Friday, October 23, 2009

HOME SAFETY - by Susan Dorne, OT
One of the biggest concerns I have as a health care professional is the safety of people. It’s amazing how many barriers are around us, many of which we are not aware of. For people without deficits, they can usually maneuver around obstacles with little or no harm or even thought for that matter. However, when you have MS and your vision, mobility, balance, strength, endurance, and sensation may be affected, consequences are often inevitable. It never ceases to amaze me when people reply “I Know But…” when I try to address potential safety risks and make recommendations.
To begin with, get rid of throw and area rugs as they are a significant safety hazard and one of the biggest causes of falls. It is best to use skid resistant rugs and mats to avoid the rug from sliding or folding over. Flooring can be tricky. Tiles can be slippery while rugs can make mobility difficult. Challenges with rugs can occur when you have weakness in the legs or feet, fatigue, limited endurance and use of different mobility aides (such as a cane, rolling walker and a
wheelchair when you have to push yourself). Choose flooring that best suits your needs and don’t be discouraged if you have to change it later on. No matter what, you always want to be aware of the surface you are walking on in and outside the home.
Rooms should be clutter free. Arrange furniture so that it is easy to move around safely and take into consideration any walking devices or wheelchairs/scooters used. Move cords so they are not in the way and make sure there is easy access to good lighting at all times. Use night lights for areas you go to regularly especially the bedroom, bathroom and hallways.
Couches, chairs and beds should be at a proper height to get into and out of easily. These surfaces should be at height equal to the back of your knees (use cushions or pillows to raise the surface), chairs with arm rests are easier to use, and avoid wheels whenever possible. Beds can be against the wall to serve as a protective barrier if there is a risk of falling off the bed during sleep. A side rail can be used for the open side if need be. If you use a wheelchair, you will need 4 ½ feet on one side of the bed for access.
A common place for falls is the bathroom. Grab bars are used to maintain balance in tubs, showers and by commodes/toilets. They come in various shapes, sizes, and colors and I strongly suggest having them installed by a licensed and insured company or individual. Towel racks and soap dishes are
not intended to be used as a supportive device as they are slippery
and can easily break from the wall. There are also portable grab bars (attached by rubber suction) to use for stability in other places and rooms, if you’re renting, or to take when traveling.
Shower chairs and tub benches are used to help with limitations in standing, mobility, and fatigue. If a tub bench is required, you will need to remove shower doors and install a shower curtain. Whenever a shower curtain is used, make sure the shower rod is bolted or screwed into the wall and the clips attaching the curtain to the rod are sturdy. A hand held shower hose provides easier showering. Non-skid mats and strips are used inside tubs and showers as well as outside for drying off.
Sensory deficits are important to be aware of and to take proper precautions. Set your water heater thermostat to 110 degrees or lower to help prevent scalding. It is best to test water temperature by touch and if you are experiencing numbness, I encourage you to purchase a water thermometer.
In addition, proper care must be taken while cooking. Be aware as handles get hot, food splatters, oven racks and sides get extremely hot as well as all baking and cookware. Eliminate or minimize use of sharp objects (this is important for visual deficits and hand weakness as well). Some examples include: purchase pre cut foods to minimize using knives; use electric razors, and use blunt scissors instead of sharp ones (if you must use them at all).
Another issue I want to emphasize is the importance of using an assistive device if you are advised to use one. Walls, furniture and counter tops do not count as assistive devices so stop using them! Do not get a walking aide and use it without proper assessment, sizing and instruction from a therapist.
The information provided are just some examples of how you can have a safe environment at home. An occupational therapist (OT) can do a full home evaluation where suggestions and training will be made based specifically on your needs.
If you’re ever in doubt whether you can or should do something, wait until you have another person is available. It’s important to always ask assistance whenever possible regardless of the situation and don’t be afraid or embarrassed to do so.
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