One of the most striking things about Bruce’s assistive technology is its variety. Practically anything can become an assistive device in his hands. Over the years, he has continuously searched for useful devices, not necessarily the latest thing, but simple effective tools that provide a clear benefit. He emphasizes the need for an individualized approach to assistive technology and recommends that consumers do their own research to find out what might be best for them.
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Bruce has both manual and power wheelchairs but he uses the power chair most of the time. He lives in a rural area in the mountains where there are lots of gravel roads and rugged terrain. Traction, power and battery life are definite considerations in his choice of chair.
The manual chair is primarily a backup in case the power chair breaks down, but there is one other situation where Bruce will only use the manual chair: air travel. The reason he won’t bring the power chair on an airplane is that “it has been damaged every time.” Sometimes his destinations did not have a wheelchair repair facility, effectively leaving him without mobility in an unfamiliar place. Even with the manual chair, air travel has occasionally been hazardous. For example, he once flew to a city while his chair was being rerouted to another destination. He had to go to his hotel in an airport chair, which he later fell out of because it didn’t fit. Another time, his chair got bumped onto a later flight, and he was forced to negotiate a loaner from a medical supply store in the destination city to avoid missing an important engagement. Bruce smiles when he retells these horror stories, but he remembers the “panic” at the time—having important things to do, but having no way to move around.
Bruce got the power chair he’s in now about three years ago. At the time, he made the decision to switch from the sling style seating he’d always had, to a solid base and back. Part of the reason for the change is a type of spinal arthritis that Bruce has called Ankylosing Spondylitis. Bruce felt that a solid base would help him sit straighter and “function better longer.” While the solid seating system has helped his posture, it has come at the expense of comfort. He had spent many years in the sling style seating system and his body had adapted so that, “everything grew into a sling shape.” The new seating is difficult and different. “Sitting on this kind of a thing almost makes me feel like I’m sitting on top of an egg.”
One of Bruce’s main assistive technology strategies is to find simple ways to adapt common devices to make them accessible. “The whole thing about adaptive devices I guess is that you’re trying to function normally … I would try to use a device that other people are using and modify it or just use it as is for my purposes.” Examples of this strategy can be found all over Bruce’s house. He uses an inexpensive foam curler to make his felt-tipped pens wide enough to stay tight in his grip. (Medical supply companies often sell special foam grips for pens but at a substantially higher cost.) The felt-tipped pen itself is also important—it takes a lot less pressure to write than a pencil or a ballpoint pen would. He also created a playing card holder by sawing slots in a piece of wood. It was his first homemade design and he still uses the original.
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See how Bruce opens door handles with a piece of string. Choose a format: |
Bruce carries a length of thin rope with him for picking things up off the floor and opening doors. He has it permanently tied in a loop so that he doesn’t have to grip the two ends. The rope comes in especially handy when Bruce is going into a public washroom. Sometimes the hallway is too narrow for him to reach the door handle and still be in a position where he can open the door. In cases like this, Bruce loops the rope through the handle, and just drives backwards. This simple tool has gotten him through many tight doorways.
Bruce has also modified his keys so that he has more leverage to turn them in a lock or in his van’s ignition. A small piece of plastic attaches to the keys with nuts and bolts. In addition to the extra turning power, the bolts give Bruce something to latch onto with his rope if he happens to drop them.
Insulated cups are a must-have for hot drinks. “If I didn’t have it insulated, hot coffee or tea would burn my hand. And when my hand gets hot, it would cramp and spasm.” Because of a lack of sensation, hot liquids can cause very dangerous burns. The insulation provides an extra degree of safety.
Bruce is now retired, but he worked for many years after his injury. Getting back to his former position as Supervisor of Training in the personnel office at the local Air Force Base was a test of his problem-solving skills. As with his home life, Bruce was always looking for simple adaptations to make common office tasks easier. He found an inexpensive rubber thimble that was perfect for turning pages and handling papers. His calculator had a large key pad to make it easier to “clearly hit the right keys.” He used rubber stamps for his signature and mailing address. “If I had a lot of papers to sign, instead of using a pen with difficulty, I could just stamp it on.” He extended the handle of his letter opener by attaching the foam handgrip from a wheelchair. These adaptations, along with building modifications and a raised desk, made it possible for Bruce to return to the job he had before his injury.
Today, Bruce keeps a study at home for his volunteer work—he sits on boards—and other pursuits. The furniture and equipment in this room are set up for maximum comfort and accessibility. Space is at a premium though, because the room is small and Bruce needs room to turn around in his wheelchair. He has two desks, one for his computer and one for spreading work out in front of him.
