Don’t Fail that Fall

by Aimee Sterk

Did you know that one out of three adults age 65 and older fall each year?

Disability.gov had such a great post about falls prevention, and safety, we wanted to share it here.

Falls are the number one cause of fractures, hospital admissions for trauma, loss of independence and injury or deaths for seniors. But you can take action! Learn how to prevent falls outdoors and at home or take a falls risk self-assessment. Visit the website of the Fall Prevention Center of Excellence to find information to keep you and your loved ones safe from falls. The site has resources for older adults and caregivers, including the three main strategies of fall prevention: balance training and physical activity, medical management and environmental or home modifications. Get answers to frequently asked questions about falls and aging adults from the National Institutes of Health’s SeniorHealth.gov. Learn about fall prevention programs and strategies from the National Falls Prevention Resource Center. For more information, read “6 Steps for Preventing Falls” for more information.

“Pawsatively” Helpful: AT for Dog Care

By Laura Hall, MATP Staff

Adler in a service dog vest laying downA few weeks ago, I attended a training that was more intense and grueling than any other training I’ve given or received, but the reward was life-changing.  For two weeks I attended “Team Training” through Canine Companions for Independence to receive my second service dog.  After working with many dogs and learning a litany of commands, I was matched with Adler, a yellow lab/golden retriever cross.  Adler, although he is not technically assistive technology, assists me in many ways.  For example, he picks up dropped objects, helps get laundry out of the dryer, tugs the basket into my room, turns on light switches, opens doors, and can help me complete retail transactions at high counters, by giving the cashier money, taking the bag and delivering it to me.  Having him has already helped me increase my independence greatly, yet, we still rely on assistive technology to help take care of each other.

Adler using a tub rope to open a doorAdler needs a few tools to help him do his job.  One of the most important tools he uses is the tug rope.  This can be an actual rope or just fabric braided together and knotted at the end.  I can tie this to laundry baskets, doors, and drawers so he can tug them open.  Upon returning to work, I was surprised that Adler could not find the power door button.  When observing his behavior, it looked as though he didn’t know where to target his nose.  I realized that he was used to pushing power door buttons that were circular, like the one at the training center.  A co-worker had the idea to paste a cardboard cutout of a round button over our rectangular button, and immediately he recognized where he was supposed to push.  During the course of the week, we cut the circular cutout smaller and smaller until he was able to target just the rectangular button.  I suppose even the smartest of dogs can use some basic, low-tech AT.

Round accessible power door button pasted over a smaller rectangular button

While Adler can do many things, he cannot, unfortunately, feed himself, fully groom himself, or clean up after himself in the yard.  This is where assistive technology comes into play for me.  Before we even returned home, I purchased an elevated food and water dish, with storage space underneath for the dog food.  This allows me to fill his bowls without attempting to reach them on the floor or missing the bowl by pouring from above.   Elevated dishes are also better for dogs’ hips, back, and neck, and promote better digestion.

Contrary to popular belief, many dogs, and Adler in particular, love to be kenneled.  It provides him with a safe, quiet place to relax and also prevents him from getting in trouble when I have to leave him unsupervised.  Finding the right kennel was a challenge.  Most wire kennels have a small latch or pinching mechanism that was too difficult for me to manipulate with poor fine motor skills.  The best solution I found was a soft crate that zips around the entire door.  Sometimes I still have difficulty getting the zipper around the corners at the bottom of the crate, but I am experimenting with various types of zipper pulls to try to problem solve.

The scooper genie with arrows showing how the bags attach and the spring loaded eject mechanismThen, there is the most joyous of dog owner responsibilities, poop scooping.  I tried many many different types of scoopers with my first dog, with only a relative amount of success.  I was never able to effectively manipulate a rake and dustpan type or a squeezable claw.  Even if I did manage to successfully grab the waste, getting the bags off the scooper and into the garbage was another (also unsuccessful) task.  This time around, a classmate brought a demonstrated a scooper I had not seen before.  The Scooper Genie is a lightweight telescoping scooper with disposable bags constructed with a wire frame which holds them open.  It allows you to scoop underneath and from the side, and has a spring-loaded mechanism that enables you to eject it straight into the trash.  There is no bending, touching the waste or knot tying involved.

