Tag: Assistive devices

Assistive devices & technology

Assistive devices and technology are anything that helps make activities of daily living (ADLs) easier and increase quality of life. This is a small sample of the assistive technologies available to help after brain injury. If you are looking for more options, check with healthcare providers, other survivors and your local brain injury association for ideas and recommendations.

Financial aid for assistive technology/devices

DISCLAIMER: the following are examples of commonly used assistive technologies and devices. Your healthcare provider will be the one to make recommendations for your specific needs, and they should be consulted if you have any questions about assistive technology. Using these devices and technology can be very helpful, but only when targeted for your abilities.

For mobility

Walking poles
Walking poles are sometimes used for active walking. They can also be used for people who want extra support and safety when walking outside on uneven ground. These walking poles can be ordered online, or in some cases can be found in sports equipment or medical stores. Make sure to find ones that are good for rehabilitation: there is a difference between sport poles and support poles. It is also important to follow instructions and use them correctly.
Canes
Canes are a walking aid, generally used by people who have some unsteadiness and need extra support. Canes can be single point or four-point.
Walkers
Walkers are an excellent assistive aid for people who are able to walk but may be experiencing muscle weakness or unsteadiness/balance issues. Compared to canes and walking poles, walkers provide more support. While most walkers have wheels for easy movement, some do not. Your doctor will be able to provide recommendations.
Wheelchairs
Wheelchairs can be manual or motorized operation and come with a variety of features designed to make mobility easier. If you do need a wheelchair, you may have to adjust your home environment in order to accommodate the change. Wheelchairs should be fitted by an occupational or physical therapist who can make sure wheel types, seating and other parts of the wheelchair are suited for the user.

At night

Bed rails
For people who toss, turn and are at risk of falling out of bed, bed rails are an easy way to increase safety while asleep.
Low beds and bed steps
Getting in and out of bed can be challenging. Lower beds and bed steps can help. They are also easy to find and add to a bedroom.
Sleep mask
For many people, they need peace, quiet and darkness to fall asleep, meditate, or just take a few minutes for themselves. One way to do this is to use a sleep mask. A sleep mask restricts light and can help someone if they are feeling overly visually stimulated.
Special adjustable beds
Adjustable beds can make it easier to find a comfortable sleeping position, improve circulation, and turn a bed into a chair for day use.
Supportive pillows
There are different kinds of pillows that can be used to help people when the sleep. Pillows can be used to help with neck, hip positioning, between the knees, and more.

In the kitchen

There are all kinds of kitchen items that can make cooking enjoyable and more accessible. An occupational therapist may have recommendations specific to your needs.

Automatic turn-off switches for stoves
There are several automatic stove turn-off devices that can be used by people who experience challenges with memory. Some even have timers. These automatic turn-off devices can be an important safety tool.
Grips for silverware
There are grips you can get to add to silverware. This makes it easier to hold a fork or spoon and eat independently. They can also be used for other utensils such as pens.
Kitchen tools developed for people with one hand ability
There are plenty of kitchen tools such as knives, cutting boards and pots/pans that are designed for people who can only use one hand. This means that people who find traditional kitchen equipment impossible to use can still enjoy cooking.
A pot watcher
There are different names for it, but a pot watcher is essentially a heat-resistant disc that goes into a pot or kettle. It rattles when liquid starts to boil as a reminder for the person cooking. This is a great tool for people who like to cook but may get distracted.

In the bathroom

Shower chairs/benches
Shower chairs or shower benches allow people to bathe safely while sitting down to help minimize risks of falls.
Grab bars
Grab bars can be installed in various places in the bathroom to help a person in an out of a shower or bathtub or up and down on the toilet. These grab bars are installed specifically to support a person’s weight. Towel bars and hooks should not be used as grab bars.
Handheld shower sprayers
For people who sit down in the shower, a handheld shower head allows for easier cleaning and more maneuverability.
Raised toilet seats
Raised toilet seats can be incredibly helpful for people who find sitting far down challenging.

Technology

Learn more about Tech for Good a digital accessibility program 

Computer programs that change screen colour & contrast
For some people with visual challenges, regular screen settings (colour, contrast and brightness for example) don’t work. There are computer settings and additional programs (free or for purchase) that can be used to alter screens to make them more comfortable for users.
Journaling applications
For people who don’t want to keep a physical/paper journal, there are free and paid smartphone/tablet applications that allow you to keep a journal. This is also an excellent option if you struggle with writing by hand.
Photo shortcuts
Some applications for smartphones are available to create photo shortcuts for actions you perform all the time. For example, a photo of a family member could be a shortcut to their phone number. This can make calling loved ones or visiting frequently used websites quick and easy. Please note: these applications are not free.
Screen readers
Computers, tablets and smartphones can be equipped with screen reader software that will read out text and image descriptions on your screen. Some computer operating systems even have screen readers (or narrators) built in. This assistive technology is helpful for people who have difficulty using screens or vision problems.

 

Not all screen readers are the same and some may cost money. You can find the right screen reader for you by asking specialists on the rehabilitation team for their recommendations. You can then begin looking at free vs. paid programs and reviews from other users to determine which recommendation would be best for you.

