend at the hip, a 90-degree bend at the knees, and 90 degrees of flexion at the ankle. This means that smaller individuals may need footstools when they eat so their feet don’t dangle. This kind of accommodation might not be possible in all places, such as restaurants and outdoor settings, but it is important in school cafeterias, classrooms, and at home in order to develop independent eating skills.
Consider using some of the following materials and equipment to help promote greater independence when eating:
Adapted plates or dishes: HiLo dish, plate (food) guard (clear or metal), a high-sided plate (regular or partitioned), or a scoop plate. Overall, these dishes are good for the visually disabled population because they give them a physical barrier to push their food up against. They are all available commercially at medical supply stores and online.
Dycem (a brand name) can help stabilize the plate or bowl on the bottom to prevent it from sliding. It can also be used to stabilize other things, such as books, tabletop projects, etc. We have even used it to keep a child from sliding out of his chair.
For those who have physical difficulty holding things in their hands, utensils with built-up handles (foam or manufactured supergrip) and hollow-handled or cuffed utensils may help. Hollow-handled utensils allow a helper to insert a finger into the handle to teach the correct motion of scooping.
Adapted utensils might also work with those who have tactile or sensory deficits, coordination problems, or reduced strength. Angled spoons may help get the food to their mouth more successfully because they require less wrist movement. Weighted utensils are good for those who need more feedback to help them grade their force when scooping food onto the utensil or if they have tremors/unsteadiness in their hands. A rocker knife or T-shaped rocker knife can be helpful for people who have the use of only one hand.
Cooking Skills and Food Preparation
Adaptive equipment can also help develop more independence with cooking skills and food preparation, especially those who have the use of only one hand.
Spread boards can be used to stabilize a slice of bread, so that it does not move when spreading food over it.
Two pins on an adapted cutting board will hold food in place during cutting tasks.
A one-handed dish scrubber can be suctioned to the bottom or side of the sink to let you wash dishes, bowls, cups, and utensils with one hand.
The Pan Holder (suction cups) keeps the pan from turning when cooking on the stove. The suction cups don’t work as well, however, when the stove top gets hot.
People with physical or visual impairments can use adaptive equipment to dress themselves more independently.
Individuals with limited functional reach to their lower extremities can use a long-handled shoehorn to independently put on and take off their shoes.
For people who cannot tie their shoelaces because of physical or cognitive limitations, elastic shoelaces are an option, as are shoes with Velcro closures. Elastic laces turn regular laced shoes into slip-on shoes by letting the tongue of the shoe stretch to accommodate the foot. They come in two different types, Spyrolaces for younger children, and Tylastic(which look like regular shoelaces) for older Consumers who want to look more age appropriate.
Reachers work well for an individual in a wheelchair who has some vision. The reacher lets the person pick up items that have dropped on the floor.
For some individuals with limited functional reach to their lower extremities, a dressing stick makes putting on and removing socks or pants simpler. Most of the dressing sticks can also be used as a shoehorn, but they may not be as comfortable for this use as the metal shoehorns.
For individuals who cannot bend down to touch their toes, the sock aid can help them get the sock over their foot (some coordination is necessary and some vision helps).
For the those who lack fine motor coordination or who have the use of only one hand, a button hook or a zipper pull might be useful.
Velcro adaptations can be made on clothing for individuals that have difficulty with fasteners, such as those often found on pants.
Some individuals use a device known as a Dressing Bar. Someone in a wheelchair that has upper body strength and some coordination in his/her hands can use the dressing bar to pull to standing and then pull his/her pants/underwear up or down. Those who have less upper body strength or coordination skills can hold onto the dressing bar while being assisted with their pants/underwear.
The Flipfold is a 4-panel device that can assist with folding shirts, pants, and towels.
Spotlight on Clothing and Dressing Hints
• Look for items with Velcro closures or snaps rather than buttons,or consider altering your existing clothing with these closures.