Both were custom-built to his specifications, with higher desktops and wider openings to accommodate his wheelchair. As well, a small section of the desktop drops down to provide space for his joystick. His printer also has copier, scanner and fax functions, which saves having to find room for separate devices. He uses a flat-panel monitor rather than a full monitor for his computer as a further space-saving strategy.
Computer input is another area where Bruce has found simple adaptations that work for him. He uses slip-on typing splints for pressing keys on the keyboard, and a commercially available trackball instead of a mouse. Bruce is in the process of researching speech recognition software because he believes it will make the computer physically easier to use. “When I type for any considerable time, particularly with the typing aids, I get sore arms. If I don’t have to type it will certainly be more convenient.”
Bruce likes to do research. It’s his way of learning and he does it a lot in order “to have an idea what’s out there that I might someday if not today, be able to use.” He reads both disability-specific and general magazines to get ideas and browses the web for further references, which he keeps on file. He also talks to people and tries things out. Sometimes he calls tech aid centres and other agencies.
Bruce has had both full-size vans and minivans in the 20 years since his injury. His latest vehicle, a minivan, has been modified with a ramp, a lowered floor, hand controls, and a tie-down system for his wheelchair. On the whole, Bruce is satisfied with this arrangement. In terms of the physical demands of driving, the minivan has clear advantages for him. “Because of my lack of strength in the arms, the big van was too hard to operate—a strain on my arms—and it also took about two acres to make a U-turn.”
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See Bruce use the ramp of his current van. Choose a format: |
Another key feature of this van is the ability to swap the passenger seat behind the steering wheel so that his wife can drive. With this feature he can either be driving or sitting beside the driver as a passenger. In other vans, the space in the front passenger area would not accommodate his wheelchair, which meant that Bruce had to sit in the back if he wasn’t driving. Being in the front makes it easier to have a conversation and to see where he’s going. Bruce finds out about features like this from tradeshows and from direct contact with manufacturers. He stresses the importance of shows for the ability to see demonstrations and try things out.
Even though Bruce’s experience with the current van has been largely positive, it hasn’t been perfect. In the early days, there were reliability problems with the automatic door and ramp; cables were getting twisted and parts were getting stuck. The local dealer hadn’t worked with this type of ramp before, and their attempts to fix the problem were unsuccessful. Bruce contacted the manufacturer, who was located in another city, and made arrangements to have them make the necessary repairs. Bruce’s strategy in these situations is to take the direct approach, but remain calm. “You make phone calls, you talk to the president or vice-president of the company if you need to, and make arrangements to go down there…. What can I do other than try to get it corrected, you know? Because it doesn’t help me or the van to go ballistic.” Eventually, Bruce worked the problem through with the various companies involved and the ramp works properly now.
The tie-down system is another essential piece of driving equipment. It locks his chair in place and keeps it from moving while he is driving. Bruce chose the particular one he’s using because of its reputation for reliability and for the fact that he doesn’t require hand function to lock himself in. A bolt is permanently attached to the bottom of his chair, hanging about two inches above the floor. He simply drives over the locking mechanism on the van floor and it catches the bolt and holds it tight. Although this arrangement is effective for driving, the bolt can cause Bruce problems when he’s not in the van. He finds the bolt can get caught on various objects such as rocks and throw rugs. Bruce continues to use the tie-down system in spite of these problems because it’s the best solution he’s found for driving.
A lot has changed since Bruce was first injured. As he sees it, more people survive spinal cord injuries. The demand and need for services is greater; more services exist and much more is being provided than was the case 25 years ago. Even so, it’s still hard to get the equipment you need and to find someone who’s knowledgeable who can help you get it. “There are many occupational and physical therapists, nurses, or doctors who have no idea how to treat a quadriplegic. And then every injury is different, every individual is different and you have to find things that’ll work for that particular person.”
For Bruce, seeking information is an active process and a very individual one. “You have to recognize what you really need or if you want to go beyond that, what would be useful to you, or what you would like just to make life easier.” His advice to new consumers of assistive technology is to remember that you always have choices and to take your time with decisions. He says, “I think the first thing for anyone that’s going to need assistive technology, whatever kind it is, would be not take the first thing that comes along. Because there are people out there, whether they’re in vocational rehabilitation or on the used car lot, they’ll try to sell you whatever they have at the moment. And so, the first thing is to take your time and look around to see what is available that might meet your individual needs.”
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