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

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?

In the Blueprints section of the Alexa development system , 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!

Telehealth: More Access to What We Need

Graphic of a hand holding a wrench. Text says, "Info, strategy"

By Jen Mullins, BS, CTRS, MATP Staff

Earlier this year, I had an experience that I think many of us have had: I was home sick with a cold/virus/etc. and couldn’t get an appointment with my regular doctor (not that I really felt up to leaving my home to drive to the doctor & sit in the waiting room anyway).  Thankfully, there was an accessible solution I hadn’t even considered:  a co-worker informed me that telehealth is a part of our health insurance and I could have a video call with a doctor to get checked out & get medicine if they decided to prescribe it.  Shortly after speaking with my co-worker, I had downloaded the app and was “on hold” waiting to video chat with a licensed physician; all from my phone! Hold screen featuring the image of a doctor. Text: You are the next patient to see Rebecca Beach-Beyer, Family Physician.

When a telehealth doctor was available, they greeted me, asked a few questions, looked at the brief medical history I had typed into the app, and prescribed me an antibiotic (she said she thought I had strep throat, but of course couldn’t do the test for it over the phone).  The telehealth doctor said that I should inform my regular physician if I didn’t get better within the next few days and book an appointment with them then.  That’s it!  The video portion took about 8 minutes and there was a prescription ready at my local pharmacy in about an hour.  My credit card was charged the price of a traditional office visit co-pay.  It was so easy & accessible to me, I remember feeling like I had cheated or something (but of course I hadn’t!)  It got me thinking: why isn’t more healthcare more accessible?  Assistive Technology can facilitate more accessible access to healthcare.

Illuminated light bulb

I’m an avid NPR/Michigan Radio listener and recently listened to a piece that talked about Telemedicine for Autism-related therapy.  The therapy mentioned in the piece traditionally requires a therapist to come to the individual’s home to provide An adult woman reading a book to a small child.support/assistance to person and the caregivers.  With Telemedicine, the therapist Skypes (does a video call) with the individual and their team/family to observe and provide those same ideas for support/assistance.  The family highlighted in the radio piece lives in a rural area and it’s not always convenient or covered by insurance to have therapists come to them; a video call is a great solution and reportedly works well for their family.

While doing some household chores recently, I turned on one of my favorite podcasts, The No Sleep podcast.  While I listened to the commercial introduction, I heard an advertisement for Talkspace: therapy via an internet connection.  My ears perked up and I smiled at hearing more about other applications of telehealth!  Talkspace’s website shares: “We created Talkspace so more people could benefit from therapy and overcome their day-to-day challenges in a stigma-free environment.  We are not trying to replace in-office therapy. Many people prefer that, which is fine. It can be difficult to wait days or weeks until your next appointment. With Talkspace, you can send your therapist a message whenever you’re near a laptop, tablet, or smartphone.  Talkspace has therapists that can help you with depression, anxiety, the challenges of being part of the LGBT Community or a Veteran, and more.”

Man texting on his phone.

The applications of telehealth I mentioned in this blog post are only a few of what’s available and more and more is being added/made accessible everyday.  Have you used telehealth before?  Would you consider using it?

Universal Design in Learning

by MATP Staffer Laura Hall

The term “universal design” has been around for quite some time.  Universal design refers to the idea that if structures are built to accommodate a particular group, say, people with disabilities, they also accommodate the rest of the population.  Power doors, for example, help people with disabilities navigate entryways, but they also help people with strollers, older adults, delivery people, etc.

This same idea is now being applied in education through Universal Design in Learning (UDL) Did you know that learning styles can be as unique to a person as their fingerprint?  The idea behind UDL is to make goals, methods, materials, and assessments accessible to every learner.

Pictures of different ways to express learning with pictures under each style. Includes: Interactive Writing, E-Book, Podcast, 5 profiles, visual narrating, narrated art, screencast, puppet video, quick edit video, Geo Map, Simulation Game and Digital StoryTaking into consideration diverse learning skills, this may mean that goals for a particular piece of the curriculum are expressly stated, written, or perhaps the student can develop his or her own goals.  Perhaps the method of teaching could vary with written instructions, verbal instructions, the use of pictures, video or other types of media, hands-on experience, etc.   The assignment a student turns in may not be something written.  A model or diagram, video or music, picture, podcast or oral story are just a few of the ways that learning can be demonstrated.

So how does this relate to assistive technology?  Just as power doors assist more than just people with disabilities, I believe that assistive technology in the classroom can assist all students, not just those with disabilities.  Photos that are described using alt-text, traditionally used by people with visual disabilities, could help any student who may be more of an auditory learner, as could audiobooks and textbooks.

Pen friend being used to identify cereal boxes
Pen Friend

I recently attended a conference session where the presenter was discussing UDL.  He gave an example of UDL in a college course.  For this course, the professor chose 4-5 students to submit their class notes to be scanned and uploaded to an online system that all of the students could access.  Some students took copious notes, some used outlines, some drew very detailed graphics, and another chose to highlight keywords.  All of these different styles of note taking could then be accessed by students with different learning styles.  Imagine if notes could also be taken with the Livescribe Pen, which records audio and synchronizes it with the text written, then accessed by all students. What if the Pen Friend, an audio labeling device, was used to help students learn the parts of the human body?  Test questions could be read with the labeler and answers given in writing, auditorily, or by demonstration.