• Homemade zipper pulls can be made by tying on a piece of cloth or attaching a circular key ring, piece of fishing line, or other object.
• Rub the lead from a pencil on the teeth of a sticky zipper to make it easier to pull.
• Slip-on shoes are easiest for dressing, and those with Velcro closures avoid laces.
• Spiral, “no-tie” shoelaces just need to be twisted once or twice and allow you to secure a shoe without having to tie a knot.
• Elastic shoelaces look like regular laces except for the elastic “give.” The elasticity will allow you to slip shoes on or off more easily. • Long-handled shoe horns are helpful for slipping on shoes without having to bend down as far.
• Sock aids prevent you from having to bend down to slip on socks. One version holds the open sock at the end of a U-shaped device that has long rope handles. Another consists of a wire or plastic frame that holds socks or stockings in place for the foot to be slipped into. Caregivers can place socks on these aids in advance for the next dressing time.
• Whenever possible, sit while dressing so you can safely rest as needed. If one side of the body is weaker, it takes less effort to dress this side first. For example, put the weaker arm into the shirt sleeve first, the stronger arm next.
The foam described above for use with eating utensils can also be used on other things, such as toothbrushes, razors, hairbrushes, and pens.
Toothpaste dispensers can help individuals with limited finger/hand function or visual impairments put the correct amount of toothpaste on their toothbrush. The main drawbacks to these dispensers are the price (they can be rather expensive) and they only work with Aqua-Fresh 4.3- or 4.6-oz pump toothpaste.
Spray-can extenders can help people with decreased movement, control, or strength in their fingers.
There are also soap dispensers with single (like the ones you see in the public restrooms) and multiple containers that can be mounted in the shower/bathtub area for easier access for people with limited hand function or use of only one working hand. The drawbacks are that the dispensers that require drilling (for mounting on the wall) might not be possible in some bathrooms, and the dispensers held by adhesives might not hold well.
Long-handled sponges allow people with limited reach to wash their backs, lower legs, and feet.
Adaptive devices such as button hooks, key holders, utensils with built-up handles, plate guards, tub transfer seats, lifting cushions, and raised toilet seats make it easier for you to perform daily living tasks. Other aids, or orthotic devices, include wrist supports to assist weak muscles and improve hand function, hand splints for positioning, and neck supports to help support and protect your head and neck.
Home and work modifications include ramps (see picture at right), widened doorways, raised seating, walk-in showers and rails. The OT also assesses safety and helps you and your family structure your environment to reduce falls. Ergonomic devices such as computer arm supports, armrests, footrests, and the no-hands or easy-touch mouse can enable those with severe arm weakness to continue working, maintain productivity at home, and enhance their quality of life.
Community resources also can enrich your life and provide support for caregivers and family members. For example, people with ALS can obtain permits to park in handicap-designated spots early on to help combat fatigue. This guide has information about community resources such as books on tape, MDA support groups and seminars, and public transportation services. You also may get some help from senior citizens’ programs, such as Meals on Wheels.
Therapeutic interventions performed by occupational therapists include range-of-motion, fabrication of splints and other orthotic devices to maintain and improve hand function, and training the caregiver in transfer techniques and stretching exercises.
Help with activities of daily living
Many devices have been designed to help you preserve the ability to perform daily tasks by modifying commonly used items. Other assistive devices make use of the stronger or unaffected muscles to increase efficiency and performance of daily tasks. For example, the button hook allows you to button clothing with a gripping motion rather than relying on finger strength and dexterity.
The following is a sample of the many simple assistive devices available. Each is designed to allow you to continue with normal activities for as long as possible. Most can be found through medical or rehabilitation equipment dealers, or by searching the Internet for “daily living aids.” In some cases you can create these and similar devices yourself.
Finger dexterity is required for buttoning clothing. If this is a problem, you may elect to use Velcro in place of buttons, use oversized buttons with large loops, or wear clothing that requires no fasteners. An alternative to these methods is the use of a button hook.
