Automatic Door Opener

Automatic door opener

Is a power door opener a luxury or a necessity? Frankly it depends upon how much effort it takes to open the door another way. I have plenty of friends and clients who use mobility equipment who might say they've gotten used to the extra steps they use to open and close doors compared to those of us who stand and walk. We don't have to think about our balance, backing up with our mobility equipment to get out of the way when we are moving the door, or having to turn our walker or wheelchair around and approach the door again in order to close it.

Lever handles and building in some space beside the door when possible, so a person can stand or sit to the side of the door while it swings open past them are two manual ways to make opening a door easier for some people. Of course sometimes it isn't practical to provide additional space beside the door.

Two manual approaches to closing the include tying a string to the door and catching it with your hand or  wheelchair as you pass through and adding an extra handle. These pictures from www.howtoadapt.com shows both. When I work with people who choose to add a handle whether it is screwed in, magnetic, or suction, I strongly suggest they take the extra time to turn around and reach forward to get hold of the handle in order to protect their shoulders, but that of course takes time.

Opening and closing a door with the push of a button seems like a really good idea to me. It could protect a person with poor balance, save a person time and aggravation, and frankly make it possible for some people to handle the task on their own. Total Home Access Solutions, installs Open Sesame Power Doors in private homes and residential communities.

This American company provides a reliable door opener that is flexible enough to work with in-swinging or out swinging, right hand or left hand doors, which allows my clients to re-use their opener if they move. We can provide a variety of switches which best meet a person's requirements.  These openers don't interfere with another person's manual use of the door and charge themselves so they are always available even if the power goes out. Give us a call if you want more details about how these doors work.

Is a power door opener a luxury or a necessity? If you can't open the door any other way; If the cost of remodeling to provide room around the door exceeds the cost of a power opener; if you run the risk of falling when you operate the door; or if you would like to get through the door and close it behind you with the same effort that most people expend, I think you'll be among the people who consider a power door opener a necessity for successful independent living.

Let us know what you think!  BPhillips@Totalrr.com

The SureHands Lift and Care Systems Body Support Can Help with Clothing Adjustments at the toilet

It takes more than just getting into the room to be able to make use of the toilet.  You need to deal with your clothing as well.  What if you can’t stand up or balance while standing?  What if you are a caregiver for someone who depends upon you to transfer or move from one surface to another?

One solution is the SureHands Lift& Care System Body Support.  It can be used with any of the ceiling based or wall based motors.  Unlike many slings, the body support leaves the buttocks area clear during the secure transfer.  This makes this a great lift support for speedy, secure, and often independent transfers, but it is also great for clothing adjustments during toileting.

Once a person is positioned over the toilet, pants can be moved over the hips to the level of the body support.  This is easier with looser pants.  Individuals with sufficient hand strength and dexterity and  arm mobility may be able to do this themselves.  It is a relatively easy task for most caregivers.  Once the person is lowered to the toilet, the thigh and chest cuffs become loose.  As the thigh cuff is removed the pants can be pulled further down each leg.  Some caregivers find it helpful for hygiene to lift a person into the air slightly for cleaning.  Other people can accomplish cleaning while seated.

When the person is ready for pants to be pulled up, the top of the pants are gathered and pulled up as high on the thigh as possible. Work with one leg at a time.  Sometimes you will need to repeat this process.  If a person’s leg can’t be lifted high enough to clear enough space to pull the pants up, a caregiver can prop their leg up on something or lean them slightly  to the side.  The goal is to gather the pants up so that most of the fabric needed to pull over the hips is over mid thigh.  Place the thigh cuffs just below the gather of material and lift the person slightly.  With the cuffs at mid thigh the person’s buttocks will be lower than usual so best practice is to lift just high enough to clear the toilet and work fairly quickly to pull the pants up over the hips.  Depending upon how tight the pants are, this step may take a little tugging to clear any folds of fabric at the thigh cuff.   Lower to the toilet and reposition the thigh cuffs correctly as high up on the legs toward the hips as possible.

The body support makes dressing during toileting activities possible for many people.   Give us a call today if you have any questions or wish to schedule a private consultation.

402-291-9514

Is your bathroom the scariest room in your house?

Are you afraid of what may happen when you are in your bathroom? Do you stay up at night wondering just how safe your older parents are in their bathroom? If so, you are not alone. Ask anyone what is the scariest place in their home and if they have a disability or mobility/balance issues, they will probably tell you it is the bathroom. It doesn’t have to be that way.

