Mark's Notebook

Activities Of Daily Living

Mary's degree in Occupational Therapy has been a great help to me both in the hospital and during my imprisonment rehabilitation at home. Not only did she know all the right questions to ask while I was still in the hospital, but she knew how to set things up for me at home before I even arrived. Mary's friend Kathleen Brandt, who also has a degree in OT, helped her set up the house to make things easier for me.

Unless you have an elderly or handicapped relative, or yourself have restricted mobility, you probably don't think in great detail about such mundane daily activities as getting into or out of bed, taking a shower, using the toilet, getting dressed, or eating breakfast. But for someone with limited mobility, these can all be trials. They are called "activities of daily living" and they are the staple of occupational therapists.

In my particular case, there is one major physical problem, and two minor ones. The major problem is that I am not allowed to place any weight on my left foot, and ideally I should not even let the left foot rest on the ground. The minor problems are (1) that I cannot bend my left knee very much due to stiffness in the leg muscles above the knee, and (2) I am not allowed to separate my legs very much because this "abduction" exacerbates the problem of the one small piece of bone that could not be re-attached with pins.

Have you ever tried putting on pants when you are not allowed to put both feet on the floor? Have you ever tried putting on socks or tying your shoes when you cannot reach your foot? Have you ever tried getting out of bed without separating your legs, and without pushing with both legs?

From the first day I was in the hospital, occupational therapists and physical therapists worked with me to help me put on socks, put on pants, and use a walker to hobble around. It's not too difficult with aids like sticks and sock pullers, but it could probably be much more difficult for someone older, or who had multiple disabilities, or who had arthritis.

Mary was proactive getting things arranged for me at home. My brother Craig brought some items like a walker, a commode, and a shower chair that my mother and my aunt had used when they were ill. Pastor Eddie of Calvary Chapel San Jose sent a brother who lives near us, Gabriel, to install some aids in our house, and Mary's son Aaron also installed some aids. Here is a list of all the aids I am using or have used:

• Commode. I used this a lot the first three or four days after I got out of the hospital. Mostly because I was too tired to hobble all the way to the bathroom. Mary put it right next to the bed. Kathleen had the idea of putting water in it ahead of time to dilute whatever I might do into it.

• Reacher sticks of various kinds. One has a hook on the end and it is useful for picking up clothes or pulling up pants by the belt loops. Another has a grip and a trigger; it is more useful for picking up books or papers. It can also be used to reach items on the dresser without getting out of bed. There is also a long shoehorn that I haven't really used much until recently.

• Sock puller. This is a clever little invention. It is smooth plastic on one side, and terry cloth on the other. It has two rope handles. You curl it up and place the sock over it, plastic side in, and terry cloth side against the sock. Then you use the rope handles to pull it over your foot. The foot slides against the smooth plastic, but the terry cloth holds the sock firmly and pulls it up.

• Grab bars. Gabriel installed one on the wall opposite the toilet, and Aaron installed one diagonally in the shower. These help me to sit on the toilet or get into the shower while placing weight onto only one leg.

• Raised toilet seat. This makes it easier for me to sit on the toilet because I don't have to lower myself as far to sit, and I don't have to raise myself as far to stand up.

• Shower chair. This lets me sit in the shower, and it also helps me to get into the shower. The details of using it show how difficult it can be do so something as simple as getting into the shower, while not placing the left foot on the floor. Move the chair to one end of the shower. Holding onto the walker, lower my butt onto the chair so that my butt is in the shower but my legs are still out. Put my right leg into the shower. Stand on the right leg, hanging onto the diagonal grab bar. (Left leg is still hanging outside the shower.) Move the chair back a little. Sit down again. Angle the left leg into the shower. To get out, reverse the process, if I can even remember what the process was.

• Walker. I was released from the hospital late Friday night. Fortunately Craig brought an old walker, because the hospital supply did not deliver the new one until Saturday afternoon. I don't know how I would have got into the house if Craig didn't have something I could use temporarily. Mary bought a basket for it, and David Brandt modified the basket to fit the new walker.

Mary made lots of other little accommodations for me. The first day out we bought slippers so I would not have to worry about tying shoes. She also bought me pajamas and new sweats so I could dress in comfortable clothes without a lot of effort. We bought boxer shorts because they are much easier to put on than briefs.

Every day she fills six water bottles that she scatters around the house so I have some in every room. She put all kinds of paper plates, paper bowls, and plastic ware on the kitchen table so I don't have to carry them back and forth from the cabinet. And she put a trash can on the table so I can just throw them away when finished. She bought little cans of fruit so I can eat a snack at the table without rooting through the cabinets or using a can opener.

There are lots of web sites devoted to ADL. Just search for "activities of daily living" using your favorite search engine. My search also showed this commercial site that has photographs of all these kinds of aids:

http://www.disabilityproducts.com/

We did not buy our products from this web site. It just happens to show some good photographs. We bought all our supplies in person from this store located next to San Jose Hospital:

San Jose Medical Market
24 N. 14th St., Suite 140
San Jose, CA 95112
408-280-0416

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Last updated Monday 3 August 2009