Winter Weather Protection for Your AT

by Laura Hall, MATP Staff

Old man winter blowing out snow

Well, the weather outside is frightful today, with the Lansing area expecting up to 10″ of snow.  For users of assistive technology, winter weather is certainly not always delightful.  During these months we are often more reliant on our AT, which makes it even more important that they are well maintained and protected from the elements.

As a powerchair user, winter can feel isolating because it is so hard to drive in the snow.  As great as my new chair, the Flash is, it doesn’t stand a chance against the white stuff.    While snow and ice will always be difficult for wheelchair users, ensuring that your chair is in the best shape possible can help.  Replacing bald tires can make all the difference.  In her blog “Maintaining Your AT – Wheelchair Edition”  Lucia Rios gives some great tips for maintenance, like working with a bike shop to replace parts.Mobility Light on WalkerSpiked walker or cane tipShoes with traction cleats

Using a walker, cane, or crutches can be especially treacherous during the winter months, and while care must always be taken to reduce falls, there are a few AT items that could make things easier.  For example, a mobility light, that attaches to the tubing of a walker, crutches or a cane, can help increase visibility and awareness of obstacles.  Spiked tips for walkers and crutches may also help with stability.   Shoe traction cleats may also provide more grip while walking in the snow.   The American Foundation for the Blind has other tips for white cane users in their article Traveling with Your Cane in Winter Weather.

man's head, wearing a headband with warmers over earsDid you know that winter weather can cause damage to hearing aids?  Cold temperatures can drain batteries faster.  Damage can occur when moving from the cold weather outside to the warmer temperatures inside as condensation builds up.   Audiologists recommend opening the battery compartment when not in use to allow for airflow. Wearing earmuffs, a hat, or a headband (some have inserts for hand warmers) may also protect the device, and some people use a hearing aid dryer or dehumidifier.

To discover other ways to protect you and your AT this winter, check out our webinar “Your Assistive Technology in Winter“.

As much we may complain about the winter and snow, there is no denying it’s beauty and the fun that can be had during the season.  I hope these tips help you to get out and enjoy what the season holds.

 

 

Winter scene from the Keewenaw Peninsula
Winter in the Keewenaw.  Credit: K. Wyeth

 

 

 

 

 

 

How Paid Leave Can Be a More Flexible Accommodation

Return To Work Cycle, with 3 sections, Accommodations (Accesibility Standards, Duty to Accommodate, Assistive Technology),Support For Recovery (Sick leave-injury-on-duty leave, Disability benefits-workers compensation, early intervention, case management and remain-return to work plan), Prevention (Employee Assistance Program and Wellness Programs, Special Working Arrangement, Occupational Health and Safety legislation and standards, Emergency and business continuity plans)
Returning To Work

Until recently, the general approach to paid leave as an accommodation was to allow or require it unless it reached the ADA threshold of an “undue burden”. For example, Federal ADA guidance suggests the following two-factor approach to this threshold:

“Undue burden means significant difficulty or expense. In determining whether an action would result in an undue burden, factors to be considered include —

(1) The nature and cost of the action needed under this part;

(2) The overall financial resources of the site or sites involved in the action; the number of persons employed at the site; the effect on expenses and resources; legitimate safety requirements that are necessary for safe operation, including crime prevention measures; or the impact otherwise of the action upon the operation of the site;”

In a case in the 7th Circuit, Severson v. Heartland Woodcraft, Inc., No. 15-3754 (7th Cir. Sept. 20, 2017 for Illinois, Indiana, and Wisconsin), the court’s decision set a much more specific standard, by saying that several months or an indeterminate length of paid leave would meet the “undue” threshold. Of course, this decision could be appealed, or other Federal Circuits could define this threshold differently. But, it is typical in civil rights law for relatively flexible standards to become more and more specific over time. This very ordinary evolution of law can be seen clearly in special education law and rules decisions, for example.

I think our community has to assume that over time, paid leave as an accommodation will become less and less flexible. We need to embrace approaches that introduce more flexibility in the use of paid leave, and which support more control by us in the use of it.

