Home Accessibility: Wheelchair User/ Physical Disability

Hands down the WORST thing about being a wheelchair user is inaccessibility. Not only is it a struggle to navigate public places but also my home. I currently live with my wonderful mother in a two story standalone home with a sunken room leading to an attached garage on top of a rather steep hill. None of the entry doors to my home had level access, although when we brought the house and renovated, we did widen some doorways incase I needed to use my wheelchair- good thinking eh? When I was discharged from the hospital in November there were 0 modifications. We had to put a hospital bed in our living room as I was not able to get up and down the steps and we put tension rods and curtains across the doorways as they had no doors. But all we had on the first floor was a powder room bathroom which was too small for my wheelchair. Additionally, to get out of the house I would have to roll to the den, which is sunken, transfer to the floor and bump my wheelchair down then crawl to the garge door, bump my chair down another three steps then scoot down those and into my chair.

Goal One: A Ramp

Picture of metal wheelchair ramp in garage leading to wooden platform
Ramp with wooden extension to lower grade ft. my awesome koala PJS

We started by trying to solve the ingress/egress issue by building a ramp. We had a few options but ultimately decided to put it in the garage because it 1) had the least number of steps 2) had the lowest rise and 3) was weather protected. I am blessed to have some handy people in my family but if you don’t, there is often a charitable organization in the area that builds them using volunteers. I would recommend calling a building supply store near you and ask if they know of anyone if online searches are not fruitful. What we ended up doing was building a 4 ft x 4 ft platform at the interior door level, then buying a pre-fab 10 ft metal ramp with grab rails on craigslist. To decrease the slope some more, we also built a small extra wedge to extend the ramp another 2 ft. My father also got stair stringers and built stairs off the other side of the platform for the bipedal members of my family. The metal ramp has worked great, it is easy to clean and durable and the handles allow me to pull myself up smoothly since it is steeper than ADA and I have a manual wheelchair. The one downside is it is rather noisy but that seems inevitable. We also added some industrial carpet squares to the platform and the wooden wedge to help dry my wheels, protect the wood, look snazzy and make it quieter.

Goal Two: Upstairs!

Picture of carl fredrickson from the movie UP riding a stairlift

My Everest. For several weeks, anytime I needed to bathe, I would have to bum shuffle my way up the stairs, scoot my way into my moms bathroom, get all nice and clean then bum shuffle in my fresh new clothes back down the hallway and downstairs. As a night showerer, this was often the straw that broke my back energy and frustration wise. Between that and getting sick of my frivingroom status, we started looking at options to get me upstairs. Being a rock climber and maker I was thinking I could rig up this ridiculous system but sadly there were some design flaws. But seriously, there was really only two options: elevator or stair lift. Elevators are EXTRAORDINARILY expensive and especially since we weren’t planning on me living here til the end of time, a stair lift was really the only feasible option. Luckily, we have an amazing company locally that does everything from adapted cars to stairlifts to ramps so we were able to go try one out in their showroom. I channeled my best Carl Fredrickson.

We found out that stairlifts are typically $3-5,000 and are NOT covered by insurance. Boo. Thankfully I am privileged enough to be able to make it happen and so we got the stairlift installed the next week. We already had extra wide stairs which was beneficial for those pesky bipedal inhabitants so that wasn’t an issue for us. The track sits on top of the stairs (drilled in) and the chair runs up and down it and is controlled by either a remote or a little switch on the armrest. The chair also swivels when at the top and bottom to allow for easier transfers. Additionally, it folds up flatter so it doesn’t get in the way when not in use. It has a seatbelt that I totally use every time cause safety first? The model I have also has these bumpers on the footplate and the base that will stop the chair if it makes contact (ie toy left on the stairs in the way etc). It isn’t super fast (52 seconds to go 14 steps) but it’s fairly quiet and reliable. It plugs into the wall but has a battery that can make (at least) 2 trips if the power goes out. It may also be theorhetically of course very nice for carying up laundry or suitcases, I wouldn’t know anything about that though. This little bugger allows me to sleep in my bed, bathe myself, access my stuff, and navigate my entire house independently. It ain’t pretty but its absolutely worth it!

Goal Three: Ditch the Hospital Bed

Adjustable bed frame with remote

Due to the nature of my disabilities and the limitations of my house at the time of my discharge, we had to rent a hospital bed for a couple months so I had a safe place to sleep while we made adaptations. While that did its job, I missed my bed and my door and all my decorations but even with the stairlift, my old bed wouldn’t be safe for me. I needed to be able to adjust my bed and feet to various positions at various times and I needed to make sure I didn’t fall out of bed. One of my wonderful friends suggested getting an adjustable bed frame which meant I could keep the mattress I already had (many mattresses are compatible with adjustable beds but not all- check before you buy!). So I got to researching and found that most queen size adjustable frames range from $200-$2000. After weighing my options and reading reviews, I decided on a frame by Blissful Nights as it was on sale and met my requirements. I could not be more pleased! This bed has changed my life!

Bed rail

This bed had lots of extra features I don’t use but the ability to adjust the head and feet so easily and whenever I needed it has really been a game changer. Gone are the days of 56 pillows being shoved in different orders and pillow wedges that are never comfortable! If I have to spend the day in bed, I can sit up and be support and change angles every few hours to shake things up. I have finally found a way to sleep inclined without messing up my hips and spine! As for the not falling out of bed deal, I solved this with a 3 part solution. 1) I keep my bed against the wall so that eliminated a whole side I don’t have to worry about. 2) I have this wonderful creation called a Yogibo Caterpillar Roll which is like a long beanbag snake thing/pregnancy pillow that can be used as support, a snuggle buddy, or in my case to keep me from punching the wall or rolling on the bed — bonus it is super cute! 3) I have a small rail/organizer that helps me transfer, prevents me from rolling off the bed and stores all my stuff.

