One of the first thoughts Jeannie had after her accident was whether or not she’d be able to hug her young daughter again. To her relief she was able to and, since her injury, she has continued to raise her daughter, who is now 14. Jeannie’s choices in assistive technology have been somewhat influenced by a number of medical issues. She has type-1 diabetes and arthritis. As well, she gets occasional bouts of low blood pressure and migraine headaches. After her injury, Jeannie went back to school to study accounting technology, and she is in the process of exploring a return to the workforce. On the recreational side of life, Jeannie enjoys drawing, ceramics and bowling.
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Jeannie has always had both power and manual wheelchairs. She spends most of her time in her power chair but finds the manual useful in some situations. For instance, it’s a great way to exercise and it’s useful when she goes to less accessible places. On the other hand, Jeannie’s power chair is particularly important in that it enables her to get around in the community, especially to take part in social and recreational activities with her daughter. When Jeannie was first injured, her daughter was three and a half years old. Jeannie enjoyed being able to take her to the playground, walk her to school, or take long walks together. When Jeannie’s daughter was younger, she would ride on the back of Jeannie’s chair when she got tired, and now the chair helps Jeannie keep up with her daughter while she roller blades.
Jeannie had her first power chair for eight and a half years. Over this time she has developed a very clear idea of the features she needs. About two years ago, she started the process of replacing this chair because it lacked some important capabilities, and parts were starting to get scarce. When she went through the assessment process, Jeannie successfully argued for power tilt and recline as well as elevating leg rests. These features enable her to manage her physical needs better by allowing her to change her position throughout the day. Jeannie started to experience difficulty with skin breakdown about two years ago, and the healing process was complicated by her diabetes. Tilt and recline enable her to independently reposition her seating system by pressing a button on the side of the chair. These periodic changes relieve pressure on her skin and help to reduce the light-headedness she sometimes experiences due to low blood pressure. Changing position also helps her relieve the joint pain associated with her arthritis.
Similarly, the power elevating leg rests allow Jeannie to control the swelling she occasionally gets in her feet by giving her the option of raising her feet as needed, without assistance. Jeannie’s first power chair did not have this feature and she couldn’t take care of the swelling independently. “I would have to pull up next to a chair and [an assistant] would have to get a couple of pillows, move the foot rests out of the way and then put my feet up that way, and I wouldn’t be able to move. Where this way I can keep my feet elevated and get around the apartment or wherever I’m at. And then once they’ve been up for a while then I can put them back down.”
Jeannie has a laptray made of Plexiglas. Among other things, it functions as a writing surface and a beverage holder. (Some of Jeannie’s medications give her a dry mouth, and she finds she has to have a drink to sip on at all times.) The choice of material is very important for safety. The clear Plexiglas permits Jeannie to see her feet and the ground while driving her chair, helping her to avoid potentially dangerous situations like potholes. The only drawback is that Jeannie is unable to remove the laptray and replace it on her own. She needs to be able to do so in order to drive. Jeannie has consulted with her physical therapist at the rehab centre, and he and a colleague are working on a laptray that she can lift up and fold over the side of her chair when she is not using it.
Jeannie has owned a converted van since 1992. Because her injury was the result of a motor vehicle accident, she was uncomfortable driving and opted to remove the hand controls. Her PCAs or family members would drive the van for her. When she was on her own, Jeannie used the local paratransit system. In part because of paratransit’s limited service hours, Jeannie eventually decided to start driving again. Over the last few months she has been taking driving lessons.
Jeannie has opted for a full-size van both to accommodate her long power wheelchair and because she feels safer in a larger vehicle. She also feels more comfortable with a lift as opposed to a ramp. She says that the lift makes a lot of noise when she is driving, “but you get used to it after a while.” Jeannie also has a control panel located to the right of the steering wheel, allowing her to control features such as the lights or the fan—anything “able-bodied people would be able to reach for.”
Jeannie finds that driving with hand controls can be physically demanding. During one of her lessons, her arm became fatigued after two hours of driving and suddenly jerked back against her chest. She responded by putting on the brake, and her instructor took hold of the steering wheel while she put her hand back into the hand control unit. To keep this from happening again, Jeannie arranged to have a piece of metal mounted to the hand control unit, which comes down across her wrist to hold it in place.
Like others who access state funding for van modifications, Jeannie participated in an assessment, and once approved, tenders went out to several vendors. Taking future repairs into consideration, Jeannie chose to go with a local vendor. She recalls that he gave her “a little bit of trouble … he dragged his feet and took a long time.” In Jeannie’s case the entire conversion process took about a year.
The van is in the shop right now having the hand control unit modified and the control panel repaired. It took some time to arrange for funding for the repairs and modifications through her state-sponsored rehab program.