We know instinctively that the bathroom is a dangerous place. Falls occur from slips and trips. Slips occur most often on wet surfaces. What floor do we tend to drip water on most often? Trips come from obstructions we don’t see. Which room is often small with limited storage so things may be placed on the floor or on storage shelves placed in the walkway? Many falls occur when lighting is inadequate. What room in older homes is usually lit by a single set of lights that we reduce even further when we close shower curtains? Better yet, if we wear glasses, what room do we routinely take them off in? Other falls occur when a person’s ability to balance isn’t adequate for the tasks they are engaged in. What room requires us to step over a 15” high barrier such as the side of a tub, get on the floor such as getting into a tub, bend over such as pulling up pants after toileting? To top it all off, which room of our house is so small that if we fall on the floor we are likely to block the door shut with our body so no one can get in to help us? Of course we know the bathroom is a scary place, but it doesn’t have to be.


Safety can be improved in most bathrooms with careful attention to matching the environment to a person’s abilities and a willingness to try something new. It may be as simple as a well placed grab bar or a rug to absorb moisture that is really slip resistant to. For some homes, it may be a little more involved such as replacing a standard tub with a barrier free or walk in shower, or adding a walk in tub. Thinking about making a change may be difficult, but consider the alternative.

Take a look at these facts from the article Falls Among Older Adults: An Overview the Center for Disease control www.cdc.gov

• More than one third of adults 65 and older fall each year in the United States (Hornbrook et al. 1994; Hausdorff et al. 2001).

• Among older adults, falls are the leading cause of injury deaths. They are also the most common cause of nonfatal injuries and hospital admissions for trauma (CDC 2005).

• In 2005, 15,800 people 65 and older died from injuries related to unintentional falls; about 1.8 million people 65 and older were treated in emergency departments for nonfatal injuries from falls, and more than 433,000 of these patients were hospitalized (CDC 2005).

• The rates of fall-related deaths among older adults rose significantly over the past decade (Stevens 2006).

How can we look at facts like these, know the bathroom is one of the most useful, but most dangerous places in our home, and still not take action to save ourselves and people we love?

Take action today. Educate yourself on ways to make your bathroom safer. It may be easier and less expensive than you think it will be. If you want some help planning a functional and beautiful bathroom experience give us a call. You are worth it.

Access client shares his wood working access ideas with a web site!

Another Reason Why We Love Touching People’s Lives!

When Bob contacted me to improve the accessibility of a house he and his wife had recently purchased, we sat together and discussed what was important for him to do in the house.   His determination to resume woodworking was clearly almost as important to him as being about to move through the doorways of the home and to be able to use the fixtures in the bathroom safely.  He had us work on access through the house while he worked on creating a workshop that was accessible to him.

A recent amputation meant he needed to use a wheelchair at times and he was having difficulty using his wood working techniques designed for a person who can stand and balance.   He went on line for some helpful ideas and found only one article related to wood working and access.  Bob did not let this stand in his way. He took the initiative and started the website http://wheelchairwoodworker.net/ to share his innovations of making his wood working shop safer and more accessible with other people who had similar disabilities.

Bob’s website is active in two ways; he is first documenting the transformation of his workspace from the large traditional shop he had in his previous house to two separate rooms in his house. The second way Bob uses his website is to bring people to together so they have a platform to share their thoughts and input.  Bob states that his website has been an overwhelming success and encourages people to not be afraid to speak up on his site. Bob gives a great deal of thanks to his wife, who happens to be an occupational therapist and was not afraid to encourage and push him toward recovery.

Accessibility is about making your home a place where you can do what is important to you.  Please contact me if you have any questions about removing barriers for daily activities like bathing or cooking, but also about removing barriers to enjoying recreation too.

Oasis Seated Shower System™ a new way to bathe people

Oasis Seated Shower System™  a new way to bathe people

Helping people bathe is not one of those activities that most of us spend much time worrying about.  Of course we were taught the importance of good hygiene from our parents and our mentors as we growing up.  Of course we are influenced by the multitude of advertisements for personal cleaning products.   For the most part though, we jump in and out of our showers and tubs without a lot of effort or thought about what we are doing.

When a person is unable to clean themselves, the bathing activity requires a great deal more attention.   Even if a health professional is the person doing the bathing,  being undressed and allowing someone to touch you is a process that is uncomfortable socially for most people.     If a person is unable to stand up, getting really clean around the genitals and anus may be very hard to accomplish.   Health professionals such as Nurses and Occupational Therapists spend a great deal of time and energy devising procedures and ways to help keep other people clean.  The consequences of inadequate hygiene such as UTIs (urinary tract infections) can be very debilitating, or even life threatening for people.

If reading my last paragraph made you a little uncomfortable, imagine what trying to clean someone else must be like or what having someone bathe you must be like.  

I'm really excited to present the Oasis Seated Shower System™  because I love to help people find solutions.  This technology allows really excellent cleaning with less hands on touching during the process.  People are still present and still helping with moving a person, drying them, doing little extra touches with hair, hands, or feet so there is still the one to one human contact, but some of the most uncomfortable and difficult  cleaning is taken care of with no touching.  Dangerous things like having a person with poor balance standing or leaning to the side to clean the buttocks area are eliminated.  

