This single decision by Medicare will positively impact the lives of many, many people. Until very recently, seat elevators were usually denied in the US. That is because this feature was automatically denied by Medicare, and almost all other medical insurers follow the lead of Medicare in their decision-making (with a few exceptions).
As a result, it has usually been only wealthy clients who could afford to pay thousands of dollars out-of-pocket or those with exceptional insurance that were able to have this capability included in their wheelchairs. As Medicare only covers 80% of costs, the responsibility of the remaining 20% will fall on any secondary insurance a client has or will still be private pay. However, this will still significantly reduce the cost to clients for seat elevation, even if they are paying out-of-pocket, making seat elevation much more within reach for many people who would benefit from this capability.
Wheelchairs with seat elevators allow people to raise and lower themselves in their wheelchairs. Why is this important? It allows people to adjust their wheelchair to meet the demands of the environment around them. It allows people to reach into cabinets, to socialize with other people at eye level, to be less likely to be hit by a car or truck when crossing the street, to more easily and independently transfer in and out of their wheelchair, to sit at the appropriate height under a table, etc.
Here is a great video that makes it easier to visualize the positive impact of seat elevation:
When a wheelchair does not have seat elevation, the rest of the environment has to be adapted to accommodate the height of the wheelchair or else the person using the wheelchair will be much more limited in what they are able to do independently. Seat elevation eliminates many of those needs and modification costs and also makes traveling much easier. This single decision by Medicare will have such a positive impact on so many people in the US.
Medicare has stated that they will also be considering the issue of standing frame power wheelchairs separately.
Does it really matter if you or a loved one falls? It’s fine as long as no one was hurt, right? Why are falls so Important?
When it comes to aging in place, one very important factor to pay attention to is falls. Why? No one wants to hear this, but the complications that can result from falls are one of the leading causes of death from injury for adults over the age of 65. Falls are also the most common cause of non-fatal injuries and hospital admissions for the same age group. 95% of hip fractures are caused by falls and falls are the most common cause of traumatic brain injuries. (1)
Did you know that falls are not considered part of the normal process of aging? Many people believe that falls are normal, and therefore they might just ignore falls and not mention them to their doctor.
Even though falls are not a normal part of the aging process, those of us who are 65 and older have a 27% chance of falling at least one per year (2).
So, how can we reduce the chance of having a fall?
Since there are many potential causes of falls, it’s important to take a look at all of the possible causes and address them. First and foremost, if you or someone you love has had a fall or has challenges with walking or balance, it is important to consult with a doctor.
What causes us to fall?
Repeated falls have frequently been linked to a decline in balance, coordination, and/or strength. (2)
Additionally, there are several medical conditions which are associated with an increased risk of falls. These include, but are not limited to:
Neurological disorders (such as neuropathy, Parkinson’s disease, etc.)
Vitamin D deficiency
Orthostatic hypotension (3)
Falls can also be increased by other factors such as:
Certain medications or the combination of multiple medications taken together
Issues in your living environments, such as not enough light, uneven floors, uneven stairs, and too much clutter (3)
What can you do to decrease the risk of having a fall?
Request a thorough exam from your medical provider/doctor
Consult with a physical therapist (PT) or occupational therapist (OT). Note: You may need to request a referral from your doctor, if one is required by your health insurance in order to see a PT or OT.
Talk with your doctor about your medications:
Make sure your doctor is aware of all of the medications that you are taking and check with your doctor to see if any of them interact with each other in ways that could be harmful
As your doctor if it’s possible to reduce or stop taking any of your medications to minimize the risk of adverse drug interactions?
Ask your doctor if you should increase the amount of vitamin D you take. Vitamin D may reduce falls by increasing muscle strength and decreasing the sway of the body while moving/walking; it also reduces the risk of fractures by increasing bone mineral density
Have your vision tested regularly
Avoid wearing multifocal lenses when walking and especially on stairs
Doing exercises that improve your gait, balance, and strength; there are multiple research studies that have shown that Tai Chi can reduce the risk of falls (insert Becki’s online Tai Chi class); In addition, walking and yoga may also be beneficial, as well as fall training/neuromuscular retraining with a physical or occupational therapist
Make sure that your footwear fits well, has a good amount of grip on the bottom, is relatively flat, and has a good amount of contact with the ground (3)
There are also changes that can be made to your home and/or work environments that can reduce the risk of falling in those environments. It is best to consult with an OT or PT about environmental modifications to ensure that the changes will be safe and successful in the long-term. Here are a few modifications an OT or PT might suggest:
Remove or secure rugs, floor mats, and bathmats
Make sure electrical cords are against the wall rather than in the middle of the room
Rearrange furniture to allow for ample space to get around a room (2, 3)
An OT or PT may also recommend use of some of the following medical equipment. They will determine which equipment is most appropriate to your unique needs. This may include:
Fall alert buttons (3)
Keep in mind that there may come a time when it is important to consider the need for increased assistance and/or supervision in order to help your loved one stay as independent and safe as possible. This can include medical or non-medical assistance, such as nursing, help with chores around the house, and/or companionship. (3)
Gerontology for the Health Care Professional, 2nd edition. Robnett, R. H. and Chop, W. C.
