Accessing your Home through Modification

Sometimes, after a spinal cord injury, your home is no longer accessible and you are told that "your home will require modification". But what are the actual modifications that your home might need? 

 

One common modification, unless your home is level with the ground, is ramp installation

 

Quick Ramp 101 - Ramps must be constructed so that for every 1" of rise there are 12"of run, meaning If your door is 6 inches up, you'll need a 6 foot ramp. 

from THAGroup.org Home health tip: How to build a wheelchair ramp

Any ramp installation must be completed according to the specified code requirements as per the Nova Scotia Building Code Regulations - but the read is a bit dry. I find the Canada Mortgage and Housing Corporation (CMHC) actually explains it a bit better. 

The CMHC also have an entire section called Accessible Housing by Design, going further in depth about renovations/modifications according to different areas of your home (kitchen, bathroom, etc.), home automation, and appropriate appliance selection.

 

For even more information and ideas, linking from the CMHC, you can also visit the center for Universal Design and their online publications section. For example, from the Design Research and Methods Journal there is one article that goes over SIX different accessible stock house plans. OR you could look over a curbless shower installation guide.

While its hard to be told that your home no longer suits your needs, these sites are here to help you understand why and what your options are. The online publications have lots of articles, each filled with ideas that go beyond the basic modifications too, and that can help you narrow down what you want as well as what you need. 

Also, visit our SCIRehab YouTube channel to see how others have modified their homes, like in the example below. I like this video I have included because it goes over good items but also points out other areas that might need modification.  

Funding for Home Modification in NS

There are very few people without financial concerns. When you own a home, those concerns often weigh heavy at the best of times, let alone after a spinal cord injury. Often I've heard people say that it's when you leave the hospital that the REAL rehab even begins. I mean, how are you going to negotiate that uneven walkway at your house, and wouldn't it be easier if the bathroom on the main floor was accessible? 

'

If you are not moving, there is a very good chance that your home may need modification - and the Community Services department of the Government of Nova Scotia wants to help you get those modifications completed by providing grants to eligible households.
'

Whoa whoa, I know - Eligible. Always a catch.

Depending on your total household income, you *may* be eligible for one of two grants that I will review with you today.

'

The grants are:

1. The Disabled Residential Rehabilitation Assistance Program for Homeowners

2. Access-A-Home Program 

'

OK, so how do they work?

1. The Disabled Residential Rehabilitation Assistance Program for Homeowners is an up to $16,000 forgivable loan that is intended to help low income homeowners make needed repairs or home modifications. Ramp construction and installation, for example, would qualify. The income limit is dependent on home location and applicants household size - which means if you are part of a household with one working member, an injured spouse, and you also have to support two children, your income limit might have a greater allowance than a household with a single person with no dependants. OH, and you might also be wondering about that forgivable loan part (as was I). In this instance, if you received the grant, used the loan to renovate, then moved - you need to pay back the loan as you basically just made money off of it. However, if you use the loan and do not move for the required amount of years then it will be forgiven - will not require you to pay it back. And I believe we are talking less than 10yrs, but again each case varies. Also - currently the income limit, for HRM in 2011, is up to or less than $29 000 - but again, this limit varies considerably depending on your own personal situation.
'

2. Access-A-Home Program. 

This program is a $5000 grant, and the income limit for eligibility, in the HRM in 2011, generally starts around $39,000 (again, can vary significantly, this just to provide an idea). This program is also specific to individuals who must adapt their home to facilitate wheelchair use. The way this program works, once you have completed the application, is an inspector will visit your home and provide specifications that you (the home owner) will then take to two contractors of your choice to receive quotes. And I believe the inspector will ensure that construction meets the specifications prior to releasing the funds for payment - that is why it is crucial that NO construction begins prior to having the inspector set specifications, otherwise the grant will not be provided. In a similar situation, construction that does not meet the inspector set specifications will not be funded. Again, more information is available on the website.
'

Finally, a note about the paperwork. 

Applications are often lengthy processes, that take a considerable amount of time and effort. Often this process may seem both daunting and intimidating. That being said, the end product is making your home safe and accessible so you can function independently once you leave the hospital. If you need to seek help to complete these applications; your local housing office should be able to help answer questions and you may already be working with a social worker or occupational therapist who are familiar with this sort of thing.