Goal Four: Upstairs Mobility

Image of a red basic wheelchair
Wheelchair I use upstairs

Now that I have access to both floors and use them on the regular, a new problem came to — getting around upstairs when my wheelchair was downstairs. I had been scooting around for a while and while I am fairly mobile, I’m also fairly accident prone and was doing more damage to my legs than I thought. I don’t have a large house so there really wasn’t much ground to cover upstairs so we tried to find a cheep solution: office chair and a bunch of grab bars (vetoed), scooter like in kids gym class (vetoed), lawn chair with some wheels (vetoed), and second hand wheelchair (vetoed due to mast cells). What we finally ended up doing was getting a basic hospital type wheelchair that I only use upstairs until I get my next chair through insurance then my current chair will be my upstairs chair. I decided to go with this chair as it was light enough for me to push and I was able to strip off the footrests to decrease my turning radius. I also removed the armrests and part of the backrest. It is small enought to get me around and wasn’t too expensive. So far it has held up decently.

Everything Else

These are the major changes we have made to make this house accessible but are just a few of the many modifications and adaptations I use every day. Stay tuned for some of the hacks, devices and strategies I use to make my day easier!

They See Me Rollin: My Wheelchair Accessible Minivan

This post will be about my wheelchair accessible minivan, what adaptive equipment I use, why I chose them, and how they work. For more information on adapted driving in general read this post. To learn about our process leading up to the decision to get a wheelchair accessible vehicle read this post.

Wheelchair Accessible Vehicles (WAVs) come in many shapes, sizes, types and can have a range of assistive and adaptive equipment inside of them. Many people assume that they have to get a full sized or minivan in order to have a WAV, but thanks to the improvements in design and technology WAVs can now also be certain SUVs, pickup trucks, and even sedans! That being said, looks aren’t everything and certain vehicles will fit better for certain people and their lifestyle. For example, I was very exciting seeing all the SUV and sedan conversions but between the lack of passenger seating left in the sedan conversions and the smaller interior space of the SUVs, a minivan was best suited to my needs and I have very few regrets!

What I Have

I have a 2018 Toyota Sienna LE with a Side-Entry Power Fold Out Ramp (or TSLESEPFOR for short ūüėČ ). This means that the majority of my car is the same as a normal Toyota Sienna (engine, interior controls, body, last row of seats, and style) EXCEPT that the entire bottom of my car was ripped out and what they put back in is a lowered floor, the ramp, and a special rear suspension system.

Cool video about the modifications a car undergoes to become a WAV

There are several different companies that convert vehicles, the main two are Braunability and Vantage Mobility International (VMI), and a few different types of conversions. I am not going to go super in depth about each one, but more information can be found on the dealer’s websites as well as from an adapted vehicle dealer. The first main distinction is where the ramp comes out: side-entry (comes from the passenger side door) or rear (comes from the trunk). The second distinction is how the ramp comes out: manual or power and the third main distinction is the ramp storage: in-floor (flat ramp stowed outside of the car under the door and slides out) or fold-out (folds in half and sits inside the passenger door upright).

Things to Keep In Mind

  • Rear entry and manual ramp conversions will always be the cheapest
  • Different brands and types of ramps will have different: ramp angles, ramp widths, doorway clearance height, interior turning space, ramp weight limits, maintenance requirements etc. This can be overwhelming but speaking to dealers directly as well as your driving rehabilitation expert can help find the best solution for you
  • Different conversions will have different passenger abilities: passenger capabilities range from 1-5 (more if full size van) in seats, some conversions can accommodate multiple wheelchair users, not all will support the wheelchair user driving or being up front
  • Different ramp types may be more suitable for different environments: fold out ramps are easier to deploy onto curbs and uneven terrain but may track in dirt and water if you live in a rainy/snowy area, in floor ramps have the option to enter/exit passenger door without the ramp deploying/ getting in the way- may be a win if you have kids
  • Safety features: fold out ramps can be manually deployed from the inside in case of emergency and have higher side edges to prevent slipping off ramp, manual ramps often need a second person to deploy
  • Maintainability: power ramps require more regular maintenance than manual ramps, fold out ramps can often be less expensive to maintain

Why I Chose My Car Setup

After visiting several dealers, wheeling up a few ramps, looking at interiors, reading online, and process of elimination we were lucky enough to have this car mentioned to us and the pieces fell together. For me, I needed a side-entry vehicle because rear entry vehicles the wheelchair user sits behind the second row seats which would prove challenging to then get into the driver’s seat. I chose the power fold out because I liked that it could work as a manual ramp whenever needed, it would be easier to deploy onto curbs (key if parallel parking or in a city), it was cheaper than in floor, and had higher edges on the ramp to keep me from rolling off the side. Once we had narrowed it down to that, by happenstance this car popped up on our dealer’s radar. It had low mileage, was a Toyota Sienna, and already had a transfer seat installed in the driver’s seat!

Because I didn’t want to drive from my wheelchair, the transfer seat slides back into the middle of my van and turns allowing me to wheel up my ramp, lock my chair and transfer right into the drivers seat that came with the car. I then use switches that move me and the seat up to the driving position. It also works well to confuse everyone you park next to ;).

Picture of tan driver's seat in car with adapted hand controls and power base
Transfer seat, hand controls and steering knob

For hand controls, I use the Veigal Compact II Push/Pull hand controls- I push to brake and pull to accelerate. These are right hand mounted, which is not typical. These controls are made by a German company and are more often installed in non adapted vehicles as they can sit right next to the console and be out of the way. Typically, hand controls are column mounted (ie go through the steering column) and are operated with the left hand. Some disadvantages of this are that you are more restricted in your seat positioning, your drive hand is far away from the gear shift, they may have to make permanent modifications to your car to install (remove leg air bags etc), and the manual ones cannot be disabled for able bodied drivers.

Black Veigal Compact II Push Pull Hand Controls installed inside a car
Veigal Compact II Push Pull Hand Controls

Initially, the main reason I liked the Veigal Controls is they are on the right side and low down. I have less strength on my left side but good range of motion and the opposite on my right. Other benefits I have found are: they can be easily disabled for able bodied people to drive, they are inconspicuous, they don’t permanently modify the vehicle (except the holes in the flooring), they allow for the user to sit in a larger variety of places, they have a parking brake for changing gears or sitting at long lights, they are not fatiguing as you can rest your arm on the armrest, and they are very easy to use! Can you tell I like them? The last piece of adapted equipment I have is a SureGrip Spinner Knob which I have mounted on the lower left of my wheel and helps me turn the wheel with one hand. I like this one because it does not slide and the knob can be removed to be out of the way for an able bodied driver.