Scheduling applications
There are plenty of smartphone and computer applications available for free or for purchase that make keeping a digital calendar or setting reminders easy.
Smart-pen and paper
Smart pens (along with the appropriate smart paper) can turn handwritten notes into digital notes and audio recordings. Some can even store pages or audio notes directly on the pen.
Speech to text software
For people who are unable to write, speech to text software can take what you say and turn it into text on a computer, smartphone or tablet. This is helpful for emails, text messages, reports, and more.
Talking clock/calendar
There are digital clocks and calendars that go one step further. They not only show the date/time: they say it. Depending on the model of clock/calendar, they may also show other relevant information such as temperature and weather.
Use smart technology to send alerts, change settings
Smart technology is becoming more and more integrated into homes. Using smart technology and applications, it’s possible to do things like send alerts to a caregiver when a person leaves their bedroom (ideal for people with memory or balance issues), set up automatic reminders, and more.

 

Smart technology does cost money and will need professional installers. Healthcare professionals may have some recommendations for smart technology that other patients have found helpful.

Voice recorders
Taking notes in any form may be difficult for some. Audio recorders can be used to record conversations, important meetings, doctors’ appointments, and journal entries. The recordings can be saved on a computer or compatible device.
Wearable timers & smart watches
Smart technology watches and timers can be worn and used by people with brain injury to remember the date and time, set timers for activities, and set reminders to complete tasks. Some can even take voice memos.

Additional aids

Hearing aids
Hearing aids are for people who have hearing problems and need technology to help them with communication. If you have hearing problems, you should consult with an ear, nose and throat (ENT) specialist or your doctor about whether a hearing aid would help you.
Large print calendars and schedules
Standard print size may not be suitable for some people. There are large print calendars and schedules that can be ordered. These make it easier for people to read, especially from a distance.
Prism glasses
Prism lenses are designed for people with double vision. The prisms help align the two images into one. Eye doctors prescribe prism eyeglasses based on specific tests.
Medical bracelet
A medical bracelet isn’t a tool or device, but it’s a valuable way to convey information about brain injury to medical professionals (such as emergency personnel), caregivers, and even the person with a brain injury if they are experiencing memory issues.

 

Brain Injury Canada has partnered with MedicAlert to provide a special rate on their services and a free medical bracelet.

An alternative to a medical bracelet is an emergency identification card or storing the information on your smartphone. Many smartphones now have a feature that enables you to make someone your emergency contact, which can be accessed by first responders.

Financial aid for assistive technology/devices

There are several different funding programs available to provide assistance to those with disabilities. They can be run by provincial/territorial governments, local nonprofits, or community organizations. Funding programs for assistive devices will have different eligibility requirements, so not all programs may be available to you. Check with your local brain injury association to see if they have information on funding programs.

March of Dimes Canada’s Tech for Impact Fund is providing funding towards purchasing technology to support Canadians living with a disability.

There are grants available at the federal and provincial/territorial levels that can assist with home environment accessibility renovations. You can find the list of current renovation grants on this page.

Tips to manage fatigue

There are some actions you can take to help manage your fatigue.

Ask for help

Fatigue can make it difficult to complete daily tasks, travel, or go to appointments. A caregiver, family member or personal support worker can assist with tasks that may leave you fatigued, and work with you as you build up your endurance.

Cognitive behaviour therapy (CBT) and occupational therapy (OT)

One of the leading causes of fatigue is the extra mental and physical efforts it takes a person with a brain injury to complete tasks.

Cognitive behaviour therapy is designed to help survivors coping with mental and cognitive changes. For fatigue stemming from cognitive changes, cognitive behaviour therapy can be helpful in building endurance and understanding what’s causing fatigue and how to manage it.

Occupational therapy is available to help people living with brain injury relearn skills or find new ways to complete activities of daily living (ADLs). When you practice these skills consistently, it will take less and less energy for you to complete them – this leads to less instances of fatigue.

Remember: the effects of rehabilitation happen over time and recovery is based on several factors. You won’t notice significant changes right away but that doesn’t mean the rehabilitation isn’t helping you. It’s like tracking fitness goals: you notice changes and improvements week to week, not day to day.

These therapies are available both privately and publicly. Private therapy is paid for by you. Publicly funded therapy is available at no additional cost: however, availability of public therapy is limited and differs from province to province based on the services available. Your doctor will be able to provide you with more accurate local information or recommendations.

Depending on your private or work insurance plan, occupational therapy and cognitive behaviour therapy may be partially or fully covered under psychotherapy services. It is always best to check directly with your insurance provider about your coverage.

Communicate your experience with fatigue

Your loved ones and friends may not understand how deeply fatigue can impact your daily life.  They may see you at a family gathering or event and make comments like “glad to see you are feeling better” or “great to see you back to normal”. They don’t know that you have had to sleep leading up to the event and will have to sleep for hours after it, just so you could have the energy to attend.

It’s okay to tell them you struggle with fatigue and you are always recovering. Openness and honesty will help educate others on the experience of living with a brain injury.