The Oasis is easy to use and set up.  It uses the existing shower water supply and drain so there is no construction.  It  actually uses less water than a traditional shower or tub and because water doesn't circulate inside the seat, it is a very clean and low maintenance piece of equipment.

Here is a link to another cool video about the Oasis.   http://www.youtube.com/watch?v=ZfOsPTtWsPI
Remember, in a few short years, you will be able to say, "I was among the first to see the Oasis.  It was the start of how we bathe people today!".  


Right now I have a loaner I can take to facilities and let a few people try it out for themselves to see how much better their residents and bathing staff feel using the Oasis than they do using the old fashioned methods.    If you have any questions about how it might fit for you, give me a call 402-291-9514 or email, BPhillips@Totalrr.com.

Check out our flyer!

SureHands Lift and Care System and Therapeutic Riding

Normally, you can find me in someone’s home, trying to make it better suit their needs.  This week though, you could find me in a barn instead!   We are visiting the Heartland Equine Therapeutic Riding Association, also known as HETRA of Omaha/Valley.  Created in 1989, HETRA has helped both adults and children with disabilities participate in therapeutic riding activities.  You can learn more about them www.hetra.org.

As Edye Godden, OTR/L, the Executive Director explains, Hippotherapy is an exciting and different form of therapy that many people participate in, which not only helps with posture and balance, but helps release tense muscles and provides stimulating social contact.  It’s also a very exiting experience that many people who are not fully mobile would otherwise never get to participate in.  However, helping people with disabilities onto horses is not always easy.  Transfers like this can be hard on the riders, the therapists, the volunteers, and the horses.  That’s where we were able to help with a SureHands Lift and Care System.

We installed a lift system very similar to one that someone could get in their house.  The lift makes it much easier and safer to help larger people onto and off of the horses, which help them relax and enjoy the therapy faster and get more benefit out of it.   So, share the news and share the video!  HETRA and Total Home Access Solutions can help get you on top of things.  Like a horse, for instance!

What to do about doorways?

Hi everyone.  I want to talk to you about doorways, mainly getting through the doorway. I work with a lot of people who use wheelchairs and walkers; sometimes they find out they are just a little bit wider than the door.

What do you do?

When you are wider than the door, you have two choices. You can do construction. You can take the door out of the frame and widen it. However, if the doorway is only an inch too small, we can do an amazing thing just by replacing the hinges!

You can see the door takes up space in the door jam.  If we use a product call an offset hinge and replace the current hinges on the door, we can use the same door, the same door jam and knob. What that offset hinge does is move the door out of the doorway when it’s open. That gives you another inch of usable space!

We also can add a receiver for your doorknob in the wall. This gives some space for the doorknob to go when the door is open.

So share the news and share the video!  You have some choices if you are a little wider than the doorway.  You can do full construction or you can try and offset hinge!

What is the cost of NOT using a stair glide?

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Stair glides do cost money, especially if you buy them from a reputable, experienced dealer who can provide product knowledge and service. I see my clients tempted everyday to save a little money and just keep on struggling up and down the stairs. I think this falls into the “penny wise, pound foolish” category of thinking.

Sometimes it is easier for a person to see the need when they’ve experienced a traumatic event and go from having no problems on the stairs to difficulty with them over a short period of time. They feel the impact that problems moving within their homes cause more keenly, and they are looking for solutions.

When the problem with negotiating steps comfortably has developed over a long period of time it is usually harder for a person to see the need for equipment like a stair glide. They may or may not have noticed that it simply takes more effort to go up and down the stairs. Perhaps they accept their arthritis pain as normal and aren’t aware of the stress that the stairs puts on their joints. Or they stumble one day and realize that they really haven’t felt comfortably balanced while maneuvering on stairs for quite a while. I will usually suspect a problem with the stairs when a person describes their daily routine in a way that makes it evident that they are arranging their lives around avoiding the stairs. I’ve met people living in older 2 story homes, who limit the amount of water they drink during the day because they don’t want to have to use the stairs to get upstairs to the bathroom. I know so many people who gradually become recluses simply because it takes too much effort or is too frightening to navigate steps to get outside.

Other people have told me quite proudly that they would never consider a stair glide. When I ask why they tell me that they believe they need the exercise or that they believe that they’ve been told by their physician or therapist that the stairs are good exercise for them. Now, I rarely come right out and disagree with another health professional, but I think there is a time and place for exercise and an area where the consequence of a mis-step is a tumble down the stairs is not it! If you have balance or strength problems, exercise somewhere else in your home where a fall is less likely to kill you.