I plan to make a video demonstrating the features of my car, how I get in and how I drive with my hand controls and probably some better pictures. Thanks for reading!

Adapted Driving: Figuring Out How to Drive as a Wheelchair User

The Transit Problem:

Since starting my second stint as a full time wheelchair user in November, a lot has changed in my abilities, lifestyle, and needs than when I previously used a wheelchair in college. I now live in an area that has very little public transit, non-localized services, and pretty hot weather. Gone are the days of wheeling out of my accessible dorm onto an accessible bus to an accessible store or to class. Now, to even get to the street in front of my house I need a car or someone to help me get down safely as we live on a hill (yay -_-). I live in a residential area on top a rather small “mountain” (hill) where the only conceivable things I could roll to with my Smartdrive are a gas station, a pool, and some schools. Additionally, I have lost most of the motor control of my legs and some of my core making driving with my feet impossible. This also means I could no long load my almost 40 lb wheelchair into my car alone anymore. So what next?

Can I Drive?

At first we knew the answer was no. My body was going haywire, I was dealing with new and unexpected issues, I had no idea what my body could and couldn’t do and it seemed like anything I did resulted in increased symptoms. But as time went on and treatment changed I started to have a better feel for my body I started thinking about driving again. I talked to my family, my doctors, my physical therapists and the suggestion of completing a driving rehabilitation assessment was proposed to determine if it was safe. From that, it was determined that I could safely drive using hand controls, a spinner knob, and a car with an automatic transmission. I recommend anyone considering driving with a disability get an evaluation from a non-biased professional.

The Process:

For many months, I just didn’t drive and my parents broke down my chair and lugged it into whatever car we drove, rinse and repeat. This was partly because I was unsure of my condition and if it would be safe for me to drive and partly because I couldn’t drive my beloved Prius or load my chair into her independently. As we started to gain more information about my condition and stabilize me we began looking at options — and boy were there many! At first, we looked at ways to adapt my Prius to be able to load my chair independently (we knew we could add the hand controls into almost any automatic transmission car so this was the main challenge). My family of engineers rather quickly determined this was not going to work.

We then shifted gears to selling my car and getting a used car that could be adapted with a lift to help me get my chair into a car. From that we found that minivans, pickup trucks, and Mazda 5s were commonly the vehicle for manual wheelchair users who don’t load their chairs the typical way (breaking it down and lifting it across your body into a seat). People were incredibly creative, building their own lift systems like the one below.

Person showing their homemade conversion to a Mazda 5

We then found out that the Mazda 5 (sliding door is key) had a specific lift that is designed to pick up your chair with a robotic arm and lift it into the space where a rear passenger’s seat would be. For me, this seemed like a great option — I didn’t have to drive a minivan or a truck! Though some of the truck adaptations are crazy cool looking like this and this I just really didn’t want a truck. So we set out looking for a Mazda 5 and reading up on lifts. Well, they don’t make Mazda 5s anymore and stopped in 2015 and they are very hard to find with decent mileage. So then we looked at minivans. I thought, that since I could stand with support and was decently strong, that if I got a minivan and removed the bucket seat behind the driver’s seat I could just fling my wheelchair up in there and yaaay, I would be done. I even found a few wise souls on the internet proving it could be done. So, we went to Carmax and tried it. I did not have the balance or strength and my chair was just too darn heavy.

Denial

After I had eliminated all the reasonably priced and homemade options I resigned myself to being driven around forever and having whatever poor family member or Uber driver transporting me have to breakdown and lift my chair. And I am incredibly blessed to have the resources and the privilege for that to even be an option. After a couple weeks of mulling it over and tossing around random ideas like “what if I brought a lighter chair and minivan and I could maybe lift it in and it would solve all my problems”. Except not. You can only get a new wheelchair every 4-5 years through insurance and if I were to try and get a new chair that would be light enough for me to lift it would be around $6,000. Plus a minivan. Yeah no.

Black toyota sienna with ramp extending from passenger sliding door

Out of curiosity my mom and I decided to visit a mobility vehicle dealer to see what the lifts looked like, how much they cost, what cars they could go in, etc. We talked with a dealer about our challenges and frustrations and his answer was, “if you want the safest, quickest, and most efficient way in and out of a vehicle, a wheelchair accessible van with a ramp is the way to go”. Well surprise, surprise I thought. Of course they would recommend that, its the most expensive option — its basic marketing! Being the frugal family we are our gut was no, no we don’t need something like that.

The Direction Change

As we thought more about my needs and future we started to shift our mindset towards getting a wheelchair accessible vehicle. We considered the weather, ability to transport myself and others, ease of getting in and out, speed of getting in and out, potential for needing a power wheelchair, potential of progression of disease, reliability, cost, versatility, and resale value. For someone like me with fluctuating conditions, unsure prognosis, aging parents, and a very hot rainy location having a vehicle that could get me in and out quickly and safely was a game changer. While there are some wheelchair accessible SUVs, they’re not great for bigger wheelchairs or power chairs yet — though rumor has it the next 5 years will bring some great new conversions.

If I got a power chair, I could easily drive it into my van and could drive from it or be a passenger without needing expensive modifications or a new car. If my parents became unable to lift my wheelchair into a trunk, they could still drive me around. When its raining, no one has to be exposed to the weather to breakdown, load, and unload my chair. If I want to drive my family and my 88 year old grandpa we can fit my chair, his walker and 5 people comfortably. While I wasn’t super stoked about it being a minivan, the potential for it to transport me and my current and future family places for years to come outweighed its uninventive style.

Embracing the Minivan with Class

Cropped image of rear of minivan with bumper sticker reading "I used to be cool".