Grip the enlarged handle of the hook and feed the wire loop through the button hole. Catch the button in the loop and slide the button back through the hole.
Adequate strength in fingers and arms is necessary to grip and zip a zipper. With increasing weakness you may need to use a zipper with a loop placed through the pull or clothing that requires no fasteners, or a zipper pull.
A hook connected to an enlarged handle is placed in the eye of the zipper to pull the zipper up or down.
As pinch strength and dexterity decrease, handwriting may become more difficult. Enlarging your pen/pencil with a triangular grip or cylindrical foam will position the fingers, reduce strength needed, and make writing easier and more legible.
You can find cylindrical foam in various diameters and may want to use it for an easier grasp for razors, eating utensils, toothbrushes and similar items with handles.
Some people use a small, hollow rubber ball in this way, or look for utensils made with larger grips.
Considerable pinch and hand strength are required to turn a key in a lock. Should weakness make this task difficult or impossible, you can use a key holder. A key holder is made with bars of stiff plastic and screws to hold the keys.
The key holder provides leverage for turning the key in the lock.
If holding soap and a washcloth is difficult, a bath mitt may solve the problem. Insert your hand and the soap into the terrycloth “pocket” and close it with Velcro.
Car door opener
Strong plastic handles for opening push button or pull-up car door handles are available. These handles use grip and leverage instead of finger dexterity.
This knife has a curved blade and an enlarged handle. You can cut food with it by using a rocking motion.
Door knob extenders
This device increases leverage to aid in operating knobs, handles or controls. For example, you can use it on faucets, door knobs, stove handles and lamp knobs.
If you have difficulty opening twist or screw-on caps with the fingers, you can use a screw cap. It fits into the palm of the hand and requires minimal strength to turn.
If your grasp is weak, and you enjoy playing card games, a card holder is helpful.
These practical, lightweight scissors are made for either right- or left-handed users. A self-opening handle enables easy operation by a simple squeezing action.
A long, plastic tube eliminates the need to lift the glass when drinking.
This metal device clips onto the side of a glass and holds the straw securely in place at a right angle.
Offset eating utensils
An angled head reduces the dexterity needed to bring food to the mouth. Utensils with oversized handles also can be easier to grasp. (See photo at right.)
Electric or battery-powered openers can open various sizes of jars and bottles, and some can be mounted under a cabinet or shelf. A manual jar opener also can be helpful.
This long, lightweight aluminum reacher has a trigger or grip closure and is designed to extend your reach upward or downward without bending or stretching.
Most standard table heights don’t allow a wheelchair to fit underneath. Risers are extenders that fit under each leg of a table to increase the table height by 2 to 8 inches. Risers can also be used with chairs, beds and couches to make transfers easier, as higher surfaces are easier to get up from.
You can secure this elastic band with a pocket around your hand to hold utensils, pencils, page turner, etc.
This wire-framed stand holds the book open and the pages back.
An elastic brace supports your wrist to stabilize your hand. This support is commonly used by people with ALS, and your OT can show you how it functions and assists you.
Resting hand splint
Made of sturdy plastic, this splint positions your hand and wrist comfortably to counteract the effects of muscular tightening.
Shampoo rinse tray
Use this shampoo basin while you’re lying flat in bed. The caregiver places your head inside the basin with your neck resting on the soft ring and pours water over your hair. A flexible plastic tube drains water to the container you supply alongside the bed.
This tent-shaped, ultrasensitive touch plate activates by a touch or head turn. A wireless doorbell also can be used as a personal call system.
Rising or lift chairs
Recliner-style chairs help you go from sitting to standing because their seats slowly rise and tilt forward. Another option is rising or lift cushions that slowly spring open to assist a seated person in standing.
These cushions are portable, so you can take them to restaurants, theaters and other places you visit.
Decreased mobility eventually may make it difficult to move to a toilet or bedside commode. Alternatives that don’t require transferring from the bed include bedpans, urinals and external catheters that drain into a collection bag.