'

There are likely other funding options out there if you do not qualify for these. 

Don't be afraid to contact involved parties, ask questions and network to find out what other resources are out there. 

Independent Living Website Guide

I came across as website today about the Independent Living Website

This website is truly amazing by how extensive its reach is.

'

At first I came across the site because of a clothing project it took on "about fashion, clothing and vanity from a seated perspective". It provides free clothing patterns, specifically designed for wheelchair users.  There are patterns for men and women, that include modifications, helpful tips, and starting from scratch. It even includes how to measure yourself, or be measured, considerations when buying fabric, and piece by piece assembly instructions. A jacket example, from the project, is seen below:

'

In continuing my investigation of the website, I soon discovered this Sweden based but internationally reaching website is made by the Independent Living Institute (ILI) - a policy development center focused on providing resources for individuals with disabilities. Their mission statement, included from their About Us page on the website, is quoted below:

'

"The Independent Living Institute (ILI) is a policy development center specializing in consumer-driven policies for disabled peoples' freedom of choice, self-determination, self-respect and dignity. Our ultimate goal is to promote disabled people’s personal and political power. Towards this end we provide information, training materials and develop solutions for services for persons with extensive disabilities in Sweden and internationally. We are experts in designing and implementing direct payment schemes for personal assistance, mainstream taxi and assistive technology."

'

Impressed? So am I! 

Even more so by how they define Independent living on their main page (take a peek!)

'

Visit their links page where you are provided with access to 703 links, from topics such as accessibility, aging, education, study, travel and more.  And, as always, each link will often lead you to more and more. There is so much very specialized learning and knowledge that this site offers, and answers that it can lead you to.

'

And what, Socrates, is the food of the soul?

Surely, I said, knowledge is the food of the soul.       Plato

Sports and Leisure

This post is all about wheelchair sports and hobbies.

There is a really amazing and extensive website I came across, called d-ability.org. Originally I planned to include several links, paired with the videos on the YouTubeSCIrehab site (yes I mention that site often, but I really want you to go look!), to give a good impression of whats out there. However, this website happily blows me out of the water! This website has described themselves as the "disAbility Leisure, Arts, Sports and Lifestyle WebGuide", and they most definitely have something for everyone.

This is a very succinct introduction: there are several broad categories listed along the top of the website, each filled with an index of options, with each option containing often several examples.

For example, in ArtyFarty, and in Dance, among the many examples is a link to this video:

In Health and Wellness, under Clothing and Fashion, among the 28 choices there is a link to able2wear.co.uk/ with a whole range of designed for wheelchair use clothing.

In Leisure and Outdoors, under Hand Cycling, there are so many links to describe the sport and specific individuals who partake.

And after that, there are still the Sports, Travel and Hot Links categories. Each category is filled with so much to explore, and very conveniently packaged together in one site.  You might even find that a hobbie or sport that you thought you would have to give up, is actually quite popular in the SCI community. Either way, you won't know until you look - Curious yet? :)

Enjoy!

Where are The Women?

Now, I realize this post is geared towards the female perspective so I apologize now.
The thing is, on YouTube, I find WAY more videos about male SCI than females and I am not sure why that is.

So this post is about awareness and challenge.

Asali Johnson has a C5 quadrilplegic injury. In her video on 'A Day With Asali Johnson" she talks about her conversation with her friends, how they might complain about their day then go "oh but that's NOTHING compared to what you are going through!". It's her reaction that I appreciate, and I realize it sounds negative (in terms of suffering), but there is a profound message behind what she is explaining. In her words, see below:

"I don't think that human beings should compare levels of suffering.. Maybe you had a bad day at work or maybe you are having problems with your boyfriend or wife. Or whatever the case is you suffer because of it.  You may not think that that is not the same as my suffering, that my suffering is something different, different kind of suffering but suffering is suffering. "

So I want to share this video with you:

Followed by a challenge - Ladies help get more videos on YouTube! Or on a blog. Just out there. So much can be learned from shared experiences, and I hope for those of you who come across this blog that you feel challenged to do so.

An online Agenda - Sometimes Typing is Easier

 

Do you rather type than write? Lots of people do! So here is a helpful tip for replacing your old written agenda and notes for free! 