Create schedules to manage your day and your fatigue

Set out a schedule and plan your activities, appointments, and tasks for each day. You only have so much time and energy, and you want to make sure it will get you through the day. Chances are your energy levels before your injury were a lot different than your energy levels now. This means you will have to practice pacing – taking a bit more time and spreading out your schedule.

When building your schedule, try to do it the night before or in the morning after you wake up. When making a schedule, make sure to do the following things:

  • Build in rest periods. One of the best ways to manage fatigue is to give yourself time to rest. Listen to your body and don’t “push through” if you’re feeling fatigued. If you know you need multiple rest periods a day, schedule them before you schedule anything else. Having a schedule with time set aside to rest will help ensure you take the time you need.
  • Schedule activities when you have the most energy. Depending on when you experience fatigue, there will be periods of time during the day that make the most sense to schedule activities. For example, many individuals have the most energy after they wake up in the morning and much less energy in the evenings. By scheduling activities and appointments during the times you have the most energy, you will minimize the risk that fatigue will interfere.

Exercise and physical activity

This should be undertaken on doctor recommendations. Exercise and physical activity have all-over health benefits but should be reintroduced slowly and under supervision. Overtime you will build up your skills and endurance, meaning you can do more and feel less fatigued.

Have plans in place for unexpected fatigue

Fatigue can be debilitating and leave a person unable to complete tasks. It can also occur unexpectedly, especially immediately following your injury. For example, you could become fatigued in a public place, at a social event, or at work.

When this happens, having coping strategies can help manage the situation. This could include having hand signals with your caregivers or having an emergency contact come get you. If you’re worried about fatigue catching you off guard, try the following aids:

  • Keep a journal to track when you commonly feel fatigued
  • Speak with your rehabilitation therapists about strategies for coping with fatigue and public outings
  • Share your feelings with caregivers or employers – they can help you come up with a plan

Manage stress

Elevated stress levels can increase fatigue, particularly for individuals with brain injury who have cognitive and problem-solving challenges. When you identify what causes you stress, you can either remove those stressors or start dealing with them on a gradual basis. Giving yourself this time to process and respond to stressors will help manage feelings of fatigue.

Manage your expectations

A brain injury is a major life change, and that means abilities have changed. It’s important during recovery to manage your expectations and focus on what you can do. Don’t always compare where you are today with where you were before the injury. That will lead to negative feelings and fatigue because you’re trying to push yourself too hard. Instead, focus on setting weekly or monthly goals and prioritizing your health and well-being.

Track your fatigue

What causes fatigue for you may not cause fatigue in someone else. It is dependent on the person, their injury, and the environment. While it can be difficult to identify triggers, it’s important that you and your caregivers learn what makes you feel fatigued: if you don’t, you may experience extended periods of fatigue or feel like you have no control over your energy levels.

It can be difficult to track your fatigue through the course of a day, especially if you’re experiencing memory issues. By keeping a journal of your activities and your feelings, you can more accurately identify periods of time where you feel fatigued.

Record all medications you’re taking

Some medications can have increased feelings of fatigue as a side effect. Keep a list of what medications you’re taking, when you’re taking them, and their side effects. This will help you identify when you may feel more tired.

Create a rating system

One way to check in with yourself and how fatigued you’re feeling is to create a rating system. Make a scale from 1-10 and measure your fatigue on that scale. For example, a 1 is not fatigued at all while a 7 or 8 is strong feelings of fatigue.

You should rate your fatigue levels before and after you complete an activity – for example, doing the dishes. If you find that doing the dishes takes you from a 1 to a 5 on your fatigue scale, perhaps take breaks or ask for help with dishes.

This rating system will not only help you identify what makes you feel fatigued; it will help you identify when to take breaks and improvements you make over time [1].

Understand what environments work for you

Some environments can increase a person’s fatigue. This includes places with loud noises, bright lights, overcrowding or that require a lot of travel. By understanding what environments cause fatigue and what environments work best for you, you can more easily participate in activities. Over time, you can reintroduce yourself to other environments for short periods of time. Wear sunglasses if it will help you deal with bright lights and ear plugs to deal with noise if it does not jeopardize your safety. Look for places that offer sensory-friendly settings – for example, some grocery stores have specific sensory-friendly shopping days.

Remember: take breaks as often as you need. You don’t have to stay out for a full day if you’re experiencing fatigue or other symptoms. It’s important to listen to your body.

Use assistive technology and tools

Assistive technology and tools help individuals with acquired brain injury manage their symptoms and complete activities of daily living [2]. There are ways to use assistive devices to cope with fatigue. For example:

  • Wheelchairs during walking rehabilitation
  • Checklists to help manage tasks and minimize stress
  • A sleep journal to track sleep disturbances

Occupational therapists and cognitive behavioural therapists can assist in developing coping methods or introduce you to tools that manage fatigue.

If you need financial support to obtain assistive devices you can explore this assistive devices program. This program assists adults with physical disabilities who are in financial need to purchase assistive devices that increase their mobility and functional independence.

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