If maintaining good hygiene becomes a problem, a bidet or a handheld shower nozzle may be useful. A bidet is a device that fits into the toilet tank and connects to a warm water supply. An under-seat, warm-water spray head operates with a hand control.
Other helpful items include toilet seat risers (or raised commode seats) that increase the height of a toilet seat and make it easier to get up and down. Some models include safety handles, and others have lift mechanisms to help the user stand.
If you’re still using a regular bed, your caregiver may appreciate a draw sheet, which will help him or her easily roll and position you. The sheet is placed under you extending from shoulder level to buttocks with at least 6 inches of sheet remaining on each side.
Some families have found that satin or nylon sheets or pajamas make turning the person easier.
Specifically designed to prevent discomfort from immobility and encourage good blood flow to the skin, mattress overlays are fabricated from foam, rubber, gels or in an innovative honeycomb design. Similar technology can be found in wheelchair cushions. These greatly increase comfort and can help prevent painful bedsores.
Head and neck support
Similar materials and technology used in foam or air mattress overlays also are used in special pillows that provide added support for head, neck and surrounding muscles.
A hospital-style bed is recommended for those who spend a majority of their time in bed or have very limited mobility. This bed allows your caregiver to adjust your position easily, elevating your feet to prevent swelling and your head for watching television, reading, etc. It also aids in positioning and weight shifting when turning in bed becomes difficult.
A major advantage of a hospital bed is that it reduces the risk of injury to your caregiver. The height of the bed can be adjusted to prevent him or her from stooping, bending, pushing and pulling, thereby lessening the chance of back strain or other injury.
You can purchase or rent traditional hospital beds from medical suppliers. Convenience features include side rails, adjustable height, and adjustable mattresses for raising or lowering head or feet. Some beds with these features are constructed to look like typical bedroom furniture, with attractive wood panels that obscure the operating controls.
Alternating pressure/turning mattresses
To help prevent pressure sores, alternating pressure mattress overlays automatically inflate and deflate cells along their length, and provide different pressure/firmness settings. Electrically powered turning mattress overlays will automatically turn you every few minutes (from side to side). Turning beds provide the ultimate in technology — the entire bed rotates, not just the mattress. All can provide great relief to caregivers.
Bed safety rails
These provide a sturdy handle or rail to grasp while you’re getting in and out of bed. Some designs slide between mattress and box springs, and others stand on the floor.
A growing selection of clothing made specifically for people who use wheelchairs is available. Pants, shirts, jackets, shoes, boots and more have been designed for comfort and convenience.
The items are designed with clever features like openings in the back, and made not to look rumpled or ill-fitting on someone who’s seated. Although not always available in your local department store, this specialized clothing usually can be purchased by mail, phone or over the Internet.
The phone holder fastens to the receiver with a Velcro closure and provides a handle on the receiver. Slide your palm into the U-shaped opening and bring the receiver to your ear.
With this flexible metal arm that places the receiver in position, you don’t need to lift the receiver off the base. Flip the switch to open the line and place your ear near the receiver.
There are numerous adaptations and accessories available that can make using the telephone easier or possible for people with ALS.
In fact, many assistive features are standard on today’s phones, such as speed dialing, one-touch dialing, speaker phones and voice-activated systems. Other adaptations can be made with inexpensive accessories, such as hands-free headsets or large button adapters for easier dialing.
Cellular phones and wireless phones offer even more independence, as users can be just about anywhere and make or take a phone call. Occupational therapists and other experts can also help you integrate a telephone with an augmentative, alternative communication device, or an environmental control unit.
Phones with “emergency response systems” are another option that provides increased ability to contact emergency workers, friends or relatives in the event of a problem. Some systems can play a prerecorded message to alert the person you call that you’ve had an emergency. They may come with a remote-control autodialer that can be activated by a button worn on a necklace or a belt.