Accessible vans are very expensive. Prices are two parts: the base price of the vehicle and the price of the conversion. Conversion means taking out the bottom part of the car and lowering it so the interior is tall enough to accommodate someone sitting in a wheelchair, adding a kneeling system so the car lowers down to lessen the ramp angle, and adding in a ramp. The conversions alone usually cost 20-40K and do not include any other modifications (transfer seat, hand controls, switches, etc). Because of all of this, new WAVs usually run in the 60-80K range. As I mentioned in my Adapted Driving Test, Devices, and Vehicles post, there are funding opportunities, grants, and resources available to help offset this cost. That being said, it has been one of the best investments my family has made for my independence. Even when I am not driving, my van is my freedom.

For a full post about my van, what adaptations I use to drive, and the ways we use the van check out my They See Me Rollin post! (when I finish it)

Adapted Driving Test, Devices, and Vehicles

Are you a new wheelchair user? Do you have a disability that effects your ability to drive a car normally? Do you want to drive again but not sure how you can? This post will be all about options for disabled people to drive including adapted driving tests, hand controls, car modifications, wheelchair accessible vehicles, and more!

Step One: Can I Drive?

While disability alone does not disqualify you from being able to drive, certain disabilities, medical conditions, and medications may impact your ability to safely drive. However, there are many people who can’t drive the typical way because of a disability, but could safely drive with adaptations and or restrictions. So how I do figure out if I can drive?

Adapted driving assessments are designed to evaluate new or newly disabled drivers on their ability to safely drive and help determine any adaptations or special equipment that would help them do so. These assessments are completed by a Certified Driving Rehabilitation Specialist (CDRS) and consists of a clinical evaluation and an on the road test (if determined to be safe). To find a driving specialist near you, you can search on the Association of Driver Rehabilitation Specialists’ directory. A referral from a specialist (usually a doctor, OT, driving school or PT) is usually needed to attend a driving rehabilitation program.

driver and instructor in car during driving exam

The clinical evaluation tests physical abilities, strength, vision, perception, attention, and reaction time through a series of tasks and movements and can often be billed through your insurance. If you are determined to be a good candidate for driving, you will then complete an on the road portion which is similar to a test a new driver completes. If adaptations are needed to drive, this part will be completed with that equipment. Examples of such adaptations include: hand controls, steering knobs, custom seating, lifts, ramps, special mirrors, and special buttons. Once the evaluation is complete, a summary will be completed with the findings, recommendations, and equipment or restrictions. The equipment can then be installed by a mobility equipment dealer. Dealers can be found through the National Mobility Equipment Dealers Association’s (NMEDA) directory.

Not sure where to start or find a program? Oftentimes states will have a driving rehabilitation program as a part of their Vocational Rehabilitation department. In some places, these services (evaluation, equipment, training) are free to residents. If you are a veteran, the VA has Vocational Rehab department that provides extensive services. I will talk more about this in the adapted car section.

Step Two: Adapted Driving Devices and Vehicles

There are a wide variety of devices that can be used and I am by no means an expert, but here are some of them I learned about in my research and evaluation.

Driver's side of car pictured with driver using hand controls and a steering knob to drive
Example of hand controls and a steering knob
  • Hand Controls: Hand controls can be used to replace using your legs to control the brake and accelerator. These can be needed if you have paralysis and amputation but also any disability that effects your lower limbs. There are a wide variety of hand controls and your CDRS may recommend a specific type, brand, or let you decide. For more information about specific types of hand controls, click here! If you have spasms, there are blocks that can be put in front of the pedals so you don’t accidentally hit them.
    Note: if you require hand controls, you are only allowed to drive automatic transmission cars.
  • Steering Knobs: If you only have one arm or are using hand controls, a steering knob may be recommended. These come in a variety of types from knob shaped to post shaped and allow for easier turning without letting go of the wheel or needing a second hand.
  • Switches: Switches can be added to the wheel, steering knob, or hand controls and are customizable buttons that allow the user more convenient access to turn indicators, wipers, hazards and other car functions. Some examples can be found here.
  • Transfer Seats: These are seats that can be put in a wheelchair accessible vehicle (WAV) that allows the user to slide and turn the drivers seat back to make transferring from a wheelchair easier. This is a great option for people who don’t want to drive from their wheelchair but can’t load their wheelchair in their car independently. A video demonstrating how it works can be seen here.
  • Pedal Extensions: Pedal extensions are devices attached to the brake and accelerator that allow people with short legs to reach the pedals from a comfortable driving position.
  • Lifts: Lifts are adaptations that help get you and or your wheelchair into your vehicle. There are car seats that swivel out the door and lower for easy transfers and even foldable boards that lift you up into the driver’s seat that can be put in several models of cars. There are also lifts that lift your wheelchair into your car, trunk or on top of your car. There are also lifts that lift you while in your wheelchair into your vehicle. These types of lifts are common in pickup trucks and SUVS. Depending on your ability, type of wheelchair, car make and model, and lifestyle this may be a great option for you.
Wheelchair accessible lift in a truck
  • Ramps/ Wheelchair Accessible Vehicles (WAVs): For those who driver from their wheelchair, have large electric wheelchairs, or cannot load their wheelchair independently, having an adapted car with a ramp can be life changing. However, to be able to accommodate the ramp and the user a full conversion must be done to the car making these vehicles very expensive. WAVs come in many make and models from your typical minivan to SUV’s to full size vans with lifts. While these vehicles are expensive, there are also funding options, grants, and programs that can help you obtain one. If you have a disability that has a foundation (MS, Parkinson’s, ALS), they may have grants and programs to help pay for this equipment and adaptations. Another resource is your states Vocational Rehab program. In many states, if the vehicle could help you return to work or school, Voc. Rehab will pay for the cost of the adaptations and vehicle conversion once. This means you would just need to pay for the retail value of the car (if you can’t modify one you have).
Wheelchair accessible Ford SUV

To learn about my experience with adapted driving and vehicles, read my post here!

Resources for Wheelchair Users

Assistive technology (AT) is my passion. It combines the best of my engineering, medical, and maker mind to solve problems for myself and other disabled people. As I have been adjusting to being a full time wheelchair user again I have had to modify, create, and improvise not only my physical environment but also my habits and goals. Having a background in AT, many of these changes came to mind automatically or through the suggestion of the many brilliant likeminded individuals of the internet. Through this, I have discovered large gaps in resources and information ranging from adapted driving to basic adaptive equipment to help you through the day. My hope is that this post will serve as a resource for people like me.