One way that has been around for a long time is to look at rehabilitation during paid leave less mechanically than, “You are on rehab leave until you are fully rehabilitated.” Individuals who have experienced a work-related injury receive their rehabilitation services at their work site, and even in the actual workstation,  they used before the accident. PT and OT, for example, are provided focused on outcomes that are tied directly to what the person did prior to their injury.

Embracing the concept that accommodation should not be just passive support, but could be organized around a more flexible concept of “return-to-work”, Assistive Technology could be a resource for an at-work sequence of rebuilding the old job around the new reality of the disability. This kind of support could be implemented without making any assumptions about indeterminate accommodations or what might constitute the ultimate configuration of AT for a person as they reimagine how they might do their old job well. The person could work into a supported version of their job gradually, by learning to adapt and as the need for accommodation evolved during personal recovery. Customization, always a core of effective AT, could be expanded to include the expectation that the configuration of individual accommodations would change during recovery.

Resources:

Accommodation and Compliance Series: Return-to-Work Programs

Return to Work or Stay at Work and Accommodations: Part 1

Return to Work: A Snapshot: Part 2

IMPACT OF ACCOMMODATIONS AND DISABILITY ON WORK (various articles)

Dating, Intimacy, Sex, Disability and AT

By Aimee Sterk, LMSW, MATP Team

This week has been a really weird conglomeration of anniversaries and news that are all muddling together in my head. Eleven years ago this week, I went on my first date with my husband. Two years ago this week, we put a deposit down for IVF that led to us having our son after battling infertility and loss for 9 years. In the news this week and this past year, are daily reports of the MSU doctor who sexually assaulted and abused hundreds of female athletes. His trial is ending and victims are making their statements. I was abused by my pediatrician as a child, the ultimate end result being PTSD that was triggered when we had our losses and I had more invasive treatments for the losses and infertility. A series of NPR stories has covered the epidemic of sexual abuse among people with disabilities, especially women with developmental disabilities. My son turned one and my daughter is due in March. I think about protecting them and teaching them about their bodies, safety, and love. Sexual abuse, domestic violence, dating, intimacy, sexual health, they are all on my mind—and I’m being bombarded with information and stories and reminders.

red and pink interlocking hearts

Like many people with disabilities, I started dating much later in life. Understanding and accepting my bi identity along with facing my thoughts about my body and my worth was necessary before I could consider dating. I waited until I was in my 30s. For many reasons, this turned out to be a good thing. While I spent many years feeling like I was unlovable, in the end I grew emotionally and built a life I loved and truly felt like finding a person to love would just be adding to something that was already pretty awesome. Ultimately, finding and marrying my husband and having children with him was the best thing that has ever happened to me. These experiences have been the very best in my life. I’ve also endured the very worst experiences of my life together with him. Dating, love, marriage—these are things that many people want to experience. With disabilities, there are extra complications and oppression.

Kristy Liddiard, in her work to face and rid ourselves of shame experienced by women with disabilities around the areas of sex and intimacy encourages us, “ …This can only happen by sharing our stories, lives and experiences. Stories can – if voiced and heard – be productive, useful, and valuable. Stories can define a place and people. They offer a sense of collective experience; a means to claim space, foster a positive identities and experiences, and demand social and sexual justice. Collectively, telling and sharing our stories is how we can build sexual cultures and communities as we want them; ones which fit all of our bodies, pleasures and desires; ones which empower rather than oppress. So, what’s your sexual story?”

Samantha Evans agrees, “From the issue of privacy in shared living or with carers, to conditions, medications and treatments making sex difficult, the discussion of sex and disability shouldn’t be shied away from.”

So, let’s take a look at just the tip of this iceberg of taboo around dating, sex, and disability. To start with, dating, there’s a great article about some myths of online dating with a disability in Psychology Today. Dating apps and websites provide a great option for people with disabilities to get into dating. I had my share of frustrations with online dating when I met my husband—I told him I was shutting down my profile and giving up and gave him my email address. That said, it did actually work out and this was very early in the online dating scene. When accessible, these platforms provide a way of meeting lots of people you wouldn’t run into in everyday life to cast a wider net. While there are sites to just connect with other people with disabilities, OKCupid, Tinder, and other mainstream sites are also open to people with disabilities. Choosing to disclose your disability is a big decision. I am quite open about my disabilities so like Emily Landau, I discussed my disabilities and other target identities early and often when online dating. Emily’s piece in the New York Times talks about authenticity and rejection and her decision to disclose when online dating. This is something to consider before creating a profile, or like her, it may be something that evolves.