Here are a few things we look for other than stairwell width, height, and length when we are recommending stair glides. These factors influence they type of options and features we recommend as well as the cost.

• Can the client get up and down out of chair safely? Do they need things like handles or grab bars for balance?

• Is there room at the top and bottom of the stairs for wheelchairs or walkers now and in the future? If the client uses mobility equipment, are they prepared to have duplicate equipment at the top and bottom of the system?

• Are there any structural changes that need to be made such as moving handrails, modifying doors around the track, or providing convenient electrical outlets?

• Will the track itself create a trip hazard at either the top or bottom of their stairs? Will the track present a hazard to others on the stairs?

• Is there clearance for their head and knees when they are riding? We have modified door casings at the top of a stairwell to provide a vital 1.5” of space for a tall person.

• What is the client’s weight? Larger weight capacity chairs cost more, but are worth it in the long run for safety, and a longer useful life if a person is close or over the manufacturer’s posted weight limit.

• Where are good locations for call/send switches.

• What safety improvements can we make around the chair glide such as removal of clutter, removal of loose throw rugs, and improvement of lighting?

Compared to your safety, your independence, and the quality of every day living, a stair glide for a straight stairwell is usually pretty cheap. Curved stairwells or stairwells with landings are more expensive as the track is often customized but is still usually less expensive than moving or a trip to the emergency room and rehab. We think the quality of your life is worth at least considering a safe way to have use of every level of your home.

Accessibility Doesn't Come at The Price of Attractiveness

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How much difference does a bathroom that works for you make in the quality of your life? We took a retrospective look at  some clients who we helped improve the safety of the bathroom while modernizing it and helping her achieve her vision of beauty. She was happy with the way her new bathroom allowed her husband to be more independent and able to shower mostly by himself now in security.  She’s been able to truly relax, and not be afraid that her husband would fall. He enjoys the privacy.

As we improved the accessibility of the bathroom, we kept budget and aesthetics in mind as well. Rather than widening the door and moving walls, we were able to use much more economical swing-clear hinges to provide the extra 1 and a half of door way width we needed. Our grab bar placement was designed to allow him to move through the bathroom and to help him up off the toilet, but matches the theme of the room without looking out of place or disruptive.

In the shower, we were able to use a pre-blocked Best Bath shower to place grab bars where he needed them, and to ensure he could place the showerhead wherever he wanted it most. Best Bath showers are beautiful, durable, and low maintenance, but their functionality and practicality, as well as their ability to be changed in the future as needed, is something else that we love about them. Here, we made use of their adaptability with a temporary threshold.  It’s secured and caulked down now, but if they ever need a roll-in shower, it’s a simple matter to remove it and for a simple, elegant conversion to a roll-in shower. You can think about Best Bath System’s life time shower concept as two showers for the price of one.

So, share the news and share the video. Accessibility doesn’t come at the price of attractiveness. It’s possible to have a bathroom that is a pleasure to be in for both its safety and its beauty.

Magic Wand of Accessibility

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Sorry Virginia, there is no magic access wand.

Sometimes we can tell that we are disappointing the person standing in front of us at a health fair or talking to us on the phone. We are simply too responsible to attempt to solve their home accessibility answer without more information and usually without going to their home. Sometimes they’ve given long explanations of what is going on and what isn’t working, and we have listened. But even when they can accurately describe their abilities and what their home looks like, they are only able to give us their perspective of those things. 

While our client’s perspective is critical and plays a huge role in the recommendations we make, they deny themselves the benefit of our objectivity and experience over the years if they ask us to rely solely on their impressions. 

Here are a few reasons why a responsible access consultant won’t just attempt to solve problems for people without a good individual and on-site review:

1. There are accessibility guidelines that some people think can be used like a cookbook for access such as the Americans with Disability Accessibility Act Guidelines, but these are not designed to meet the personal need of every individual and they aren’t required in private residences unless they’ve been incorporated into a building code.

2. Every person is different from others and should be treated individually. Even two people with the same medical condition, same age, same size, and same sex, will have different goals, preferences and abilities.

3. Houses are very different from each other.
In short, there really is no notebook or cookbook that says what is exactly right for every person and we know there is really no such thing as accessibility magic wands so we have to rely on good old evaluation, knowledge about a multitude of options, and the experience to match those options with the individual’s needs. We feel like the best way to solve an access issue is to listen to a person to understand their goals and observe them in the environment they want to change. So if you give us a call with an access question, we really don’t want to disappoint you. Expect a thorough residential access answer to include a visit to you in your residence. 

If you want an objective, professional solution to your residential access problem, call us and set an appointment with one of our designers. We provide in-home assessments with no travel fee in the Greater Omaha, Nebraska area. All other areas in Nebraska and Iowa are possible with a travel fee. We will give you a firm estimate of your costs for consultation when you call to make an appointment.