***This is an ongoing page, links will be added in as I finish posts***

Adapted Driving Test, Devices, and Vehicles

Wheelchair accessible van with ramp extended out, manual wheelchair user inside vehicle
Wheelchair accessible minivan

This is one of the areas I found the biggest information gap in and incidentally, the category of AT that I knew the least about. Click the above link to read my post on how I drive being a wheelchair user, the wheelchair adapted vehicle I use, and information about disability driving evaluations.

To read about my personal experience with adapted driving and vehicles read my post: Adapted Driving: Figuring Out How to Drive as a Wheelchair User.

For more information about my van’s adaptations check out my post: They See Me Rollin: My Wheelchair Accessible Minivan.

Home Accessibility: Wheelchair User/ Physical Disability

In this post I talk about some of the major modifications we have made to make our two story, standalone home accessible to me. Read to find out about stair lifts, ramps, adjustable beds and more!

AT Hacks from Everyday Items

Affordable AT

Wheelchairs and Mobility Aids

Add a Smartphone to your holiday shopping list… for the seniors in your life

Okay, I know what you’re thinking. I’m crazy. I bet you tried to imagine your beloved senior texting, or even making a call and laughed. I was lucky enough to spend the summer around my grandpa, an 86 year old NASA physicist who helped put a man on the moon with the computing power of a basic calculator. In this time we upgraded him from a flip phone (which he never used when he had) to an iPhone 8. Why on earth did we embark on this learning journey with a man who had no desire to text, get addicted to Candy Crush, or even chat on the phone? Good question people of the internet. Turns out that 40 years working in wind tunnels without ear protection combined with age meant that my grandpa’s hearing just wasn’t cutting it and the hearing aids he had for the past two years weren’t either, it is a noisy world out there. So he went to his audiologist who recommended these next gen hearing aids that could be paired via bluetooth to a smartphone and adjusted¬† via an application. Pretty neat.¬†

Cue the learning process. As the family’s “tech” person, I spent my summer helping my grandpa learn to use his new hearing aids and smartphone and it has changed my perception on smartphones for older adults. Here are a few reasons you may want to consider switching your loved one to a smartphone.

Hearing Problems or Hearing Aid Use

Example of hearing aid and control application
  • Hearing Aid compatible smartphones: Many commercial hearing aids are now Bluetooth compatible. This means that once initially paired, the aids can be controlled (volume, directionality, power) via an application (hearing aid specific) on the smartphone. Additionally, settings can be adjusted so that their phone notifications (ringer, texts, etc) will ring in their hearing aids. For a list of iPhone compatible hearing aids click here. For general phone compatibility click here.¬†
  • Live Listen (Apple): This feature uses your iPhone’s mic to focus conversations in loud environments and stream this audio directly to hearing aids. This is a game changer for 1:1 conversations in public places and is compatible with several commercial hearing aids and is now compatible with air pods (wireless Apple headphones).
  • Sound Detectors (Samsung): This feature can be enabled and allows the phone to listen for doorbell sounds and crying babies (second one might want to leave off) and sends an alert to the user if that sound is detected.
  • Flashing Notifications:¬†This allows users to have either the camera flash (iPhone) or the notification light (Android) flash for notifications (calls, texts, etc).

Vision

Magnifier App in iPhone
  • Dynamic Text/ Font Changes:¬†These settings on various devices allow the user to make text larger in apps and on the web for those who have trouble with small type.
  • Magnifier (Apple)/ Magnifier Window (Samsung): This can be added to the control panel and uses the phone’s camera to magnify anything, newspaper, photo, or prescription bottle! In the app you can enable the flash to brighten the view, as well as invert colors/adjust contrast for easier viewing. On screen items can also be zoomed in for higher detail.
  • High Contrast Keyboard/Fonts (Samsung): These settings allow for high contrast keyboards and fonts which help for identification and reading

Dexterity Issues

Assistive Touch Menu on iPhone
  • Assistant Menu (Samsung)/ Assistive Touch (Apple): These menus help those who are new to touchscreen use and “gesture” control or have trouble with dexterity. These menus float on screen and allow complete control over the phone and functions just with single finger tapping.
  • Touch Accommodations (Apple): These are settings that can be enabled to ignore repeated accidental touches, or set the phone to register only the final position of a touch on screen as deliberate (i.e. if they touch and drag their finger it only selects what they end on).¬†
  • Siri and Google Assistant: No need to touch the screen, phones and function can be controlled with their voice!

Applications for Seniors

One of the many benefits of smartphones is access to the respective application stores. There is an app for just about anything and this does not exclude seniors both for fun and safety! Here are some of the types of apps that may be good to add to your loved one’s new phone.¬†

  • Medication Reminder Apps: Not only does this allow them to have a place with their up to date list of their medications but can delivery automatic reminders for them to take their medication, what it is, how many and even what it looks like! Many of the apps have cloud capabilities so that caregivers can check use and update remotely.
  • Panic buttons: Apps like this function similar to a fall alert button but have an app that will send location information to emergency contacts with the press of a button. Some are compatible with Siri and other voice commands.
  • ICE Medical Information: These applications (built in on some phones) allow the user to input critical medical information, emergency contacts, allergies, medications and other first responder information and can be accessed without needing to unlock the phone.
  • Video chat (FaceTime, Skype, Hangouts): Allow for long-distance relationships, sharing, and help finding those darn keys around the apartment.

If all of the above are not enough reason to reconsider getting granny an iPhone, also take into consideration learning new things can be exciting and help keep their faculties sharp. Sure, there is a learning curve and my grandpa has surely surprised me with his progress, but in my opinion it is worth it! My grandma even mastered emojis!