Local phone companies have TTD equipment that’s generally provided for people with hearing impairments. This equipment, which sends telephone messages that you type, can also be useful if you’ve lost the ability to speak. Of course, e-mail also replaces many telephone functions.
The local library and used bookstores are good resources for audio books, as is the National Library Service for the Blind and Physically Handicapped. Mechanical page-turning devices enable hands-free reading. E-readers, such as the Kindle by Amazon, offer read-aloud features for a wide range of books and publications.
Books and the vast resources of the Internet can be accessed hands-free via eye-gaze or eye-tracking software.
MDA ALS Caregiver’s Guide — Chapter 2: Daily Care of Your Loved One with ALS
Mobile Tech Tips for Weak Hands, Quest, October-December 2011
Bidets: A Disability Friendly Way to Go, Quest, April-June 2011
Get Up, Get Out, Get Going, Quest, November-December 2008
Low-Tech, Low-Cost Assistance for Daily Living, MDA/ALS Newsmagazine, September 2008
Splish Splash: Easier Ways to Get Clean, Quest, January-February 2008
Sleep Aids: Low-Tech Strategies for Improving Sleep Comfort, MDA/ALS Newsmagazine, March 2007
MDA national equipment program
MDA assists individuals with obtaining and repairing durable medical equipment through its national equipment program. The program is open to anyone for whom durable medical equipment has been recommended by an
MDA clinic doctor.
Through its local field offices, MDA gratefully accepts donations of durable medical equipment for distribution through its equipment loan program. MDA is able to make minor repairs to gently used equipment. MDA staff also can help you locate other local sources and funding options for daily equipment and assistive technology.
American Occupational Therapy Association, (301) 652-2682. Can help you find a specialist in your area.
National Library Service for the Blind and Physically Handicapped, (800) 424-8567. Through a national network of cooperating libraries, NLS administers a free library program of Braille and audio materials circulated to eligible borrowers in the United States by postage-free mail.
AgeSmart would like to thank Steve Fulton from Linc for providing this blog and also for presenting this topic at our July Snacks and Facts.
Steps to Protect Your Eyesight
Have your eyes checked regularly by an eye care professional—either an ophthalmologist or optometrist. People over age 65 should have yearly dilated eye exams. During this exam, the eye care professional should put drops in your eyes that will widen (dilate) your pupils so that he or she can look at the back of each eye. This is the only way to find some common eye diseases that have no early signs or symptoms. If you wear glasses, your prescription should be checked, too. See your doctor regularly to check for diseases like diabetes and high blood pressure. These diseases can cause eye problems if not controlled or treated.
See an eye care professional right away if you:
- Suddenly cannot see or everything looks blurry
- See flashes of light
- Have eye pain
- Experience double vision
- Have redness or swelling of your eye or eyelid
Protect your eyes from too much sunlight by wearing sunglasses that block ultraviolet (UV) radiation and a hat with a wide brim when you are outside. Healthy habits, like not smoking, making smart food choices, and maintaining a healthy weight can also help protect your vision.
The following common eye problems can be easily treated. But, sometimes they can be signs of more serious issues.
- Presbyopia (prez-bee-OH-pee-uh) is a slow loss of ability to see close objects or small print. It is normal to have this problem as you get older. People with presbyopia often have headaches or strained, tired eyes. Reading glasses usually fix the problem.
- Floaters are tiny specks or “cobwebs” that seem to float across your vision. You might see them in well-lit rooms or outdoors on a bright day. Floaters can be a normal part of aging. But, sometimes they are a sign of a more serious eye problem such as retinal detachment. If you see many new floaters and/or flashes of light, see your eye care professional right away.
- Tearing (or having too many tears) can come from being sensitive to light, wind, or temperature changes, or having a condition called dry eye. Wearing sunglasses may help. So might eye drops. Sometimes tearing is a sign of a more serious eye problem, like an infection or a blocked tear duct. Your eye care professional can treat these problems.