 

First let's talk about Typing - do you find you are having trouble with keys repeating from pressing down on a key too long? for examppppllleeee. Well there are built in options in your computer to adjust that and the rate that letters repeat.

 

Go into your control panel and select Keyboard (it could be listed under hardware, or Ease of Access, search for keyboard if required). Once in your control panel (and they are all different) you are looking for options such as repeat rate, repeat delay, bounce keys, slow keys - all these can help you avoid accidental key strokes and even ignore repeated key strokes, or it can just slow the rate of repeating key strokes. Many computer come with these options and it just takes a little exploring on your part. You can even select an option that -beeps- when you use caps or num lock - SO helpful for those of us who tend to hit the caps key accidentally and typically don't notice till much later!

 

Now that typing is down - what's this about a free agenda online?! well read on!

 

Remember a few posts back about the video YouTube account? (if not, you should check it out!) Well, you have an option to create a google email or gmail account. Once created you have opened up the doors to a whole range of accessible options.

 

With gmail accounts you can create your own calendar/agenda, and it has many options to personalize it to function according to your preference. For example - you go into your calendar, select view by day, then double click at a certain time to create an appointment. While creating your appointment, you can even select to have several email reminders sent to you over the course of the day, pops ups on your screen (if you leave the computer open) or each day your calendar will email you your daily agenda at a specified time (mine is 5am) and you can print it to have with you. Even better, you can link your calendar up to others and share content you specify - maybe you have a loved one who would like to add to your schedule.

 

 

And again - this is all free! Easy to use. And super helpful for someone who may not be keen on writing.

 

 

Seating and Positioning

 

I was very discouraged with my first wheelchairs. It took me a couple of years to figure out that your chair is part of your attire. A chair should fit you like a well-tailored suit and its design blend with your personality. When all this works together you hardly know it's under you! ~ Frank (T12 SCI) from Spinal Cord Injuries: Management and Rehabilitation by Sisto, Druin, Sliwinski

 

A properly fitted wheelchair will facilitate maneuvrability, control, and your general mobility to move about and do what you need to do. A poorly fitted chair will do quite the opposite - it can make a ramp seem like an impossible impasse, prevent your maneuvrability, and can negatively affect your overall safety and posture.  

 

So then, how does someone decide what your wheelchair seating and positioning needs are? To answer that question, you should have a look at New South Whales Spinal Cord Injury Service website, specifically their Seating Education modules.

 

The website offers 10 educational modules, each with additional resources such as print-outs, videos, and quizzes. Here is the list of the ten modules:

 

1 - Spinal Cord Injury and Seating

2 - Developing a Client Profile

3 - Hands-on Assessment

4 - Body Measurements

5 - Evaluation of Seating and Wheeled Mobility Systems

6 - Seating Made Easy

7 - Postural Interventions

8 - Pressure Management

9 - Manual Wheelchair

10 - Power Mobility

 

Also, check out the other links on the site, there is so much, its worth spending a few afternoons to go through.

A Few Good Books

 I love to read, and some of you may as well, so here are a few reference books that are jam-packed with helpful information! I am posting the link to these three specific books, in a gmail book search format, for a few reasons.

 

First - These three particular books have lots of information that you cannot always find on the Internet. They list other resources, and they recognize the sensitive nature of the subject while providing clear explanations with helpful illustrations on an extensive range of SCI subjects.

 

Second - These books were recommended to me by others, whether professional, aspiring professional, or interested other.

 

Third - Why the google links? Did you know that you can often preview books in google? Well, you can and it usually helps you get a feel for the information in the book without having to pick it up. The first book from the Mayo Clinic has a good preview. The second two do not, but you have an option to search 'From Inside the Book' , meaning search the actual book for the subject you are curious about.

 

Fourth - This blog is based out of Nova Scotia, Canada - and these books were available at the university Library! That's right, the free to borrow library :) Also the universities and colleges are all linked together by a search engine called Novanet, if you are a member of the library you can have books brought in from anywheres including out of province. If you are not a member, you are still most definitely allowed to go into, say, the Dalhousie Kellogg library (which is wheelchair accessible) and look through the books as you like without taking them out. There are lots of options.