AT/Software for High School andCollege Students with Disabilities

Having a disability or being chronically ill in college comes with many challenges: time management, memory, missing class, taking notes, studying, typing papers, reading textbooks and more! While this by no means will be an extensive list, here are some applications, software, and modifications that you might find helpful broken down by task. *Note: if you have an IEP/504/ College Disability Accommodations, some of these may be available to you for free through your school or may be covered under insurance so talk to your case managers!*

Time Management:

Timeglass (Free)List of three timers in a screenshot of timeglass app

This is a simple application that allows for the use of multiple timers at once, including multistep timers, repeats, customizable icons, and a visual timer. There is a limited feature free version on iTunes.

 
VisTimer Lite (Free)
screenshot of visual timer
Another simple visual timer application that has customization options such as display size, circle color, alert sound, and time warnings. Available in iTunes Store here for free with ads, upgrade available. Compatible with iPhone and iPad.

 

 

Things 3 ($9.99 iPhone/Watch)

I have tried many to-do list-esque applications over the years and while most start off great I find I stop using them after a week or so because they are too complex, don’t sync well between devices, or don’t help. Things 3 is the exception. It has iPhone, iPad, Apple Watch and iMac/Macbook compability, iCloud, Reminders and calendar syncing, it clean and easy to use and helps me immensely with homework, projects, things I need to buy, and my “remind me to think of…”. It is available here.

screenshot highlighting the upcoming feature of Things3 appscreenshot of start page of things3 app
Why I love it:
  • items are easy to move, categorize and mark as complete
  • a log book is kept for your completed items for the inevitable “oh shit I didn’t actually do that” moments
  • it syncs well with devices
  • it syncs with iOS Reminders, Calendar (including google), iCloud, and various devices flawlessly
  • You can set due dates, reminders, and assign a time to complete it
  • You can make subcategories
  • It helps a lot with packing and grocery lists too

Taking Notes:

Microsoft OneNote (Free)

Microsoft OneNote is part of the Office365 suite and is like Word, Powerpoint, and a Notepad combined. It offers the users to create subject sections, draw freehand, add tags such as “question” “to-do” or “follow-up”, simultaneously record and take notes, highlight, change page color, and more! Additionally, if used on Windows, “Learning Tools” is a free package download that includes features such as text-to-speech, focus mode, font-spacing, page coloring options, reading tools for low vision, dyslexia and other print disabilities, and more! I find OneNote to be the most useful one touch screen devices, especially for working out things like math problems that are hard to type out correctly or quick sketches. OneNote is also integrated with Office Lens (below).

screenshot of OneNote application               screenshot of One Note app

Notability ($9.99)

screenshot of notability app on ipad

I have only just started using Notability by Ginger Labs instead of¬†OneNote and while the two applications have large amounts of crossover in terms of functionality, I prefer Notability’s design as well as ease of integration of pictures, better functionality of audio recordings, more functional highlighter, and overall more functional to use and sync.

Writing/ Reading

Wrise ($59)

Wrise is an accessible word processor for Mac that includes word prediction, text-to-speech, tags, and an export to iTunes feature. It is made by Assistiveware and is switch compatible. It also has tools to help people who struggle with similar sounding words, spelling, and reading.

Dragon Dictation (Naturally Speaking- $69.99)

Dragon provides one of the best speech recognition/dictation softwares out there. For those with fine motor issues, hypermobility in fingers, or who just prefer to talk rather than type, this is an amazing software. Dragon works with most common word processors (Word, Notepad etc) and can also be integrated into social media and web browsing.

Studying

Quizlet (Free)

Quizlet is a free study tool that allows the user to make e-flashcards, practice tests, and learning games all from a study set. The free version allows for pictures to be used on flashcards as well but you are limited to a small database. Additionally, study sets can be shared with classmates, worked on collaboratively, or you can search for pre-made study sets by other users. Some of the really beneficial tools of quizlet are: web based with app options, several different modes for learning from traditional “flashcards” to an adaptive learning course that prepares you for your exam. As someone with a learning disability, the ability to have the cards/ questions read to me when I want to is a major plus.

Crash Course Videos (Free)

These videos are fantastic! While you are limited to the topics they cover, I find them informational and think they do a great job of summarizing and presenting information without being too complex. These are great reviews for science courses, history, and other introductory courses. Also just fun to watch to learn something new. They even have videos on study skills!

Khan Academy (Free)

For more specialized informational needs, especially in math and science, Khan Academy does a good job of summarizing, providing examples, and covers more discrete topics.

Other

Office Lens (Free)

Office Lens is a free mobile application (integrated with OneNote) that gives you a scanner and optical character recognition (OCR) in one application — and for free. I use this app all the time!

Things it can do:

  • take a picture of a whiteboard at an angle, auto-crop it, and perform OCR (scans and converts characters to type)
  • take a photo
  • take a picture of a business card, crop it and perform OCR
  • save anything you snap to camera roll, OneNote, PDF, email attachment and more
  • scan and read a document to you
  • scan a document, perform OCR, send document to OneNote, then edit the document
  • compatible with VoiceOver and switch access
    screenshot of note and keeble keyboard

Keeble Accessible Keyboard ($24.99)

Another product of Assistiveware, Keeble is for anyone with vision issues, limited use of hands, dyslexia, and switch users this app is an accessible keyboard that can be added just like a foreign language or emoji keyboard and allows for customization of color, font, word prediction, quick phrases, auditory feedback (speaks what you type), Open Dyslexic font, ALL CAPS, and arrangement (ex. switch user making keyboard in frequency order as opposed to QWERTY).

 

 

Hope some of this helps!