- Eyelid problems can result from different diseases or conditions. Common eyelid problems include red and swollen eyelids, itching, tearing, and crusting of eyelashes during sleep. These problems may be caused by a condition called blepharitis (ble-fa-RI-tis) and treated with warm compresses and gentle eyelid scrubs.
The following eye conditions can lead to vision loss and blindness. They may have few or no early symptoms. Regular eye exams are your best protection. If your eye care professional finds a problem early, there are often things you can do to keep your eyesight.
- Cataracts are cloudy areas in the eye’s lens causing blurred or hazy vision. Some cataracts stay small and don’t change your eyesight a lot. Others become large and reduce vision. Cataract surgery can restore good vision. It is a safe and common treatment. If you have a cataract, your eye care professional will watch for changes over time to see if you would benefit from surgery.
- Corneal diseases and conditions can cause redness, watery eyes, pain, problems with vision, or a halo effect of the vision (things appear to have an aura of light around them). Infection and injury are some of the things that can hurt the cornea. Some problems with the cornea are more common in older people. Treatment may be simple—for example, changing your eyeglass prescription or using eye drops. In severe cases, surgery may be needed.
- Dry eye happens when tear glands don’t work well. You may feel itching, burning, or other discomfort. Dry eye is more common as people get older, especially for women. Your eye care professional may tell you to use a home humidifier, special eye drops (artificial tears), or ointments to treat dry eye.
- Glaucoma often comes from too much fluid pressure inside the eye. If not treated, it can lead to vision loss and blindness. People with glaucoma often have no early symptoms or pain. You can protect yourself by having regular dilated eye exams. Glaucoma can be treated with prescription eye drops, lasers, or surgery.
- Retinal disorders are a leading cause of blindness in the United States. Retinal disorders that affect aging eyes include:
- Age-related macular degeneration (AMD). AMD can harm the sharp vision needed to see objects clearly and to do common things like driving and reading. During a dilated eye exam, your eye care professional will look for signs of AMD. There are treatments for AMD. If you have AMD, ask if special dietary supplements could lower your chance of it getting worse.
- Diabetic retinopathy. This problem may occur if you have diabetes. Diabetic retinopathy develops slowly and often has no early warning signs. If you have diabetes, be sure to have a dilated eye exam at least once a year. Keeping your blood sugar under control can prevent diabetic retinopathy or slow its progress. Laser surgery can sometimes prevent it from getting worse.
- Retinal detachment. THIS IS A MEDICAL EMERGENCY. When the retina separates from the back of the eye, it’s called retinal detachment. If you see new floaters or light flashes, or if it seems like a curtain has been pulled over your eye, go to your eye care professional right away. With surgery or laser treatment, doctors often can prevent loss of vision.
Low vision means you cannot fix your eyesight with glasses, contact lenses, medicine, or surgery. Low vision affects some people as they age. You may have low vision if you:
- Can’t see well enough to do everyday tasks like reading, cooking, or sewing
- Have difficulty recognizing the faces of your friends or family
- Have trouble reading street signs
- Find that lights don’t seem as bright
If you have any of these problems, ask your eye care professional to test you for low vision. Special tools can help people with low vision to read, write, and manage daily tasks. These tools include large-print reading materials, magnifying aids, closed-circuit televisions, audio tapes, electronic reading machines, and computers with large print and a talking function.
Other things that may help:
- Change the type of lighting in your room.
- Write with bold, black felt-tip markers.
- Use paper with bold lines to help you write in a straight line.
- Put colored tape on the edge of your steps to help you see them and prevent you from falling.
- Install dark-colored light switches and electrical outlets that you can see easily against light-colored walls.
- Use motion lights that turn on when you enter a room. These may help you avoid accidents caused by poor lighting.
- Use telephones, clocks, and watches with large numbers; put large-print labels on the microwave and stove.
Remember to ask your eye doctor if your vision is okay for safe driving.
Here are some helpful resources:
National Eye Institute
31 Center Drive MSC 2510
Bethesda, MD 20892-2510
National Library of Medicine
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