Dale is wheelchair bound and will soon be discharged from the hospital. He doesn’t have a lot of support at home, and because of his disability, his immediate concern was not being able to get his pants up on his own after toileting. Accompanied by his OT, Whitney of Spalding Rebah PSL, and her OTA student, they toured the Lifeway Mobility showroom in Denver and explored various bathroom accessibility solutions.
Below are 4 steps Dale & his OT followed that can help make toileting graceful and independent for older adults and those with disabilities.
1. Toileting Height
Customizing your toilet height is step one of toileting for anyone with mobility challenges. If you are standing and sitting, the height of the toilet is very important. The most common toilet height is 13 inches, but a taller toilet can make standing up and sitting down so much easier. Newer toilets are ADA height or 15-16 inches.
Also, you can add a porcelain insert called a toilevator underneath the toilet (red arrow in image above) to add 3.5 inches more or add a elevated toilet seat for 5 more inches. A bidet is another option that can added for easy cleaning, warm water, warm seat, and other luxuries. Bidets can replace the seat on any toilet. They do not need a second seat or a transfer and do not require a power outlet close to the toilet.
2. Shower Chair or ShowerBuddy
A second step to make toileting an art, is consider a bath or shower chair that rolls over the toilet. These types of products are made at the correct seat height to roll over the toilet, and eliminate the transfer to the toilet. In the seat is a cutout so that you don't have to move from the rolling chair. These chairs can also roll in to the shower for bathing and cleaning. The ShowerBuddy has the advantage of connecting to a bathtub or shower and allow the seat of the chair to slide into the tub or shower.
3. Overhead Ceiling Lift
During the visit, Dale was educated on the SureHands ceiling lift with the Body Support system. This overhead lift setup is great because it grips in just the right places when lifting: Under the thighs and under the arms. It mimics the arms placement and gentle lift provided by a caregiver. Best part is that it can be operated independently.
The OT demonstrated the use of the ceiling lift from a bed while Dale looked on.
It was then Dale’s turn to test the SureHands ceiling lift out, from his wheelchair. This required some extra hands during the initial trial run, which is common.
A sling variation was then attached to the ceiling lift. The goal was to find the best solution that would help Dale toilet independently, while remaining comfortable and painless.
4. Bedside Commode
Most health care professional will recommend a bedside commode, which is like having a plastic toilet in your bedroom. Bedside commodes are helpful but typically a last resort. A bedside commode is made of a steel or plastic frame with a bucket under the toilet seat.
Art of Toileting Summary
In all, the show home tour, the education about the various toileting solutions, ceiling lift systems, and the actual trial runs took the group just over one hour.
The end result? Dale found his ideal body lift and transfer solution and left with a smile under his mask, and newfound reassurance that he’ll be okay on his own once he gets home from the hospital.
You have decided you need a stair lift. Maybe you are caving to the nagging from well-intentioned and worried family members. Maybe you have read the shocking statistics. Like, one-fourth of Americans over the age of 65 fall each year, and the older you get, the more likely these falls can be fatal.
If the stairs start to become too difficult to manage at home, there are usually two options that people can consider to solve the problem. The first option is to remain at home (with modifications), and the other is to move to a senior living or assisted living facility. Both are feasible options, but many prefer to remain in their home because it prevents the stress of having to move again, and makes it possible to remain in the place that has so many positive emotional ties. A home is a place of comfort as it is where most people build lasting memories with family and friends, whether it be from holidays parties, or social gatherings with friends.
Layout and Design
Overhead ceiling lifts have been available for many years. Most people are not aware that such items exists. Depending on a person’s mobility, an overhead track lift could be a great solution for anyone having difficulty transferring from bed to chair. We normally recommend a lift system over the bed area. In this particular home we installed a lift that travels from the bed into the family room, through the hallway and into a bathroom. This is not a typical lift layout, but we pride ourselves in creating solutions for our clients.
Structural Modifications
This two story home has been engineered with TJI joist and multiple ceiling heights. Most new homes nowadays have such a joist. TJI Joist and overhead lifts don’t go well together, and here’s why: ceilings are made to hold the floor above, not a hoist from below. With some design work and modification to the ceiling and door ways, we were able to get this track system installed.
Types of Overhead Lifts and Alternatives
If one is considering a ShowerBuddy transfer system, it’s good to understand that in most cases this can prevent a rail from traveling throughout the home. We would normally recommend an overhead lift that starts over the bed transferring onto a TubBuddy system. This way the end user can be rolled over a toilet and slide into the tub.
There are multiple types of installations available for overhead lifts. We prefer to use a wall mounting system which would prevent modification to the ceiling. Such installations are normally quick and can be removed with very little damage to the walls. If one wishes to travel from room to room, a wall mounted system cannot be used.