finger toothbrushFinally, grooming is an important part of my routine with my service dog.  Not only is grooming important for his health, it is important as we continue to build our bond.  In training, we learned that physical touch and care is important for trust building and the dog’s sense of safety.  In order to do this, I needed to ensure that I could reach Adler and groom his entire body.  Currently, I use my shower chair as a grooming bench, but there are grooming tables (which I’m looking into purchasing soon) designed for easier access and reach for bathing, brushing and other routines.   Other tools we use in the grooming process include a grooming mitt as opposed to a brush for brushing fur, which is easier to hold, a fingertip toothbrush that allows me to better access his teeth, and enzymatic toothpaste, which has special enzymes that when they come into contact with air forms hydrogen peroxide.  Enzymatic toothpaste only needs to come in contact with the dog’s teeth to begin working.  This is a benefit for a dog like Adler who prefers to lick the toothpaste rather than have it brushed on (but begrudgingly complies).

I’m sure that I will discover other AT that will help Adler and I as we continue to grow as a team, and I am looking forward to our long working and loving relationship.  For more information on AT and our furry friends (including cats!), check out our archived webinar, “Devices to Help With Pet Care”

Memorial Day Post: The Larger Possibilities of AT

Memorial Day has been a time of taking stock since it was created. The holiday has the strength of being recreated every year in a form that reflects the personal histories and connections that veterans, their families, and their friends have with their lived experience, their social networks, and the larger society.

A veteran dressed casually in a wheelchair looking at part of the Vietnam Memorial Wall that means something to him on a warm summer day
Reflection

It seemed reasonable to me as a veteran to think about the ongoing importance of personal support in the crafting of freedom and choice in each of our lives on this Memorial Day, the 50th since I first entered Vietnam.

Over time, I have come to see Assistive Technology as far more than devices or single-purpose apps. To the extent that we focus on the small affordances that devices enable, as important as those affordances are, we miss out on the core purpose of AT, which is to facilitate universal access that allows each of us to forge the life we want and not just the life we have been dealt.

To me, that means that social connection enabled by technology is as much AT as an automatic can opener, and, to the extent that our vision of what AT can do extends to all who use it, and not just those of us who see ourselves as part of our common disability community, the use of AT builds inclusion and lasting social relationships throughout our society.

So, one of the values we need to remember on Memorial Day is the way our personal reflections and our personal struggles for choice and freedom must facilitate the building of all our futures together.

Using Amazon Echo in an Emergency

Amazon Echo Dot

By Jen Mullins, BS, CTRS, MATP Staff

Earlier this year, I watched a very interesting video on the Pennsylvania Assistive Technology Foundation PATF’s facebook page.  Woman seated in a shower, her wheelchair nearby.The woman featured in the video is a wheelchair user and shared that she uses a shower chair while showering.  She said if there’s an emergency in the shower (such as if she starts to fall out of her chair) and she’s by herself, she can’t physically unlock her phone to call for help, but she can Amazon Alexa to call someone in her life for help.  I recently met someone who uses a powerchair and he communicated that he can’t afford an Apple Watch or a newer iPhone, but wants to be safe in his home. His solution was to buy 2, Amazon Echo Dots (about $49.99 each vs an Apple watch that is about $329-$399).  He shared that he knows that the two places in his home that he’s most likely to fall are his bathroom and his kitchen.  By putting 1 Echo Dot in his bathroom and 1 Echo Dot in his kitchen, he knows he’ll be able to call someone if he falls.

More and more, traditional Personal Emergency Response Systems (PERS) are being replaced by Smart technology (like Apple watches, Amazon Echo’s, and others) and being used in even better/more helpful ways.  Why the shift? I really think it comes down to cost and user interface. People who choose to use Smart tech to contact family/friends/neighbors/etc. in an emergency are:

  1. Talking to someone they know (who likely knows how to best help) versus strangers who are a part of a traditional PERS.
  2. Not paying any additional, monthly fees (other than what is included with the device in general such as an Amazon Prime membership or wifi or cellular data plan).
  3. Choosing how they get help (having more autonomy over their lives).

