independent living

Technology and other aids to help people "age in place"

Most people who have a choice prefer to remain in their own homes as they age and require more care.

No one wants to give up autonomy. Nursing facilities are expensive. Remaining in one's home as long as possible can be strategy for preserving one's estate.

Sometimes people with chronic and age-related disabilities become socially isolated when they choose to live independently. When it requires a lot of effort to get out, a person's friendships can shrink to the number of paid professionals who come in to give assistance.

A person's social needs may be better met in a nursing facility or retirement home, which can be akin to living in a college dorm.

But there are an ever growing number of devices -- some inexpensive, some expensive – which can help a person compensate for a loss of vision, hearing, mobility and fine motor skills.

Keys to whether these devices will allow a person to "age in place" often hinges on their mental acuity and willingness to learn new things -- or the acuity of a spouse or loved one sharing the home.

Safety and security

The newest fall detection devices do not require a button to be pushed for help to be summoned. This is an important feature for people with dementia or other cognitive difficulties who may not remember how to operate the technology.

A device called "Be Close" tracks a person's activities throughout the day, producing hard data a loved one or caregiver can monitor to see how many hours the individual is sleeping and whether they are being active enough to maintain good health.

Dementia patients with an inclination to wander can wear an ankle bracelet that electronically transmits their location -- a godsend if they were to become lost.

Environmental Accessibility

Ramps are easier for anyone who needs a mobility device -- even if it's just a cane.

Mini elevators provide accessibility with a smaller footprint, and they're finally becoming portable and more affordable. They must be operated from a concrete pad, however, which may be an issue for landlords.

Stepping over the tub lip -- or swinging one's legs over it from a seated position -- are the most common accident that happens at home. Of course, probability of slip-and-fall accidents increases when people are wet.

Swivel seats with a tracking apparatus that moves the seat to the middle of the tub without shower doors will help, although the legs will still have to be raised over the lift. These seats also do not submerge the person into the water, which can make it difficult to cleanse genitalia.

Tubs with a door remedy the step-over problem, but many people don't like feeling exposed while the water fills and drains.

Health and Wellness

Taking medications can become complex when a person has several prescriptions. There are a variety of medication reminder systems that help dispense pills and make it possible to monitor at a glance what meds were missed. Unfortunately, they are rarely covered by health insurance.

A simple yet effective one is a pillbox in which pills are compartmentalized into morning, noon, evening, and bedtime compartments for up to seven weeks at a time.

Wristwatches can be programmed (probably by a caregiver) to buzz when it's time to take medications. Electronic dispensaries be set to ration medication at the time the pills should be taken. That almost eliminates the prospect of someone becoming confused and overdosing.

Communication and Engagement

Cell phones are a safety feature because a person who remembers to carry it can always call 911. Simple phones with big buttons will be easiest to learn to use.

Many phones have accessibility features like sound amplification and display brightness, but an older person will probably need to be shown them -- and practice using them with a patient teacher -- before feeling confident to use these features on their own.

Pocket devices are available which allow people with hearing loss to hear their televisions without waking their neighbors.

People who are open to learning to use an iPad or other lightweight tablet computer are always glad they did. These devices keep news, information and entertainment within reach. Older readers who can use the reverse pinching gesture to enlarge type usually embrace e-books.

Communications technologies also help people stay in touch with friends and family. Most enjoy using email, Facebook, and video-conferencing applications like Skype -- although they may need help setting it up initially.

Keyboards with bigger buttons in contrasting colors are readily available for people with vision or neurological challenges. A computer mouse with a track ball may be easier for people with compromised fine motor skills to use.

Low-tech assists for independence

* Straps that make it possible to pull up socks without bending all the way over.

* Claw reachers can eliminate the need to stand on chair or climb a ladder.

* Electronic locators that beep to help find misplaced key rings (if left in or near the home).

* Jar openers

* Device mounted above the stove sounds an alert if a burner is left on or some food starts to burn.

* Lighted, hand-held magnifiers are useful for reading labels.

While assistive technology can be expensive there are loaning libraries in many communities.

Disability Network/Lakeshore has a variety of items to loan at it's Holland office. Call 616-396-5326 to find out if we have what you're looking for.  

DNL & the VA: Working Together

Disability Network/Lakeshore (DNL) works hand-in-hand with the VA in a program called Independent Living (IL).  The IL program is part of the VA’s Vocational Rehabilitation Program and focuses on helping veterans with service connected disabilities find meaningful, sustainable careers.

For veterans who are unable to return to work, the program helps identify accommodations, assistive technology, and community-based services that enhance independent living skills.  That’s where DNL staff come into the picture.

Susan Jones and Christine Wistrom work as Independent Living Specialists coaching veterans via peer support services.  Having lived with disabilities themselves, Susan and Chris can lend emotional support and guidance to veterans for coping with their disabilities.  They connect with veterans several times a month, both by phone or computer and in a face-to-face visit.  They assist the veterans in identifying goals for what they’d like to achieve and developing a plan to reach those goals.

