Adaptation and Technology
Assistive technology (AT) is any item, piece of equipment, or product system that is used to increase, maintain, or improve the functional capabilities of individuals with disabilities. These items can be acquired commercially off the shelf, modified, or customised. They include wheelchairs, lifts, bathroom equipment, communication aids and more. In this section we provide ideas for how assistive technology and adaptive equipment can make life easier.
There are many devices available that are useful and yet are increasingly being made with an eye toward aesthetics as well as function. Hospital beds, at one time always looking like medical equipment, are now being made to look more like bedroom furniture. Lifts and power chairs are becoming more compact and less bulky.
Many items once found only under “disability” are now being sold to wider audiences and are therefore more sensitive to aesthetic sensibilities. For example, voice activated computers that were once targeted primarily to people with disabilities are now being marketed to people who don’t like to type! A physiotherapist, occupational therapist, or speech and language therapist can familiarise you with the kind of equipment that is available.
There are many types of devices and equipment that can improve ease and safety in the bathroom. Bath seats/benches, transfer seats, handheld showers, wheel-in showers, and shower chairs are all options that may be useful, depending on the physical environment of the bathroom and the person’s abilities.
‘Low tech’ items that can make bathing easier include soap-on-a-rope, a washcloth mitt, and different coloured sponges that can be used for different parts of the body. If bathing must take place in bed, a ‘bath-in-bed’ unit might be a possibility. Such a unit requires no plumbing connection and can be used with standard or electric beds. It includes a soft, flexible under-liner surrounded by a collapsible aluminium frame that supports the liner to create a ‘bathtub’.
There is also a ‘shower anywhere’ portable shower that can be used with it if the head of an adjustable bed can be raised.
There are many inexpensive, low-tech items that can be extremely useful. For example, reachers, weighted utensils, Velcro® closures on clothing, special drinking straws, non-skid bowls, and built up handles may support independence.
There are a variety of commodes and bedpans that can be used. Commode features such as adjustable height, removable arms, seat lifts and those that double as a shower chair are available. There are urinals for men and women and a variety of bedpans that can be used for toileting in bed, many coming with lids to avoid spills.
Many wheelchairs can be adapted for driving with options other than a joystick. Driving mechanisms for power wheelchairs include headrests with driving controls, a breathing type control system called ‘sip and puff ’, tongue and cheek switches, a specialised touch pad, and more. A creative and experienced supplier and an occupational or physiotherapist who understands MS can take advantage of any remaining active motion to control a wheelchair.
There are both high and low tech options available. If possible, you may want to consider moving the bedroom to the main floor. Residential through floor lifts and stair lifts are very helpful for moving a person with limited mobility up and down stairs, although they can be expensive.
There are through floor lifts specifically designed for home use,elevator stairs that rides on two steel rails and is designed for situations where space is limited. Remember, when it comes to a stair lift, a person must be able to transfer and have good sitting balance. Be careful if it seems less expensive to rent a device than buy it. Be sure to ask if the rental price can be put towards the purchase price.
is available to help those who need to make reasonable adjustments to their home in order to make it more suitable for their needs. Medical evidence is required in support of this application, as well as financial information as evidence of household income.
This grant scheme is means tested. The maximum grant amount for each individual depends on their yearly household income. Houses with an income over €60,000 per year are not eligible for grant aid.
Another option to save time going up and down the stairs is an “electronic aide for daily living unit”, formerly called an environmental control unit, that can be located by the bedside and can operate the TV, telephone, lights, call system, and other devices through the use of one or more switches. The control system can be adapted with a variety of switches—head switch, bite switch, finger switch, etc. Using such a device promotes independence and means family Care Givers may need to be called upon less often.
There are a number of devices that can help your loved one to alert when you are needed. These range from a bell or buzzer system to baby monitor-type devices to personal amplifiers.
There are many devices that can help keep your Dad mobile. Options range from lowered floor minivans to special seats and wheelchair lifts that can lift him into the van. Some power wheelchairs have elevation and rotation features to facilitate such transfers. Other options include rear entry kneel vans, and vans equipped with a powered lift system capable of lifting up to 600 pounds.
Assistance with the costs of an adapted vehicle for a passenger - Primary Medical Certificate
The following website has some useful further information about vehicle adaptations:
There also various benefits, entitlements and tax reliefs available for disabled drivers and passengers – further information is available here
There are many different types of devices that can be helpful for getting your husband in and out of a bed or chair. There are lifts that attach to the ceiling or wall and take up minimal space, as well as lifts that roll on the floor. If the person has some mobility and can sit up,
there are also transfer type lifts.
Typically the ceiling, wall, and floor lifts use either a hydraulic system or a motor to lift the individual. The sling or harness goes around the person and then attaches to the lift. The lift is then raised either with a pump, crank or button depending on the type of lift (manual or electric/battery). There are many styles of slings and harnesses.
It’s a good idea to investigate all options before making a purchase in consultation with your Occupational Therapist. The slings and harnesses are made with many different fabrics and materials. They are an essential part of these devices. Modern type slings can easily slide behind and around the person so that the individual does not need to sit or lay on the sling all day (which may cause pressure on the skin).
If possible, try the lift out in your home. Many of the suppliers will bring samples to your home. They may send a video or DVD to aid in making decisions. The advantage of electric lifts is that they are easy to operate. Depending on the lift and the individual with MS, however, some lifts may require two Care Givers to operate the unit, which might not always be practical. Don’t hesitate to ask questions.
One resource for an evaluation is to have a public health nurse, physiotherapist or an occupational therapist familiar with wound care do an evaluation. There are many different types of support surfaces that are available for use on a bed. Home medical companies that specialise in support surfaces for beds can help you select from the various types and models. Some of the options include alternating pressure pads, gel pads, and fluidised beds.
Augmentative communication devices help people with serious speech problems communicate more easily and effectively. These devices range from a board with pictures representing a person’s daily needs, to electronic speech synthesisers.
Manual communication boards are an inexpensive and practical mode by which an individual can communicate. The term “manual” refers to the fact that the system does not involve any mechanical or electronic parts. An object i.e. toothbrush, a photograph, a symbol, and/or printed words can represent the user’s message and the individual with MS points or gestures to the symbols.
Word or letter boards can be created so that the person can point and spell out words or everyday phrases. A higher technology approach includes augmentative speech devices, and amplification devices. Computer software is available that converts text to speech, and recognises speech (even slurred speech), Modifications can be made to the keyboard and mouse, and head and eye control systems are available for inputting data and more.
There are many products specifically designed for just having fun! A large screen TV can help someone with poor vision enjoy TV and movies. Low tech items such as playing card holders, or books on tape may be useful.
A camera mount is available to mount a camera to a wheelchair, opening up photography as a hobby for someone who might not be otherwise able to hold a camera. Wheelchairs with special tires can be mobilised over sand or rough terrain, opening up possibilities for outings to the beach or woods, and several gardening adaptations are available.
Many families continue to enjoy travel and sightseeing. There are many travel agencies, travel guides and other resources specifically oriented to people with disabilities.
Many cruise lines and hotels provide wheelchair accessible space and other services. An occupational, physiotherapist or your local MS Regional Office can help you brainstorm ideas to make a trip enjoyable for you, e.g. travelling with a portable bed rail to use in a hotel that will make bed mobility and transfers easier.
There are more and more options for recycling medical or assistive technology. Check with your local MS Regional Office
Assistive Technology Video Series
Two part webinar delivered to MS Ireland on Assistive Technology for People Living with Multiple Sclerosis, their circle of support, family and friends