Thursday, October 31, 2019

Accessible Travel Tips For Land, Sea, & Air

With the holidays quickly approaching, people will be travelling to visit friends and family from all over the world! Traveling is a wonderful opportunity to broaden your horizons and experience new places, people, and foods. Sometimes, the challenges of traveling with your wheelchair and/or other adaptive devices can put a damper on things. Surprisingly, planning ahead can minimize most of that hassle. Remember: getting there is half the fun! Here are some quick tips to help you get ready for your next adventure! 

Equipment Check-Up

  • Before heading out, it’s important to make sure that your wheelchair, scooter, lift, and accessible vehicle are ready to travel. It’s a great idea to have your equipment serviced before you go. Better to be safe than sorry!
  • Our Accessible Living articles have some great tips for power and manual wheelchair users, including some great service recommendations. Click here to learn more.

Don’t forget us! Our service team at Custom Mobility can make sure that your equipment is in tip-top shape. Before you hit the road, we’d be happy to check your accessible vehicle, lift, and/or wheelchair. Feel free to give us a call at 800-622-5151, or visit https://www.custom-mobility.com/mobility-services to schedule an appointment. Remember, in case there any parts that may be needed to ordered, be sure to perform any maintenance to your equipment at least 3 weeks in advance.

Air Travel
We can all agree that it’s quicker to travel by plane than it is by car. For wheelchair users, flying is a bit more involved than it is for able-bodied passengers. To learn a bit about guidelines for traveling by airplane, click here. Please note that all travelers must be screened. If you need more assistance, feel free to call the TSA helpline, 72 hours ahead of time at: 855-787–2227.


Unfortunately, airplane aisles are too narrow to accommodate manual or power wheelchairs. If you are a wheelchair user, it is probably best to inform the airline that you need an aisle chair. These devices are the perfect size for squeezing into those narrow aisles and can get you to your seat. Since transferring can be difficult, requesting a seat located in the bulkhead and/or a seat with flip up armrest, will make the process so much easier.

Ever get that feeling like you’re forgetting something? Let’s take a few precautions to be sure that nothing from your wheelchair goes missing! By securing anything that could be separated from your wheelchair, such as cushions, footrests, armrests, etc., you’ll be more like to disembark the plane with all of your belongings intact.

For wheelchair users that have therapeutic cushions, taking this item on the plane will make sure that it isn’t lost, and will help to prevent any skin issues from occurring during the flight. 

Not all ground workers are familiar with wheelchairs. Before you head to the airport, be sure to type up instructions for assembling and disassembling your equipment. It’s also a good idea to speak with the crew, and explain how they should handle your wheelchair.

Expect the best, but prepare for the worst. In case something comes loose or needs adjustment, travel with a small tool kit. If you can, it’s always a great idea to travel with spare parts, such as tires, tubes, etc. If you plan to remain at your destination for an extended period of time, these items not readily available in most stores.

Once you make it onto the airplane, it might be difficult or impossible to move about the cabin. Most airline lavatories are extremely small and difficult to maneuver in. To prevent yourself from needing to use the restroom during transit, it’s a great idea to use the restroom before you board the plane.

Getting around once you land
For wheelchair users, hailing a taxi isn’t always an option. If you need an accessible taxi, here is a list of taxi services that offer accessible rides. In selected cities, Uber and Lyft might offer accessible transport.

For those who can drive with low-tech hand controls, some rental cars can be equipped with portable hand controls. Please call and the check availability with each rental car company.  

In case you need a ramp or other accommodations, it’s possible to rent a Wheelchair Accessible Vehicle at your destination. For those coming to the Tampa Bay Area, Custom Mobility has a fleet of accessible vehicles for rent. Just give us a call!  


Road Trips and Accommodations
Staying with family or friends is a great way to save money! If you’re staying at a new location, it’s important to call ahead and ask accessibility-related questions. Don’t forget to ask family and friends to measure entryways, paths, door widths, bathroom space, and bed height. Stairs are like roadblocks for wheelchair users, so be sure to ask if your temporary residence has any. Just in case, it’s always a great idea to purchase a portable ramp and carry it with you. 

For the more adventurous at heart, staying at a hotel is always an option. Proper planning includes making a reservation for an accessible room. A hotel with 200 rooms is required to have eight rooms with accessible bathrooms. Of those, only two are required to have a roll-in shower. Smaller hotels, which have less than 50 rooms, are not required to provide roll-in showers. Remember, planning is key!

Accessible bathrooms typically consist of a bathtub and a bench. This accommodation typically which doesn’t work for those who use a roll-in shower chair. Calling ahead can help you to figure out whether the hotel has accessible bathrooms and, if so, which type they are. For the adventurous at heart who travel often, it might be a good idea to purchase a portable, roll-in shower chair. 

Room size matters too, especially because a wheelchair can take up a lot of space. A suite is often a good idea and might be a good alternative for those occasions when accessible rooms aren’t available. These are better than standard rooms because they offer more space and more bedding options, which is especially great for those traveling with companion. 

When traveling internationally, it’s easy to forget that ADA guidelines are not applicable. Before adventuring to other parts of the world, take special care to research accessibility items such as: curb cuts, steps, door width, elevators, and accessible bathrooms. 

Travel by an accessible RV can be another fun way to hit the road. What’s better, is that you only need to unpack once! Information outlined above, regarding accessible bathroom space and bedding, also applies when renting an accessible RV.

Cruising
Online research is a great way to learn about various cruise lines. Be sure to type “special needs“ or “accessibility” into the search bar, and call the company if you have additional questions. 