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For seniors and those with limited mobility, grab bars can be a lifesaver. There are many types of grab bars that can be added throughout different rooms in a home to provide stability for people who have trouble walking.
The bathroom is often the room that makes the most sense for the installation of a grab bar because it is the most dangerous room in a house for seniors or those with limited mobility. In fact, falls in the bathroom due to a wet, slippery floor is one of the top causes of injuries for elderly men and women. Whether it's the barrier that makes it difficult to get in and out of a tub or shower or a toilet that is tough to get off of, the bathroom definitely presents its challenges.
After being diagnosed with ALS, Larry chose to prepare his home to accommodate his FUTURE accessibility needs. The key word is FUTURE. Learning of the diagnosis was not easy, yet he has accepted it, and with acceptance comes change. He has taken multiple steps to achieve a wheelchair accessible home, to plan for the when:
When he needs a power chair
When he needs access into his home
When he needs a bathroom that will fit a power chair
When he needs to get downstairs
When he needs to go outside to enjoy the outdoors
When he needs support from loved ones
Larry is a very special man, husband, father, grandfather and friend. We invite you to meet him to learn how he has chosen to plan for his FUTURE, for WHEN he will need a wheelchair accessible home.
If you plan to add a wheelchair ramp to your entryway, you may be wondering how long it needs to be. Some people might think a shorter ramp is better because it takes up less space and may cost less money. However, if you add a ramp that is too short for the rise of the entryway being ramped, it can be both hard to use and a safety hazard. This often results in a very steep ramp that may resemble a ski jump!
Stepping over the edge of the bathtub wall can prove dangerous for many elderly and disabled people. Create step-in access to your tub/shower with a tub cut out, a low-cost tub-to-shower conversion solution that will provide step-in accessibility to your existing bathtub.
As of February 1, Colorado Medicaid can approve up to $14,000 for Medicaid Home Modification. This has been a 2 year journey and the Federal Government has finally approved this increase. The State Legislature has voted in 2014 and again in 2015 to increase the funding for this valuable program, but the Affordable Care Act required any changes in these programs had to be to be approved by the Federal Government (Centers for Medicare & Medicaid Services). This is perfect for Colorado Home Modification or Denver Home Modifications.
Since the cap has not gone up in 15 years, this restores the benefit that helps CO citizens stay in their home. This will help a Colorado family who is disabled have an accessible shower and an accessible wheelchair ramp/lift. Due to inflation over the last few years, each Medicaid beneficiary was getting less and less for home modification benefit. The benefits are real.
The State of Colorado reported in 2013 that it cost $73,000 to have a Medicaid patient in an assisted living/nursing home. They also report that it was $27,000 to have the same person stay in their own home. They already want to stay in their own home and this is a big savings to the State as well. When you can modify your home, your independence goes up. When your independence goes up, you can better take responsibility for yourself and reach for a better life.
Currently, the State of Colorado Medicaid provides home modification, accessibility, and assistive equipment thru this program throughout the state and in major cities, such as Denver, CO Springs, & Loveland. This includes the following home accessibility solutions:
Accessible bathrooms and roll in showers
Wheelchair ramps and platform lifts
Stair lifts
Ceiling lifts and patient lifts
Grab bars and railings
Door widening
If you have used your Medicaid Home Modification benefit in the past, you can access the additional $4,000 for additional projects or use it for repair/service. This increase only applied to the Adult waiver programs, and doesn’t cover the Spinal Cord Injury Waiver at this time. Hopefully, the federal government will approval this additional benefit for more programs soon.
The State of Colorado has posted further details on the Home Modification Benefit Website – https://www.colorado.gov/pacific/hcpf/home-modification-benefit.
You can apply for the Medicaid Home Modification Benefits which is a part of the Medicaid Waiver Programs. There is one Single Entry Point for each County. Visit https://www.colorado.gov/hcpf/single-entry-point-agencies to see a list of Single Entry Point contacts.
You can also use the following link to help Medicaid Home Modification Funding Process:
Medicaid Home Modification Funding Guide
Lifeway Mobility is a full-service, licensed contractors for all home modifications in the state of Colorado.
Contact us today to set up a free home accessibility consultation!
At some point, due to age or disability, you or a loved one may be faced with the prospect of having to use a wheelchair to assist in your primary mobility at home. Whether it be a temporary fixture to your home or something that will be more permanent, there are a number of simple modifications that can help improve accessibility and make life easier.
If you are like most people, you live in a home that was not designed to accommodate wheelchairs. Below are some simple ideas on how to make sure that you will be able to stay in your home despite the necessity of a wheelchair.