DNL staff work to help troubleshoot problems the veterans may be encountering in their everyday lives, such as scheduling medical appointments or locating information about assistive technology devices that can increase independence.  Following the philosophy of DNL, they focus their efforts on “teaching to fish” rather than doing things for veterans.  They want veterans to know they are capable of handling their own problems, but also understand the DNL staff members are there to provide guidance and support when needed.

Some of the services provided in the IL program may include: 

·         Evaluation and counseling to determine needs and identify goals

·         Consultations with specialists to identify special needs such as medical therapies, or rehabilitation

·         Information and referral to resources such as health care services, special technology and equipment, community living support, and family counseling

·         Information and referral with home modification programs such as the
Specially Adapted Housing (SAH) grant, and Home Improvement and Structural Alterations (HISA) grant. 

The IL program allows veterans to receive up to 24 months of support. 

Eligibility requirements include:

·         Having received a discharge that is other than dishonorable

·         Having a service-connected disability rating of at least 20% from the Department of Veteran Affairs (VA)

·         Applying and being approved for Vocational Rehabilitation and Employment (VR&E) VetSuccess services. 

For more information about the IL program or for other veteran-related questions, please contact Susan Jones or Chris Wistrom at 616.396.5326.

Problems At Home

Working at Disability Network/Lakeshore means helping people with disabilities find the answers they need to remain independent in the community.  That’s kind of a mouthful, but basically it’s just saying we want to connect people to the resources they need to stay at home rather than go into a nursing care facility.

One of the programs I work in is called NFT: Nursing Facility Transition. 

In the NFT Program, we work to help residents who are already in a nursing facility but could live in the community except for various barriers that keep them from going home.  One of the main barriers we deal with is housing…specifically, low income housing.

Yes, you might say, but aren’t there already apartments available for people who have a low income? 

The answer is yes, there are…but not nearly enough, and, not nearly inexpensive enough.  You see, many people with disabilities are unable to work.  They, after a long, exhausting fight, manage to get disability income or supplemental security income, and that does help.  Unfortunately, it’s not that easy.

If you manage to qualify for supplemental security income (SSI), then you’ll get approximately $740/month to live on.  That’s for everything too: housing, telephone, groceries, transportation, etc.  Low income is a necessity in this instance, but keep in mind that you may sit on a waiting list for months or years waiting for an apartment to become available.  And in the meantime, what do you do?

There are some places out there that are inexpensive enough.  It takes a while to find them, but even then, they may not have the features needed by someone with a disability.   

What we need are more inexpensive apartments that are accessible to people with disabilities, and that allow the people living in them to have enough money to purchase groceries and pay their other expenses. 

I’m not sure what the answer to the problem is going to be.  Maybe more small economy apartments.  Maybe more apartments that are Government subsidized.  Maybe there are other possibilities that I don’t know about. 

What do you think?  What’s the answer to the need for increased housing for people with disabilities?  There has to be an answer out there somewhere.

- Chris Wistrom, chris@dnlakeshore.org

A Common Disability Agenda

If you’ve never read over Michigan’s Common Disability Agenda, it’s worth taking the time to do.  Sometimes people have a tendency to think that what’s going on in the disability arena doesn’t apply to them.  Nothing could be further than the truth.

As you age, the likelihood of your developing a disability increases dramatically.  We tend to go through life thinking, “It’ll never happen to me,” but even those aches and pains typical with the aging process can change your outlook on life.  And then there’s the likelihood of developing arthritis, back injury, osteoporosis, diabetes, etc.  If you’re lucky enough to get by without developing a condition that restricts your independence, consider that we don’t go through this life alone.  Your siblings, parents and friends are all aging too.  They face the same age-related conditions the rest of us do.

So, knowing that there is someone monitoring how Michigan is treating our citizens with disabilities is important.  The Michigan Statewide Independent Living Council (MISILC) has done a nice summary of the primary issues if you’re interested.   These issues include:

  • Access to comprehensive health care. Preventative health care saves money and helps maintain independence.
  • Long-Term Care reformation. People with disabilities want to live in their homes rather than in institutions
  • A strong workforce. People with disabilities want to work, but face many barriers trying to access the workplace.
  • Affordable, accessible housing. People with disabilities are more likely to have a lower income, so finding affordable, accessible housing is difficult.
  • Accessible, affordable public transportation. Nearly half of Michigan’s 83 counties have little or no public transportation. 
  • Effective land use policy. Most Michiganders live in urban or suburban cities.  People with disabilities are often cut off from the resources they need because they lack the financial resources, natural supports and transportation to make connections.
  • High quality education. Michigan has two separate education systems, one for persons with disabilities and one for those without.  This is expensive and doesn’t provide a quality education for children with disabilities.
  • Achieving rights as a citizen. People with disabilities need to make decisions about what’s important to them.
  • Accessible voting. Michigan needs voters, but many barriers exist at the polls that prevent people with disabilities from voting.
  • Accessible recreational facilities and programs. Recreational facilities and programs must be designed or modified to provide universal access to everyone.

Michigan’s Common Disability Agenda—take the time to learn about what Michigan is doing for her citizens with disabilities!