Geriatrics Evaluation & Management Tools, 1st edition. Copyright 2013 by the American Geriatrics Society. Source: Geriatrics Review Syllabus: A Core Curriculum in Geriatric Medicine. New York, NY: American Geriatrics Society
shower is one of the most dangerous places in your house. Not only is the
flooring usually more slippery in the bathroom to begin with, but, when we take
a shower, things tend to get wet, making everything even more slippery. All of
this makes it much more likely to have a fall while in the shower than during many
other activities around your house.
Since it’s also nice to get clean, we want you to be able to do so as safely and independently as possible, which is why we wanted to tell you about this shower caddy. This type of shower caddy is best suited for people who stand up to take a shower. If it’s no longer safe for you to stand to shower, or if you have any questions about what the best set up is for you so that you can bathe safely, we recommend consulting with an occupational therapist. If your therapist can see your home and your specific bathroom, they will be able to give you advice tailored to your exact situation.
If you do stand to take a shower, we want to mention that a shower caddy is just one small piece of an overall system that can help make your shower safer. You should also make sure you have something on the floor of the shower, like a shower mat, which can add some friction and reduce your chance of falling. You might also want to consider having a grab bar or two installed as well so that you have something sturdy to grab onto if you do start to fall.
While it is impossible to fully
eliminate the chance of falling, it is possible to reduce that risk by making
your shower set up as safe as possible. One of the main advantages of using a
shower caddy is that it lets you put all of your supplies within arm’s reach so
that you do not have to bend down to pick up the things that you need. When you
bend down two things can happen that are potentially unsafe. First, you could throw
yourself off balance when you bend over, and, second, you could get water in
your eyes. Since vision is closely related to balance, getting water in your
eyes can also cause you to lose your balance. Don’t try this at home, but just
to show you an example of this: If I keep my eyes open and stand on one foot, I
can keep my balance relatively easily. However, if I close my eyes and then
stand on one foot, you can see that it’s definitely harder for me to maintain
my balance. Therefore, if using a shower caddy helps you avoid bending and
avoid getting water in your eyes, it can help you stay a bit safer while you
shower. We also like that this shower caddy is rust-proof because it will last
longer and look nicer than one that is not rust-proof. We have tried the ones
that are not rust-proof and we had to replace them much more quickly. Even the
rust-proof ones do get a little bit of rust where the pieces connect, but we
have found that this happens to a much lesser degree.
If you want to give this shower caddy a try to see if it will work for you, you can find a link to it here. Note these are not affiliate links, just links to products we think make sense. Also, don’t forget to also get a shower mat and possibly some grab bars installed so that you can stay as safe and independent as possible when you shower.
Once you get the shower caddy, you can just hang it over the head of your shower, then put the toiletries you need onto the shower caddy. Different showers may be arranged differently, so you will want to make sure the shower caddy will work in your shower before you purchase it.
When you want to take something hot out of the oven, what do you grab? A pot holder or trivet? A dish rag? So many people grab whatever is nearby that will sort of get the job done because it’s easier, but it’s just not safe. Grabbing that nearby dish rag will increase your chances of getting burned or dropping your food and dishware onto the floor. We want you to be able to stay as safe and independent as possible for as long as you can, which is why we wanted to tell you about these silicone oven mitts, which we love.
We used to use standard oven mitts and they worked most of the time. But we often burnt holes through them and every once in awhile they even caught on fire. Even when we did not burn holes through them, I noticed that my hands often felt really hot when I was using them, like I was about to get burned even with my hand inside the mitt. At other times, I noticed that Becki would just grab a dish rag to get things out of the oven because it was right there. As an occupational therapist, this got me really worried because I could see how easily this scenario could end badly.
Then, one day, we discovered these silicone oven mitts and they made things so much easier. We actually still have the same ones that we originally bought, because they have never gotten holes in them or caught on fire! These oven mitts are made from 100% silicone on the outside and they have some texture added to them. This makes it much easier to grab and hold onto objects than when you use a regular oven mitt. These silicone mitts are heat resistant and safe to use for cooking up to 500 degrees Fahrenheit, which should cover most of the cooking that people do. I cook a fair amount, and I have never needed to cook anything higher than 450 degrees. (However, if you do cook at higher temperatures, you will need to look into other options!) These oven mitts also have 100% quilted cotton on the inside and our hands have always felt protected when we use them. They are also easy to clean. I usually just use a soapy sponge to wipe the outside, rinse them off, and then hang them on a hook or leave them in the dish drainer to dry. While nothing can guarantee that you will not get burned or drop hot items onto the floor, these oven mitts can significantly reduce your chances of having those things happen. However, if you have any specific medical conditions that might make these mitts challenging to use, we recommend that you consult with a doctor or occupational therapist about your specific situation.
We love these and we hope you will too. If you want to give these a try to see if they will work for you, you can find a link to them here. We hope these will keep you cooking safely and independently for a long time to come!
If you decide to try out these oven mitts, make sure that once you get them, you also find a safe place to keep them that’s close to your oven and easy to reach. Making it as easy as possible to grab these instead of something else will increase the chances that you will use them and stay safe!