It should be noted, however, that UDL should not replace accommodations or specific assistive technology need by students with disabilities in the classroom.  UDL provides the opportunity for AT to be used in a broader sense, but each student should be assessed for their individual needs and be provided accommodations or technology that meets those needs.

Personally, I know that I am an auditory learner, one that takes detailed notes, and expresses myself best through writing.  What type of learner are you?  What do you think of Universal Design for Learning?

 

 

 

Smart 911: Your Path to Safety in a Disaster

One of the enduring problems for people with disabilities who find themselves in an emergency or a disaster is the inability of the systems of emergency response to actually help them with the problems and threats they face. Once the emergency has occurred, it is too late to go through the complexities of your personal support system and health care needs. Response systems are largely operating on automatic during the early part of the emergency and they seem incapable of nuance.

Various registry approaches with, for example, power companies have been set up, but they all involve great practical difficulties in actual use not the least of which is the need for updating every time your needs in an emergency change.

There is a system out there that goes some way to reducing these barriers to safety in a disaster for our community. It is called smart911, and its purpose is to enable first responders to know what you need and want while they are responding. It is very flexible and allows for a wide variety of the kinds of preparation you can build with first responders. I would suggest that you work on it a little at a time so that you can more easily think through what you need.

You can start at the home site for smart911 at https://smart911.com/

I would scan the “How It Works” menu first. You can find out whether the service is part of your area by entering your zip code. You should also review the Security and Trust section, maybe several times over the period when you enter information. It can be daunting to fill out even if you know the information you are sharing could be crucial to your survival in an emergency.

I live in Ingham county and there is an active smart911 service here, so I have been working on filling our data in over the last week.

You can include just about anything you believe is important to your safety, even for pets and service animals.

Note that the information is only available after you call 911 during an emergency and only to first responders. Smart911 saves about 11 minutes per person in response, which is a lot of time in an emergency. And the info is only available for a short period of time. The service is very popular with users.

Take a look today. We all need support for emergency response.

hispanic female fire chief from Washington, D.C.

“One of the things we fail to think about is the fact that when a person is dialing 9-1-1, it can be a very chaotic environment and there could be a lot of panic involved. If they have preloaded a profile that automatically populates for our responders, we have useful information, even if the person cannot relay all needed information to us.”

Are You Spring Cleaning? Consider using the ATXchange.org!

skunk on snowy groundWhile the weather in this part of Michigan continues the long cold winter, there are some subtle signs of Spring, despite the snow coming the next few days! We were woken from a deep sleep last night at about 3 AM by an encompassing awful (!) aroma of skunk. I’ll take daffodils any day over that sign of Spring!

Blue bucket, pink mop and multiple bottles of cleaning products

One of the things many people do in the Spring is clean and clean out. As you delve into those closets and garages, you may find still usable assistive devices that have been outgrown, replaced or no longer needed. If so consider listing these on the Michigan’s Assistive Technology Xchange web site!

The AT Xchange is a web site where people can buy, sell, or give away assistive technology (AT). The AT Xchange is open to vendors who have used equipment for sale also don’t worry about cost, AT Xchange is a free service! Check out our article on safe online buying and selling using the ATxchange: Using the ATXchange: Buying and Selling Tips.

Did you know you can also check to see if someone has posted a want ad? One the site, select “Items” and then under Item Type, select “wanted”.

And if you need Assistive Technology to help with your Spring Cleaning, you can check out our webinar on AT for Spring Cleaning!

Spring will come (eventually). I can’t wait to open windows and see flowers! Happy Spring Everyone!

daffodils in snow

My Driverless Car!

Post Foreword: Driverless cars seem to be in the news more and more these days. The recent, tragic accident raises concerns and the potential benefits for people who can’t drive due to a disability.  Guest blogger, Cathy McAdam shares her desire for a driverless car in this blog post.

Car parked on the street. No one appears to be in the driver seat.

By Guest Blogger Cathy McAdam

Yes, I want one: Self-driving car, and have been asking family and friends if they will take a ride with me, (a driver who is totally blind)! Many have said yes, and some hesitate wondering as many do just how safe these cars (autonomous-vehicles) will be.

View of the inside of a taxi from outside of the vehicle. There are fuzzy dice hanging from the rear view mirror and a sign that says: taxiMy initial excitement has been a bit dampened by the reality of licenses needed and the current demand for a steering wheel and breaks and in most cases a backup driver.  However, I still feel for many of my low vision friends and others with disabilities that there is tremendous potential for driving, and adding to public transit options; such as a driverless taxi.

Technology is of course always changing.  A wheelchair user I connected with online expressed concern for maintaining his current adaptive equipment, and this of course is a valid concern. How many times do people make assumptions that something we love, use, and even need, is no longer a valid approach? And then it gets removed from the market (for example: simple, basic cell phones). For many others the increased support of warnings for backing up or changing lanes, and assistance for parallel parking may already be a welcome support. I choose to believe that somewhere on this winding trail there will be many benefits for those of us across the disability spectrum. Some with low vision now drive with the help of optical lenses, and surely will appreciate some of the progressive changes already in motion. Many who have difficulty concentrating or processing information under stress will also silently benefit as safety features increase.