 

Fifth - If these books don't interest you, now you know how to look up ones that do. Search google books and you can select 'preview and full view' in your search options to get a peek inside the book. I actually get lots of great recipes using this trick! but you can read whole books there - http://books.google.com/ 

 

happy reading!

 

1. Mayo Clinic Guide to Living with a Spinal Cord Injury: Moving Ahead with Your Life by The Mayo Clinic

 

2. Spinal Cord Injury: Functional Rehabilitation by Martha Freeman Somers (although I actually have only seen the 1st edition, I bet this one is even better!)

 

3. Spinal Cord Injuries: Management and Rehabilitation by Sue Ann Sisto, Erica Druin, Martha Macht Sliwinski

What is my Blog List?

If you look to the right, below the archived posts, there is a list called 'My Blog List'.

Those are other Blogs that you might find interesting, that I have found during the research for this Blog.  Keep in mind the goal here on Beyond Rehab is to have something for everyone as naturally everything is not going to appeal to everyone. It is also important to note that although not all of the blogs are SCI specific, the ones that are not usually have wheelchair and/or disability wisdom, or other helpful information.

For example - wheeliecatholic blogspot has a huge blogroll to also peruse, linking you to even more helpful blogs.

With that being said...

Be curious! See what others have to say - who knows, you might find something you never expected.

This Blog has a sister YouTube site

Videos can be super helpful.

Ever wonder how other people transfer?

What their home modifications look like?

Want to see how other wheelchair sports are played?

Want to know what its like to travel in a wheelchair?
'

Well, a video can show you that. This blog didn't seem complete unless we could include some of these great video resources. Sadly, I don't really know how to do that - but I DID know how to make a youTube account. This post is going to help you access the YouTube account with all the cool videos.
'

SCIrehab has a channel on YouTube that you can access here: http://www.youtube.com/user/SCIrehab

Once you visit that channel, if you already have a YouTube account (which is pretty handy and easy to get, with instructions on the YouTube site) you can subscribe which makes it easier to follow. Or, if you are not interested in having an account, follow the above mentioned link and peruse from there.
'

Once at the site, on the very top next to 'SCIrehab Channel subscribe', you should see a list of options such as 'All, Uploads, Favorites, Playlists'. To get a sense of how many videos there are, click on playlists. The list to the right side of the currently displayed video should become a scrollable list - which is actually all the playlists. Scroll through the playlists until you find one you like, then click 'More Info'. The scrollable list should then display all the videos specific to the playlist you have selected.
'

Videos range from bed mobility, to cooking, to travel, to transportation, to sports, to home modifications, and so on and so on. I have also tried to separate the video playlists by videos specific to paraplegia and quadriplegia. As this is a growing endeavor, some lists have many videos, and some have few. The goal is to let the channel grow as I find new videos. Feel free to let me know if you have any good ones to link up!
'

Another neat thing on the YouTube channel, if you scroll all the way down, is the list of subscriptions. Those are other channels that were also interesting and might be worth checking out.
'

Happy video watching!
'
'
(ps - why the weird spacing? well, this blogger site seems to have forgotten to recognize the enter/new line bar - so for now, weird spacing. )

What is This Blog?

I have sat here for a few hours trying to think of how to start explaining this blog - that should be the first post I assume. I think I should start by introducing myself, and we'll go from there.

I am an Occupational Therapy (OT) student, currently doing a field work placement in a spinal cord injury (SCI) rehab. It's not that the OT dept only does SCI, its just that particular section is where I do the majority of my learning. I am grateful for the opportunity to have gotten to know some amazing people, who have been kind enough to let me learn from them during a crucial time in their lives.

During my placement at the rehab, I have spent a considerable amount of time learning from individuals and researching online about various related SCI subjects, and I realized it would be easier (of course!) if everything was together.

That is the brain child that spawned this blog. Everyone spends so much time on the internet, including myself, why not try to put as much as I can in one place? And mostly, I wanted to give something back to everyone who is sitting at a computer investigating spinal cord injury and the life journey that goes with it.


**However, please keep in mind I AM NOT an expert. My plan is to post links to sites that were found to be useful - but not everything works for everyone, and everything posted should be taken with a grain of salt. Consult the experts if you need to, and remember not everything in print or on the internet is always right!!**

Phew, ok. With that being said - peruse away, and check back for more information as it gets posted!