Getting to know each other and intimacy are a big chunk of the dating framework and how long those last before moving into sexual intimacy is entirely personal. I’m not really coming up with wisdom, advice, or AT for building intimacy right now, so I’ll jump right into sex.

People with disabilities are often left out of sex ed classes. This is a huge disservice to us. Surprise! Many people with disabilities do have sex. We need to know how our bodies work and talk about healthy relationships. We also need information on safe sex, pregnancy prevention, and consent. More and more, this information is being shared, but for many of us that are long out of school, we need to seek out other resources. Here are a few:

All the articles I can find on AT for sexual intimacy focus on physical disabilities, and many commentaries are mostly assuming people are interested in heterosexual intimacy and sex. If you know of resources for AT and sexual intimacy for LGBTQIA people with disabilities, or mental health, sensory, or cognitive disabilities, please share them!

I can’t end this article without some resources on domestic violence and sexual assault. People with disabilities are far more often targets and victims of domestic violence and sexual assault. Key points here for me: it is never your fault and there is help available. We all must work together to end abuse of people with disabilities.

While my journey to find intimacy, love, and sex has had many detours and obstacles, ultimately loving and finding myself, seeing and appreciating my disabilities, and understanding and honoring myself as a sexual human being all have led me to my “fairytale” (for now at least) ending. Online dating was a key piece of AT that I used to address anxiety, meet a variety of people, and explore relationship building in a relatively safe environment. In addition, resources AT for sexual intimacy are also available. As  Valentines’ Day approaches, perhaps you are thinking about finding love and/or sexual partners. Hopefully these resources are helpful.

Maintaining Your AT – Wheelchair Edition

By Lucia Rios, Guest Blogger

Someone resting feet up on an empty wheelchairOne of the most important pieces of assistive technology in my life is the manual wheelchair. It’s the accessory I never leave home without. Wheels enable my independence. Wheeling gives me confidence. Not only has my wheelchair been customized to fit me, but each ding, scratch and tear tells a deeper story of its use.

I use my wheelchair 365 days a year. I use my wheelchair from the moment I wake up until the time comes for sleep. That’s a lot of time!

Yet my wheelchair is not just an object to get me from one place to another, it’s part of my world and loved.  Just like a car, a manual wheelchair can only take so much. I think a wheelchair undergoes more abuse than a car because the demands of its use are constant. And yet it’s like owning a car – you’ve got to keep it running.

I must admit that I’m totally clueless when it comes to maintaining a car, which is why I use a mechanic. You can ask for referrals from friends and there seem to be many options on places to take your car. However, I realized that durable medical equipment providers – such as Airway Oxygen and CareLink – are not always the easiest to connect with or affordable when on a budget.

Let’s be honest, it’s an expense to own a car and the same goes for maintaining a wheelchair. As I started to utilize my wheelchair more often I noticed the upkeep took time, money and problem solving.  I’m not one to keep my information to myself, so here are solutions I learned along the way.

Bike Shops

road bike hanging in repair shopTo be honest I didn’t think of this solution by myself.  While interacting with a new friend – who also uses a wheelchair – I told my woes about wheelchair maintenance. Having to make an appointment at the medical equipment provider, high costs, etc.  He asked if I thought about using a bike shop.  I hadn’t.  

So I started visiting bike shops.  I asked for help airing my tires, and inquired about buying tires for my chair.  The first pair I bought were under $30 and there was no service fee to put them on!  I was hooked.  I ditched the medical equipment venues and went to my local bike store for all my wheelchair maintenance needs.  

Tires, lights to use at night, tightening of spokes and unexpected flats – the bike store was my go to.  Better yet, I didn’t have to schedule an appointment!  With each request I was treated with dignity, charged a reasonable fee, and air was always free!           

Online Stores

When I was being fitted for a new wheelchair – which is exciting because at that point my wheelchair is on its last spin – I hear what insurance considers “extras”.  