Prior to her accident in 1990, Jeannie was studying to be a medical secretary. When she was ready to return to school in 1992, she decided to pursue a degree in accounting technology on a part-time basis and completed the program in 1997. Jeannie started using a computer when she started school because she had difficulty writing. Both she and her vocational counsellor believed that a laptop would be easier, more convenient and more flexible than a desktop computer. As the parent of a young child, Jeannie’s time away from home was limited, and the laptop allowed her to take her work home with her.
Today, Jeannie has a desktop computer at home as well as her laptop (but the laptop was recently stolen and is being replaced by her insurance company). Because the laptop was fairly old and didn’t have a modem, Jeannie was unable to access the Internet from it. With her desktop she is able to use the Internet for research purposes and to keep in touch with family and friends through email.
For word processing, Jeannie either types manually or uses speech recognition, depending on the task at hand. She finds she is fairly efficient using the knuckle of her pinky finger on the keyboard and her other hand on the mouse. Another efficiency booster is a software tool called “sticky keys.” Using this tool, which is built into all Windows computer systems, she is able to perform keystroke sequences that involve pressing more than one key at a time (e.g., Shift, Ctrl, Alt). With sticky keys you can press the key and release it instead of having to hold it down while pressing a second key.
One problem with typing is that Jeannie has to place the keyboard on her laptray. The keyboard is longer than the laptray and it doesn’t quite fit properly. Also, when there is an interruption such as a telephone call, Jeannie has to remove the keyboard, deal with the interruption, and then get set up again. As a result, Jeannie sometimes finds continuous speech input “more functional,” especially when she is working on a longer document such as a letter. Also, speech recognition is more efficient than typing and helps to prevent arm fatigue. Jeannie believes that when she goes back to work, speech input will help her performance on the job.
Jeannie’s printer has a top-loading paper feed, which unfortunately is inaccessible to her. She plans to buy a front-loading printer so that the paper can be loaded onto a tray in the front and the printed page comes out in the front as well.
One of Jeannie’s favourite activities is sketching and painting. At first she wasn’t sure she would be able to sketch again and says, “I just decided one day I was going to sit down and work at it like I had with my handwriting.” Jeannie’s sister brought her art supplies to the rehab centre, and one afternoon, Jeannie and her daughter sat by the lake sketching. She was pleased with the result. Jeannie also likes oil painting, but because of her wheelchair, she can’t get close enough to her easel. She hopes to get a folding metal lap-top easel that she can either place on a table in front of her, or on her laptray. Jeannie also enjoys working with ceramics.
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Prior to her injury Jeannie liked to bowl, and while she was in rehab, she went bowling with a group once a week. To bowl she uses a portable bowling ball ramp, which someone sets up for her at the alley. To get ready Jeannie has the ramp unfolded in front of her with a rectangular flap placed on her laptray. The ball is positioned in the crease of the ramp and Jeannie pushes it down the ramp. She has been able to match her pre-injury scores.
Jeannie participated in a fishing program at the rehab centre last summer. She had always enjoyed fishing in the past. The only real difference now is that the reel on the fishing rod is motorized and battery powered. She would like to pursue this interest further in the future.
Jeannie uses a reacher that extends eight to ten inches. Instead of a conventional clamp with a pinch action at the end of it, this reacher has a sticky pad at one end and a magnet on the other. Either can be released with the push of a button. Jeannie is alone for extended periods of time during the day, and the reacher enables her to pick up objects such as paper, her writing splint, or her TV remote control.
Jeannie keeps a pouch at the side of her wheelchair to hold everyday items such as eating utensils and an eating splint, a writing splint, and keys, which she keeps in a modified key holder.
Jeannie likes to cook and bake with her daughter, and when she was in rehab, she was given a magnetic potholder. This device is shaped like the letter “M” and sits on a wooden base that can be set in place on the stove top with a magnet. The potholder grips the pot handle and enables Jeannie to stir with one hand. She recently tried an immersion hand blender with a simple on-off switch. To use it, Jeannie places the bowl on her lap and holds the blender with both hands.
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Jeannie keeps her makeup in a basket. The basket rests on her lap for easy access and has a mirror attached to it. She keeps her supplies in an upright position. The basket’s handles have been built up with foam for a firmer grip.
Jeannie has a toothbrush cuff similar to a writing splint that she uses to brush her teeth independently. Once the cuff is placed around the palm of her hand, the toothbrush is ready to go.
The automatic front door opener on Jeannie’s apartment permits her to go in and out on her own. When she’s out in public, she has found that most buildings have automatic door openers. If she needs to go somewhere where there isn’t a door opener, she can usually get someone’s attention (sometimes by knocking on a window) and ask for help.
Jeannie’s advice to new consumers of assistive technology is to know your resources, ask questions and talk to other people who use assistive devices. When dealing with vendors, especially for big-ticket items like vehicles, Jeannie has a pragmatic attitude. She says that, in these situations it’s sometimes necessary “to take some initiative. Sometimes if you just rely on other people to do things for you they don’t get followed up and they don’t get done. So just stay pleasant about it and follow up with phone calls.”
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