Amazon Alexa Echo Dot resting on a stack of books.Writer and podcaster, Brant Huddleston, shares in his recent article why traditional PERS systems/fall detection systems didn’t work for his older mother, but why the Echo Dot definitely does.  Huddleston writes, “My experience installing the Echo devices has been a sheer delight, and with their naturally intuitive voice interface (Alexa), my mom has taken to the technology like a duck to water. We are both continually surprised at the opportunities Alexa offers to engage her intellect, expand her world, reconnect her with friends and family, and generally improve her life. Voice first technology, like Alexa, is increasing the probability that my mom’s wish will come true, and barring a fall, that she can age in place with dignity until the day she dies.”

Amazon even has specific skills for the Echo that can help during an emergency.  I cheer when people don’t have to accept supports that don’t work for them and can “hack” the system to get the supports they need and how they need them. I’m glad more and more Smart supports are being created/finely tuned and offered to more users.  Apple watch on a person's wrist.If you’re interested in learning more about how the Apple Watch can be used in an emergency, read Kathryn’s blog post: A Personal Emergency Response Alternative.  

Do you use Smart technology for PERS?  Would you consider using it? Comment your thoughts!

Wheelchairs and Airline Travel: A Turbulent Experience

By MATP Staff Member Laura Hall

Earlier this month, I had the opportunity to represent the Michigan Assistive Technology Program at the National Symposium of AT Act Programs meeting and visit Capitol Hill to speak with legislators about the importance and benefits of assistive technology.  Typically, I fly to this event, but due to some bad experiences in recent years, chose to travel by rail (an adventure all of its own that I will write about soon).

Cartoon of an airline conveyor belt delivering broken wheelchair parts to a wheelchair user
Photo Credit: Doug Davis, New Mobility Magazine

If you use a mobility device or other type of expensive AT, I’m sure you can understand why I made this choice,  Taking a flight often means you’re taking the gamble of your equipment coming out in one piece.  Since most mobility devices can’t be brought aboard, they are typically stored below with luggage, and just like luggage, they can be lost or damaged.  I’ve had my power chairs arrive at my destination with broken armrests, headrests, joysticks, and in one situation, completely inoperable.  Airlines are required to compensate for damaged wheelchairs, however, the process of getting payment and the repair itself can take many months.  I am not alone – a United Spinal Association Survey of Wheelchair Damage and Air Travel found that on average, people with disabilities experience wheelchair damage aboard flights 1 to 3 times.

A few companies have marketed products to improve transferring and protect equipment in-flight.  For example, the Comfort Carrier and Transfer Pants are portable products that claim to assist with transfers during travel.  “The Flyer” Wheelchair Protection Case is a rigid box with a top and bottom piece that claims to be “armor for your wheelchair”.   It should be noted that there are few reviews on these products and the MATP never promotes or endorses any particular piece of assistive technology.

Fortunately, there are disability advocacy groups working hard to require better standards related to passengers with disabilities and their mobility equipment.  I recently participated in United Spinal Association’s webinar: How to Improve Air Travel for Wheelchair Users.  In addition to discussing the problems that passengers with disabilities experience, the presenters also spoke of efforts that are being made to improve air travel.  Specifically, they are working with lawmakers to pass the Air Carrier Access Amendments Act of 2017-2018.  This legislation would increase penalties for damaged wheelchairs, and allow passengers with disabilities to sue in court.  It would also require higher standards for accessibility, safety, and airline/airport employee training.  Finally, it would help create a Passengers with Disabilities Bill of Rights and a federal advisory committee on the air travel needs of passengers with disabilities.  If you would like to support this legislation, United Spinal urges you to contact your legislators to co-sponsor and support S. 1318 (Senate) and H.R. 5004 (House).

Have you experienced problems with air travel?  Do you have tips or tricks for minimizing the chance of damage to AT equipment?  Leave us a comment!

Personalizing Alexa for Yourself and Your Family

Echo Dot: A round device labeled Amazon, with a blue light around the edge showing that it is listening for user direction.
The Amazon Echo Dot

The New Alexa Blueprints

Many members of our community have learned to use specific Alexa Skills as AT to solve support problems in their lives. But how do we customize skills to exactly fit our needs? Developers have been able to create “skills” or programs for Amazon’s Alexa assistant for some time. What about those of us who don’t have coding chops?