  • Tires with better traction for snow – an extra $100 to upgrade.
  • Vibrant colors – insurance won’t cover your preferred choice so you’ll have an out-of-pocket expense.
  • A bag to hold personal items – sorry you’ll have to pay $50 for a standard black tote.
  • And the list goes on.  

Frustrated and looking for a cheaper solution I went online.  I was excited to see their were options for a wheelchair user that were not only affordable, but trendy.

Social Media

I’m a huge fan of social media, especially when it comes to spreading awareness about the disability experience.  Being able to use pictures to explain barriers that I face in my day-to-day life has been a great way to educate, but also challenge others to think of their environments.  Facebook has also been a go to when I’ve run into problems with flat tires, inaccessible venues and a quick way to ask for assistance!  

Once my tires went flat while I was at the store.  I typed a quick message on Facebook, asking if anyone knew of an open bike store – it was business service hours.  Within minutes I had offers to assist, website addresses to bike shops, and a person willing to pick me up!  I took up a friends offer and met him at the local brewery so he could patch up my tire.  He fixed it, bought me a beer and gave me my own small tire repair kit!  

So, I’m curious, what maintenance tips do you have for your AT?

Advocacy Help for AT

By Aimee Sterk, LMSW, MATP Staff

A manual wheelchair reclined back showing the various angles of the tilt in space featureMy friend contacted me last week asking about the process for working with a nursing home to get his father, a resident in the home, a new wheelchair. It seems the nursing home suggested a very specialized wheelchair to meet his father’s needs, but when the home was told they had to provide the wheelchair out of their regular per diem rate, they were now suggesting a far cheaper, inferior option. That made me think it was time for another blog about advocating for AT needs.

There are a couple options to help you advocate for your needs for assistive technology (AT) or durable medical equipment (DME) in Michigan.

If you have a MI Health Link Plan (a combination of Medicare and Medicaid) the MI Health Link Ombudsman Program is here to help you access the DME you need if you have been denied coverage or are having trouble getting what you need. Call them directly—lawyers answer all the calls and are ready to help—at 888-746-6456. It is also possible to contact the Nursing Home Ombudsman program if the nursing facility is not providing needed AT at 866-485-9393 or 517-827-8040 for the State Long Term Care Ombudsman.

If you need help getting AT or DME through your school system, community mental health, the MiChoice Waiver, Medicare, Medicaid (or Medicaid funded nursing facility), or Michigan Rehabilitation Services (if employment related), contact Michigan Protection and Advocacy Services’ AT team at 800-288-5923. Michigan Protection and Advocacy Services receives direct federal funding to help people with disabilities of all ages access the AT they need.

The following is from Justice In Aging:

“Consumers with both Medicare and Medicaid face recurring problems getting approval for Durable Medical Equipment (DME), getting repairs, and finding reliable suppliers. DME includes many vital items, such as wheelchairs, walkers, hospital beds, home oxygen equipment, and even diabetes test strips used with a glucose monitor. ”

Some of the obstacles in getting access to DME include:

  • Conflicting DME approval processes for Medicare and Medicaid
  • DME access problems for people who have Medicaid first and then become eligible for Medicare
  • Getting coverage for repairs, particularly getting Medicare coverage for an item originally obtained through Medicaid
  • Differences between Medicare and Medicaid approved suppliers (many providers are approved for one program, but not the other)”

It is so important that people access the equipment they need to live in the setting of their choosing. Please, use the advocacy services to get the AT/DME you or someone you care about needs.

Have you contacted Michigan Protection and Advocacy Services for help with getting AT? Have you used an ombudsman program? What was your experience? What other advocacy tools have you used?

 

Organization Made Easier

By Guest Blogger Kellie Blackwell, Disability Network Capital Area

 

Pen Friend 2 with buttons labeledThe Pen Friend is a device that I have demonstrated to many individuals over the last few years. It is a great tool for labeling many things. I wanted to take a moment to share some of my tips for maximizing its use. I would love to hear from others as well, please feel free to share any ideas you may have on ways it can be used.