College a cycle chart

 

 

Tips for an Inclusive Halloween

Halloween can be a real struggle for kids (and adults) with disabilities. Here are some examples of aspects of halloween that are not accessible:

  1. Walking around in the dark
  2. Being surrounded by people who look different than normal
  3. Sensory considerations with costumes
  4. Sensory considerations with house decorations (flashing lights, motion activated stuff, jump scares)
  5. Lots of walking/ rolling and physical accessibility of getting to house’s doors
  6. Talking to strangers (Trick or treat, asking for candy, responding to what your costume is)
  7. Food allergies or inability to eat
  8. Fine motor skills needed to grab candy
Here are a few adaptations/considerations that will help mitigate these challenges:

Food allergies/ inability to eat: Meet the Teal Pumpkin Project

The Teal Pumpkin Project is an initiative to include those with food allergies or special diets in trick-or-treating and to raise awareness. To participate paint a pumpkin teal (or print a picture and tape it to your door) and stick it on your porch. When you go out to buy candy, also buy some non-food items for kids. Examples: silly bands, party favors, bouncy balls, silly putty, vampire teeth or stickers! Party stores have lots of this stuff! Then, when trick or treaters come, simply hold two bowls and let the child choose! Believe it or not, there are even some kids who just don’t like candy (real bummer for Halloween).
Resources and further details found here! This year they have even added a map where you can tell the world your house is participating!

Trick or Treaters who don’t say Trick or Treat

There can be many reasons why someone might not verbal say trick or treat. They may be deaf, have anxiety related speech issues, be nonverbal, or just unaware that they are supposed to/why they are supposed to. Some may carry cards like this. Some may have a communication device. Some may just expect you give them candy. When in doubt, just give the kid some candy!

Decorating Your House

Keep in mind that for kids, terrifying is more likely to mean they will skip your house rather than bravely wandering forward. Be careful of extension cords as tripping hazards, poorly lit uneven surfaces, steps needed to climb to get candy ratio and other dangerous factors that might be hard to see at night, kids are unpredictable and hopped up on sugar. Also consider use of strobe lights, fog machines, and motion activated decorations as they may cause sensory overload, breathing issues, seizures etc. If you do want to use a strobe light, set it at a lower interval and it will be less likely to cause problems. Remember: its about the candy, costumes and fun…
Pro Tip: If you live in a house with more than 5 steps you might want to consider sitting down by the sidewalk during the main rush to hand out candy if you don’t want to get skipped!

Be patient and Enjoy!

Give that kid who appear to be indecisive a little extra time to look at his options, he might have allergies, motor planning issues, or just wants to get candy he actually likes instead of accidentally grabbing the stinkin pretzel bag. Don’t force children to speak to get candy. Give compliments on costumes even if you have no idea what they just said they were but also keep in mind that a kid not wearing a costume may have sensory issues, fabric allergies, or is scared of costumes. Also, if a teenager, adult, or other non-kid comes to you trick or treating don’t make them feel out of place, they’re participating and nothing wrong with being a kid at heart!

HAPPY HALLOWEEN!

Not being able to speak is not the same as not having anything to say! AAC Awareness Month

¬† ¬† ¬†Augmentative and Alternative Communication (AAC) is any form of communication that supplements or replaces speech. AAC can take many forms, from sign language to facial expressions, to printed communication books to high tech speech generating devices (SGDs AKA “talkers”). Basically, if it isn’t speech it is AAC! High tech does not always mean better and just like study habits and treatment plans, what works for one person might not work well for another, even with the same diagnosis. AAC users are of all ages, genders, races, disabilities, and literacy levels but they all have either no speech, speech that is difficult to understand, or have trouble forming fluent speech.

Remember that last time you lost your voice? I can almost guarantee you that you became frustrated at least once during that time period. Now imagine that you have an itch on the center of your back and you cannot speak. You’re only given this sheet of laminate paper.

You can’t sign, speak, or write. How do you tell me your back itches? Maybe … “I/me/me — help — turn…” then directional words until your communication partner happens upon the place your back itches??

Sounds “no want”? What? Not the word you were thinking of? Oh well… good enough. NO NO NO!

     Everybody should be given access to words (and symbols). Words are powerful and they make us who we are and allow us to connect with others. They surround us from the moment we are born to our very last breaths. Words are more than just basic needs and wants. Words are social, personal, creative and powerful. Nobody should have that kept from them.

Tips for Communicating with a person who uses AAC:

  • Be patient!¬†One of the most frustrating things for me if being asked a question and halfway through your response they say something like, “oh, nevermind” or “don’t worry about it”. Similarly, group conversations can be VERY difficult when it takes you longer to respond. I often form my answer and by time I have finished my response is irrelevant. Don’t be offended if I tend to be quieter in groups, I am listening! I know it is hard to take the time to slow it down but I guaranteed you the AAC user will be very grateful!
  • Don’t limit to yes and no questions. It gets boring really quick. That being said, if an answer is needed quickly, it might be helpful to ask yes or no questions or give a few options to chose from. Ex. “Julie, the house is burning and I need to know, should we use: unicorn power, ninjas or rocks to stop the fire. Unicorn power? (yes/no) Ninjas? (yes/no) Rocks? (yes/no) Something else? (wait for response using AAC).
  • Presume competence.¬†Talk to us at an age appropriate level and normal volume and rate (unless known to have hearing or processing issues). POP QUIZ! (all based on actual experiences)
    • ¬†Billy is 40 years old Giants fan and uses a speech generating device. When talking to Billy you should:
      1. HELLO BILLY BOY! HOW————ARE———YOU?!
      2. Hi Billy, how are you? I saw the Giants won last night!
      3. *turns to Billy’s wife* Hi Betty! How are you? How is Billy doing?
      4. HI. My——-name——–is———S-U-S-A-N. NIIIIIICCEEEE TO MEEET YOU! YOUR CHAIR IS SOOOOOO CUTE!
    • If you answered #2, wahoo! You get it.
  • Advocate¬†with us and for us!

 

Cool AAC Related Stuff:

Above: Video compilation project showing AAC users doing various activities and living their lives!

Above: An example of a SGD and computer controlled with the users eyes. For more information click here.

For a great website for AAC resources (use, teaching, awareness) click here (PrAACtical AAC)!

Examples of popular low and high tech systems:

 

 

Getting Hip with the Lingo

  • Augmentative and Alternative Communication (AAC):¬†includes all forms of communication (other than oral speech) that are used to express thoughts, needs, wants, and ideas. We all use AAC when we make facial expressions or gestures, use symbols or pictures, or write (Source: ASHA)
  • Speech-Generating Device:¬†Any piece of technology that turns user inputted text or symbols and turns it into spoken computer generated or synthesized voice. AKA a machine that talks for you.
  • Switch Access:¬†using a switch to control your AAC device (like an automatic door switch). Switches can be activated using touch, light, sound, breath, or even tongue movements!