Alexa Blueprints are templates that will allow you to create Alexa Skills without needing to code. You will need an Amazon account to use the blueprints, and you can use the same account that is tied to your Alexa App.

The Blueprints section of the Alexa development system is at https://blueprints.amazon.com/ .  The templates (21 right now) are organized as a grid, and using them is as easy as:

  1. Pick a Blueprint.
  2. Fill in the Blanks.
  3. Use the skill you just created.

Many of the Blueprints are focused on family and friend activities. There is also a section of Blueprints for creating stories using various themes. I think that as the number of Blueprints expands, there will be ones that the disability community can use. For example:

There are two themes, one focused on creating information for a sitter, and one for creating information for a pet, that could be easily hijacked to:

  • Create basic information for a personal assistant about your needs, red flags, locations of important resources, scheduling important tasks, emergency contact info, specific responses to your emergency reactions, and so on. The skill could be easily adjusted to deal with life changes or the unexpected.
  • Create basic information about your service animal, so that their unique needs can be easily reviewed by anyone who has predictable interaction with the animal. When should the dog poop, how often, what food isn’t safe, what behavior is a red flag, and so on?

There is also a Houseguest Blueprint that could be used to orient care staff to where things are in your house, what to watch out for, how your neighborhood is laid out, where stores you use are located and local travel issues.

I would guess that the number of Blueprints will expand, but if you have an Echo and use Alexa for supporting your independence now, you might want to play around with one or more of the current Blueprints to get a feel for them. If you do, you’ll be ready to use Alexa as a more customized AT device when Amazon expands the repertoire of Blueprints.

There is a Help Page with a short video that outlines how to set up a Family Trivia Game. It also contains information about how to make better use of the huge library of existing skills.

Give one of the Blueprints a try, and let us know how it went!

When Spring Didn’t Come

Spring-snow-flowers-daffodil1_-_West_Virginia_-_ForestWanderThis spring, it seems like winter is never going to let go! As I sit here using my lightbox, I wonder when can I start tapering off using it each morning? I use the light box to help keep my circadian rhythm in tune with the rest of the world. Otherwise, especially in Winter with my tendency toward Seasonal Affective Disorder (SAD) and Delayed Phase Sleep Disorder (i.e. extreme night person!), I would not sleep at night and be useless during the day.

With more natural light in the warm months along with more opportunities to be outside, I don’t need to use the lightbox every day. I usually taper off sometime in the spring, typically by the beginning of June and then start again in mid-September.

Spring usually brings more energy, you know, that feeling we used to call “run naked through the woods”. Not that we did, but it was a pretty good description of the feeling. [There used to be a TV show called Northern Exposure. One episode was about the annual spring “bull” run through town. Yes, could relate to the feeling!]. Maybe the feeling has a theme song like the song “Here comes the Sun” by the Beatles. The urge to get outside, to throw open the windows and clean out the dust of winter (see “AT for Spring Cleaning!)

Except one year when spring didn’t come. Well that is, outside the birds returned and flowers bloomed and the days got longer, but inside me, it was missing. Actually the lack of the “run naked through the woods” feeling made me even more depressed.

sad

This was more than SAD. For those of you who have had major depression, you know. It’s hard to explain to people who haven’t been there. I’d get advice like “It’s a beautiful day, get outside, open the blinds, you’ll feel better.” So I’d try and the contrast between the Spring outside and the darkness inside me simply made me feel worse.

“April is the cruelest month, breeding lilacs out of the dead land, mixing memory and desire, stirring dull roots with spring rain.” – T.S. Elliot

Did you know, contrary to a common belief, suicide rates don’t peak during the winter holidays. They are highest in the spring and fall.

If you have SAD and use a lightbox and find you can’t taper off in the Spring as usual, please reach out and get some help. There’s apparently something called “reverse SAD”. However, it’s also possible that something more than SAD is going on. Depression is a life threatening condition and not to be taken lightly. Please take care of yourselves and of each other!