As someone who experiences vision loss, I have found it to be useful with labeling file folders; keeping track of utility bills and other important household documents. I have also found it useful for labeling different items that may have detailed instructions. An individual that I was working with a while back shared that he placed one of the stickers on his iPad, as a reminder tool for some of the apps and important settings within the iPad. I found this idea to be very helpful! Another individual shared that they used it for each of their debit/credit cards, as a way to store the card numbers, as they were not able to see the numbers on the cards. I should also mention that for some tasks, individuals may need sighted assistance.

Pen friend being used to identify cereal boxesI must say one of the most beneficial ways I have used the Pen Friend is labeling grocery items. Here is what has worked for me, as well as for others.

I use the stickers, along with index cards and a rubber band. I place the stickers on the index card and use a rubber band to secure the card on the food item, such as a soup can. This way, when the food/packaging item is used up, I have the index card and the sticker. This also then becomes a way to create a grocery list. I can then take each of the index cards with me to the store.

Pen friend RFID stickers showing large square stickers, small circles, and magnetic buttonsI also love how each of the stickers can be reused. As an example, think of when you have thrown out the last bit of cinnamon spice and you now need that sticker for a new box of cereal; just place your index card with sticker on your next box of cereal and record over your last message. Also, because the device uses Radio Frequency Identification (RFID) technology, you can also use just one sticker to label, let’s say 4 of the same item!

Interested in trying out this device? Please feel free to contact Kellie Blackwell to set up a demonstration of the Pen Friend and many other devices through Disability Network Capital Area.

A Jagged Gorgeous Winter

By Jen Gosett, BS, CTRS, MATP Staff

December is one of my favorite months! There are lots of holidays and (it seems like) more opportunities to celebrate together with friends & family. The holiday I enjoy celebrating the most during this month is Yule. Yule, also known as the Winter Solstice, is celebrated today & tonight on December 21st, “this is the longest night of the year, meaning that despite the cold winter, the days get progressively longer after the winter solstice.  The winter solstice is celebrated by many people around the world as the beginning of the return of the sun, and darkness turning into light.”  Generally, on Yule/the winter solstice my framily (friends who are more like family) and I gather around the fireplace, drink mulled cider, exchange small gifts, play board games, eat a cake decorated with a sun on it, burn the yule log, and just enjoy time together.  “The yule log is a remnant of the bonfires that the people would set ablaze at the time of winter solstice. These bonfires symbolized the return of the Sun.”  In recent years, we’ve also claimed The Main Drag’s “A Jagged Gorgeous Winter” as our holiday song!

During these dark months, I often feel much less motivated and have found that listening to podcasts can be really motivating for me.  I really don’t feel like doing the laundry or dishes or cleaning in general, but I’ve found that if I put an interesting podcast on, I can distract my brain a little and get some work done (or maybe reward my brain for doing the work!).  pexels-photo-374703I think of podcasts as a form of Assistive Technology as they’ve gotten me through some mentally & emotionally challenging times in my life. 

Though I know some friends who listen to podcasts, I’ve found that many people still haven’t heard about them or know how to listen & enjoy them.  I’ve written this post to try to help with that.  If you’re not currently listening, I think you’d really enjoy podcasts if you gave them a try :)!  So let’s start at the top, what’s a podcast?

A mic standing on a laptop computer with headphones in the background.“Podcasts are free audio programs distributed over the Internet. You can download them and listen to them as you please, essentially creating a radio station focused entirely on the topics you want to listen to. There are podcasts out there covering almost any topic that you can imagine – and probably dozens of podcasts on that topic.  Because you can choose programs that match your interests and can swap programs in and out as you wish, it becomes much like having a customized radio station for yourself that you can even take with you wherever you go if you have a smartphone.”

The Podcast Host has created a great guide, How Do I Listen to a Podcast?, that will help you get started, “Here we look at the different ways that you can listen to a podcast, from Smartphone to smart speaker.”  Podcasts can also be enjoyed on your desktop computer and even in your car.  In the car, I especially love that I don’t have to listen through songs I don’t like or NPR shows I’m not particularly interested in.  I can be my own radio show programmer!  Stitcher logoMy favorite way to listen is by using the Stitcher podcast app on my iPhone (also an Android app).  I load the app, scroll through shows I’ve saved, and search for new shows I might enjoy.  There are built in help features so if I forget how to do something, the app reminds me.  🙂  The Stitcher podcast app is free and so are the shows I listen to on there (they do offer a paid, premium version, but I feel like I need it).