IDK MY BFF JILL

If you don’t know that reference it is from an 2007 phone commercial. Classic.

Anyways, I wanted to write a post about technology as assistive technology (AT) and more than just soul sucking relationship ruining screens that give you cancer. I will talk about how I use my devices as AT and why they are important for me and because of such, will be talking exclusively about Apple iOS devices because that is what I use. I plan to do another post about iOS as AAC devices and switch access eventually so this isn’t the longest most boring post ever!

I am a die hard Apple fan. I was a die hard Apple fan before I got sick and have fallen even more in love since then. First, I am in no way paid by or speak for Apple or anything, I don’t know why people have to say that but they do so I will! Second, I am not going to talk about Android because I know nothing of Android. I know they do not have as extensive built in accessibility features but they work better for some and that is fine. Lastly, I’m mainly going to be talking about why I choose Apple products as a person with a disability and what features help me or might be of help to those with similar conditions. So leggo my eggo (not paid by them either ūüė¶ )!
First I’m going to talk about some settings/features that aren’t technically accessibility settings (other menus) but that I have found to be helpful.¬†

Visual Voicemail and Transcription

 

Phone>Voicemail
Apple’s visual voicemail system is one of the most underrated features in my opinion. For people with hearing/auditory processing issues, gone are the days of trying to remember which button to press to repeat the message…giving up and having to call VM all over again because you didn’t quite catch that middle part. New to iOS10 is a beta for automatic voicemail transcription. Now, when you click on a message and press play, the recording plays and an automatic transcription is written below. If it picks up a phone number it will be hyperlinked and a long press will give you options to call, message, or add number to contacts. For someone with Dyslexia this is a god send. I call/text wrong numbers constantly when I try to manually copy them down. Additionally, it is useful for those with hearing loss, auditory processing issues, or even if you want to scan the content in a meeting to know if it is urgent.

Find My Friends/ Location sharing in apps such as messages

At first I was not into having my mom be able to open an app and track my phone but it really has grown on me. This is definitely not the set-up for everyone (could be with someone other than your mom) but in times where I have gotten hauled off to the ER and they leave a VM on her phone saying “Julie’s in the ER”, being able to see which ER, if I am still there, or where I am if I am too confused to figure it out can be super useful. Again, not for everyone.¬†

SIRI

Siri is great and almighty electronic goddess, obey her.

EMERGENGY HOME SCREEN MEDICAL ID

(to set up) Health App>Medical ID> Edit
At the minimum please put in your organ donor status, name, and emergency contacts. It can be accessed by EMS/ED staff even if you have a lock on your phone. To view access, get to the lock screen with the number panel, click emergency in the bottom left, click medical ID.

ACCESSIBILITY SETTINGS (iPad and iPhone though most are available on laptop just different paths etc)

******There are so many– I’m just going over what I personally use******

Display Accommodations

 

Settings>General>Accessibility> Display Accommodations

 

Another brilliant addition to iOS10 was the Color Filters setting. This allows the user to tint their screen to their liking/need. This is a godsend for anyone with photosensitivity, migraines, color blindness, eye strain, and other vision conditions. It allows me to turn my screen a nice pinky-orangey tint that I would otherwise have to wear my specialty  indoor migraine glasses for. Another feature in this category is Reduce Whitepoint. This setting allows the user to reduce the intensity of bright colors on the screen by 25-100%. No longer need you be blinded by a white screen loading a webpage on ridiculously slow internet.
 

Speech

Settings>General>Accessibility>Speech
I wouldn’t be able to do much of my homework or social media without text-to-speech software due to eye strain, dyslexia, migraines, photosensitivity and reading comprehension issues. This is definitely one of my most undervalued helpers and it wasn’t until I was trying to read a textbook chapter on a different computer that I realize how much I rely on it and am assisted by it.
       Features/Settings:
  • Speak selection: when on, this will give you a “speak” button when you highlight text (next to copy/paste etc)
  • Speak screen: dragging two fingers from the top down will start speaking items on the screen
  • Highlight content: highlights words/sentences/words and sentences as they are read
  • Typing feedback: options to have keys/words/sentences you type to be read back to you
  • Voices: different synthesized voice options for speaker for gender, language, and accent
  • Speaking Rate: how fast the voice talks
  • Pronunciations: tell it how to say certain words like Ehlers-Danlos

Reduce Motion

Settings>General>Accessibility> Reduce Motion
This one is really helpful if you have vision triggered disabilities or just don’t want all the fancy graphics for things like opening and closing apps.

Switch Control and Assistive Touch

Settings>General>Accessibility>Switch Control or Assistive Touch
These are more specialized/complicated but amazing accessibility features I plan to do a separate post or maybe video for but I will just share their purpose now. Switch Control is for people with physical, cognitive, or sensory disabilities who have trouble accessing all or many of their functions or their iDevices via direct selection AKA touching the screen with their hand or a stylus. It is a built in program that allows the device to be controlled and used entirely via 1 or 1 switches. Switches can be the whole screen, head movements, external switches (wired or bluetooth), sip and puff (controlled by mouth movements) and more! For an example of switch access by someone who can do amazing things with it, watch the video! Assistive Touch is basically an accessible menu for people who have physical challenges performing actions like pinching to zoom.

Subtitles and Captioning

Settings>General>Accessibility>Media> Subtitles and Captioning
I actually only recently learned about this feature but if you like subtitles or need them, make sure you have this setting turned on and it will automatically turn on subtitles when available in apps like facebook, netflix, chrome etc.

Accessibility Shortcut

Settings>General>Accessibility> Accessibility Shortcut
Another relatively new feature this one can wear many different hats based on your needs. What is does is set a shortcut on/off switch for a selected accessibility feature by triple clicking the home button. On my phone, this turns on the pinky-orangey tint from my Color Filters settings. Since I only use that at night usually, it saves me a couple clicks turning it on/off everyday. On my iPad, I have it set to turn on Switch Control (more on that later) for when I use that.