Google seems convinced that a true driverless car without a steering wheel is possible.  View from the driver seat in a car behind the steering wheel.Some propose that the software is “the driver” leaving room for revising licensing.

One of the things I found when researching this topic was very exciting. The inventor of cruise control was an engineer who was blind. Fears of his invention parallel some of the concerns that drivers will day dream, not pay attention to their surroundings and lose control. (Maybe you were pulled into the hoax of a Stella award given to a woman/man who left cruise control on to go make a sandwich in the back of their Winnebago).

So I imagine we’ll hear many exaggerated stories about this awesome technology being developed for my driverless car. The more we include people with disabilities in the development, testing and real discussions about this technology the better the outcome! I’ll still be waiting to drive my real friends even if it takes 20 more years!

Will you come for a ride with me?

View from the passenger seat and the outside world is speeding by in a blur.

Panic Attack? There’s an app for that!

I had my first panic attack exactly 3 years ago, outside my doctor’s office. I’ve also had some PTSD flare ups recently so wanted to share this older blog post about my first panic attack as a reminder to myself and hopefully a help for others who have panic attacks.

In 2015, stress from recent health crises and triggers from childhood trauma culminated in a very scary experience–the panic attack in the parking lot of my doctor’s office. My friend was able to talk me through breathing /stopping hyperventilating and came to get me and take me home.

I later talked with my therapist about plans to prevent a future full-blown panic attack. She suggested noticing symptoms that came up as my anxiety increased. For me this is sweating, pounding heartbeat, and feeling trapped. Knowing this, she suggested using several interventions to prevent escalation and  breathing techniques to try to calm myself. This worked and helped for the next couple of days.

That is, until I was at an emergency preparedness conference and they were talking about critical incident stress management (CISM). I had recently run into a woman who I worked with when she/we were attacked and she was choked at our workplace. She could have been killed in the attack. After that incident, we had a critical incident debriefing. At the conference, the memories of that incident started to come flooding back, along with the feelings of guilt having recently run into my former colleague. Then, the conference presenter showed a video of workplace violence as an example—in a hospital setting (which was the setting of our attack). So, then I was done for. I hastily left the room and retreated to a quiet corner down a hallway.

I was breathing rapidly and tried to call a therapist friend immediately as my attempts at regulating my breathing were failing miserably. I got a voicemail. Not wanting to bother the friend that helped me last time, I decided I was going to try to go it alone until the therapist could call back.

the front page of the PTSD Coach App

I remembered that I had downloaded PTSD Coach, an app designed by the Veterans Administration, onto my iPhone and had been using it for anxiety and depression. The app has a tool for managing symptoms and one of the symptoms you can select is “Reminded of Trauma.” I selected that and rated my distress on a level from 1-10. I gave myself an 8 and the app suggested tools accordingly. It gave me the option of distracting and laughing/reading a comic book. I thought to myself ummm no, that isn’t going to work right now, so I gave that a thumbs down and asked for a new tool.

PTSD Coach then suggested Deep Breathing—putting on headphones and being led through a breathing exercise. Nice idea, but I left my headphones at home and I was at the end of a hallway where people could possibly hear me. New tool please!

Then we started to get somewhere—the app suggested slowly counting to 100. Yes, that helped me calm down some. Progress! After that, I asked for yet another tool, and it guided me through the RID Tool. R= relax. The app suggested breathing in and out slowly. As you breathe in think “let,” and as you breathe out think “go.” A 30 second timer started counting down.  You can then add 30 more seconds or move on. I took another 30 seconds.  The I=identify the trigger. The app suggested going over the last few minutes and hours and identifying what reminders of your trauma you encountered. I easily listed these in the space provided.  It then said once the triggers are identified, it is important to notice how it is just a reminder, and not the actual trauma happening again. At first I thought, “Well, duh, I know that,” but telling myself that did actually help. Then I filled in the box about how this experience was different from the actual trauma. In D, you decide what to do now, the app said you can try to decrease the trigger’s power by deciding to stick around and see that you can handle it and that your stress will actually go down the longer you stick it out. It also suggested if you are angry or in danger of harming yourself or others, you should take a time out and seek support. I decided to sit outside the meeting room for a little longer in peace and rejoin the conference at the next break. I did attend a few more sessions then found myself completely exhausted and decided to leave the conference early.

Meanwhile, I tried one more tool before going back to the conference. The app suggested a grounding exercise, “Walk slowly focusing your attention on what it feels like to take each step.” This was a great way to re-center and continue calming myself. I got outside for a walk and remembered that walking and being in nature always helps me. After my walk, the app asked me to again rate my distress level. I gave myself a 5. Much better than before.

***Note if you give yourself a 9 or 10 the app does suggest calling for help using people you have pre-loaded into the app and/or nationwide hotlines.

Have you tried PTSD Coach? Has it helped? Any other apps that help you?