As I was preparing & planning to write this post, I started to think about podcasts I wanted to recommend. Two people looking on their smartphones together.Then, I had a better idea: include what others AND I like.  There are so many different podcasts that cover so many different topics!  From America’s Test Kitchen to Anderson Cooper 360; the topics & show choices are endless.  Here are a few suggestions from people in my life; my own recommendations are at the bottom of the list.  If you listen to podcasts, what do you listen to? Comment! 🙂

Katie W’s recommendations: I listen to Buffering the Vampire Slayer-which is about…Buffy the Vampire Slayer. Each week the hosts watch episodes one at a time (it starts from the pilot and as of right now they’re in season 3), and they discuss the episode.  I also just started Rupaul: What’s the Tee? with Rupaul and Michelle Visage-they basically just pick a topic and talk about it. Usually relating it back to their own life

Greg’s recommendations: Tanis, Rabbits, & The Black Tapes are all great sci-fi/horror stuff. Wolf 359 is a more comedy leaning space adventure. If you’re interested in history, History On Fire is a great in depth look at a variety of historical figures and eras. If you like old time radio, Thrilling Adventure Hour is a comedic spin on that style.

Katie C’s recommendation: She-Explores is my favorite! It focuses on women’s adventures in the outdoors. It’s empowering, inspiring, and often includes good story telling.

Jessica’s recommendations: Heard a great one on Living Myth. I listen to podcasts from End of Life University. There are some interesting topics.

Bri’s recommendation: The only one I listen to with loyal regularity is Thinking Sideways. It’s a round table style (two men and a woman) discussion on an unsolved mystery each week. They cover true crime, cryptozoology, mystery people, conspiracies you name it. They have great chemistry and I like their approach.

Diana’s recommendations: I love The Moth Podcast, Ted Radio Hour, Ted Talks Daily, and StoryCorps.

Beth’s recommendations: I second “The Moth“. Also enjoy “99% Invisible” it kind of sort of focuses on the broad topic of design.

Lindsey’s recommendations: For politics + humor: Lovett or Leave It, Throwing Shade, Fake the Nation.

Jesse’s recommendation: The Fantasy Focus Football podcast; I listen to stay up to date so I can manage my fantasy football team.

Mike’s recommendations: I like listening to podcasts while I’m driving.  I like Intercepted, it’s political and keeps people in check.  Pod Save America is a good political one; some of the hosts used to work for Obama when he was in office.  Adventure Zone is fun; people get together & play d&d (Dungeons and Dragons)! And Radiolab has interesting stories that are compelling.

Arika’s recommendations: The Longest Shortest Time is a good parenting one.  Majority 54 & Pod Save the People are a good political ones.  Dear Sugar is a realistic advice column podcast.  Oprah’s Super Soul features Oprah herself talking about spiritual things with different people.

Aimee’s recommendations:
Happier
Another Round
Book Riot
Sporkful
Death, Sex, and Money
Note to Self
Double X
Mom and Dad are Fighting

My recommendations:

  • This American Life‘s show usually focus on topics all of us usually have a relation to (like topics of conversation over dinner).  I like this show because the stories shared on there seem to somehow better connect us all/make us more aware of each others’ life experiences. 
  • The No Sleep podcast is a horror fiction show with voice actors who read fantastic stories!  I can’t see scary movies or shows, but I can listen to podcasts and enjoy the creativity of the stories shared! 
  • Anderson Cooper 360!  My partner and I don’t have cable and thus don’t have access to watching Anderson’s nightly news show.  BUT this audio version of his show is a pretty good free option.  I like & respect Anderson Cooper and appreciate the multiple, different points of view represented on his show.
  • Game of Thrones podcast!  After I watch this show with my partner, he usually has to go to bed and I don’t get to recap/chat about the episode with him.  This show features 2 hosts who recap the episode, talk about theories, and read listener feedback.  I often will learn about things I didn’t pick up during the show and hear interesting takes on the various characters & their motivations.