The effects of an acquired brain injury (ABI) are not the same for everyone. An individualâ€™s response will vary from that of another. Cognitive deficits, issues with proprioception, balance or coordination, mobility, ambulation, weakness, tiredness, paralysis, pain, numbness and problems with bladder or bowel control can all change the way a person functions in the home. These are all true of an ABI survivor. Medical intervention along with rehabilitation are essential components in order for an ABI survivor to reach their goals and function safely in the home and in the community. The impact of a traumatic experience on an ABI survivorâ€™s living environment may prove significant. Some deficits may not be noticed until the ABI survivor returns to daily tasks. Changes to the home are most effective when they meet oneâ€™s specific needs. An Occupational Therapist along with a Home Modification Specialist can help to determine the most suitable and cost effective solutions that will address any safety issues that may exist and provide solutions for barrier free living. If addressed immediately, it is a good idea for the ABI survivor to have a trial visit at home before he/she is discharged from the hospital. If changes and corrections to modifications are required, they can be made before the individual returnâ€™s home permanently. In any case or situation, home safety and accessibility should be an active component of a discharge plan. Not all modifications have to be extensive and expensive. For example, a simple, but properly built ramp or grab bar can provide significant independence to an ABI survivor. Also, before spending a lot of money on modifications, remember function can continue to return and what may be required in rehab may not be what is ultimately needed a year or two post-injury. The basics, like ramps, usually top the list of immediate needs after discharge from rehab. Home Accessibility for an ABI Survivor By John Groe How dangerous is the Bathroom? In our first segment we will review and determine needs within the bathroom. Although not always apparent, the bathroom can be the most dangerous place for people with physical or cognitive disabilities. Without the proper layout and nonslip materials on floors and walls, one may slip and fall causing further injury. Your typical bathroom modification usually consists of converting a conventional bathtub to a walk-in or roll-in shower. The following is a list of a standard bathroom modifications:
- Remove bathtub and convert to roll-in shower sloped shower base allowing proper drainage
- Install 2â€ x 2â€ non-slip tiles to bathroom and shower floor
- Install 6â€ x 8â€ matt tiles to shower walls
- Update all faucets to posi-temp single lever faucet
- Install hand held shower wand
- Install comfort height toilet
- Install GFI electrical outlet
- Install water tight light in shower area
- Install ceiling exhaust fan
- Widen entry door to min. 34â€
- Install wall mount sink/roll under sink
- Insulate exposed piping
- Install water resistant gypsum board
- Seal all tiled areas
- Install towel bar, toilet holder and tilting mirror
- Install chrome shower bar with vinyl curtain
- Install 3 to 4 chrome garb bars
Many safety issues come into play when having to use the toilet. We recommend installing a grab bar or a P.T. rail. A grab bar is usually installed along the side of a toilet and also across the back wall of the toilet. A P.T. rail is a wall or floor mounted grab bar with pivot support design. This product gets installed beside the toilet, and will allow you to fold the rail to a 45 degree position. Grab bars will help individuals stabilize themselves when sitting or getting up from toilet. Changing the height of the toilet is also an option. A â€œcomfort heightâ€ toilet reduces the distance from standing to sitting position.
This may prove beneficial to an individual with an ABI as there may be balance and strength issues.
In the event that a wheelchair is required for ambulation, the ABI survivor may find it difficult reaching a standard sink. The perfect solution is to install a wall mounted sink or a â€œroll-underâ€ sink.
Wall mounted bathroom sinks are not only space saving but are ideal for people with restricted movement.
A â€œroll-underâ€ sink usually has a bigger counter but works in the same way as the wall mount.
All exposed pipes should always be covered or insulated to prevent leg burns.
The above is a standard guideline (Bathroom), which provides insight to barriers that may exist for an ABI survivor. No two individuals will respond the same to a heady injury. Recommended modifications will vary from person to person and from living environment to living environment.
–John Groe is an Accessibility Consultant and Managing Partner for Accessible Daily Living in Vaughan.