Be sure to check their policies on accessibility, especially if you plan to travel alone. 

Travel agents, especially ones that specialize in travel for people with disabilities, can be an incredible resource. These individuals are extremely familiar with the ships, port access, and accessible excursions. They can even arrange for pre- and post-cruise accessible hotel rooms. 

Cruise travelers who have disabilities, may need things that most people don’t consider. Click here to learn about nine of the best cruise lines for people with disabilities.

Wherever you go, enjoy the ride! By taking the proper precautions and preparing for every possibility, you can finally relax and have fun! Life is too short not to. Here’s to wishing you safe travels!

Author:
Mary Carol Peterson

Thursday, October 17, 2019

Smart Home, Practical Home

The Google Home and the Amazon Echo have become staples of the modern house, and can be even more integral to the functionality of Smart Home technology. For people with disabilities, it can be extremely powerful to control the home environment through either voice control or the touch of a button. As a quad-amputee and a power wheelchair user, I’ve taken full advantage of this technology. Let me tell you how some of these devices work and how they’ve helped me become more independent.

To get started, you need to figure out what to purchase. Ask yourself: "What am I trying to accomplish?" There are a multitude of products out there, so I would recommend starting small. As a wheelchair user, maybe there is a lamp that you have difficulty reaching. I know that I’ve certainly been there. Smart Home devices can assist you with either turning that pesky lamp on or turning it off, without straining yourself. If you can operate a smartphone or tablet, you can use Smart Home technology control that lamp, or any other lamp in your house. If you have the use of your voice, and experience difficulty using a smart device, you can even use a Google Home or Amazon Echo product to operate your Smart Home devices.


Either way, every product will require you to download some kind of app. Some will require you to purchase a hub, like Samsung’s SmartThings Hub, which can control a wide variety of products, made by a variety of manufacturers. This list includes: Philips Hue, Sylvania, Cree, Leviton, and IKEA, to name a few. These devices range from motion sensors, to lamps, to fans, to in-wall switches, to thermostats, and to even TV’s. All of these devices are operated through the SmartThings app. Some products, such as the Kasa Smart Wi-Fi LED Light Bulb by TP-Link, don’t require the purchase of a hub. If you plan to add more devices to your Smart Home, I’d highly recommend that your purchase a product like the SmartThings Hub. If you only want to control a few lamps, and don't think that you'll use a variety of Smart Home equipment, hubless light bulbs may be the way to go. Either way, you can't go wrong.


I actually use Smart Home technology in my room, and marvel at the amount of independence that it has given me. Through my Google Home Mini and my Samsung SmartThings Hub, I can operate everything in my room. With my voice, I can control the Leviton in-wall switches, which operate the fan and the bathroom lights. Two lamps are plugged into Leviton Lumina RF Plug-in Dimmers.


All of these switches can be dimmed to my liking. I even use a few devices in unconventional ways. Before I owned Smart Home technology, I needed assistance charging my wheelchair. Now, I’ve plugged my charger into a Leviton Appliance Module, and even have it on a schedule so that it turns on and off at specific times.
Because it’s easy to over- or under-charge wheelchair batteries, this addition has been priceless. Power wheelchair users, take particular note of this product. Additionally, the light for my saltwater aquarium is controlled via a Plug-In Module, and is also set on a timer.


Let my bedroom function as an example of what you can achieve through Smart Home products. In fact, this example merely scratches the surface of the technology’s potential. There are a number of additional devices that can be operated with Smart Home technology, including: air conditioners, blinds, alarm systems, cameras, and even doorbells. All of these products may even be linked to motion sensors, meaning that you would neither need to use an app nor a Google Home or Amazon Echo, to turn them on or off. Smart Home technology could be that one thing, which you never knew that you needed.

Author:
Kyle Romano

What Is An Accessible Vehicle?

Before I even had the desire to drive, my family had a van with a lift. Because of my experiences, I just assumed that I'd always need a chauffeur. After all, how could somebody reach the petals, if they didn't have legs? Whenever I would attend school or physical therapy, all of the other kids would arrive in either buses, or vans that were similar to my own. That's just how things were, and I didn't pay much attention to the idea.

As I reached the age of sixteen, like every other teenager, I started to foster a desire to drive. As a quad-amputee, that entire process would become very complicated, very quickly. I had briefly heard about adaptive driving devices, but had never seen any. Before I graduated high school, I began to work with a counselor from Vocational Rehabilitation. A few years, and a couple counselors later, I was finally approved for driver's training; however, to complete it, I needed my own vehicle.

In a number of these blog posts, I've stated that I'm very happy to live in this day and age. With the advancement of technology, has come increased opportunities and access for people with disabilities. When speaking about mobility vehicles, the availability of reliable solutions has drastically increased. With that, the National Mobility Equipment Dealers Association (NMEDA) stepped in to ensure and certify the quality of mobility vehicles. This approach prevents people from purchasing vehicles with sub-par conversions, and includes warranties that exist alongside manufacturer warranties. As an extension, twenty-four hour, emergency service is also provided.

Now, to the big question: with all of the available options, how do you decide which mobility vehicle will suit your needs? Firstly, anybody in the market for a mobility vehicle should only purchase from an NMEDA certified dealer. Though the first mobility vehicles were vans and mini-vans, trucks and SUV's can now be converted into mobility vehicles.

There are now a number of mobility vehicles to choose from. How do you know which one is the best for you? Many factors of daily living will impact your decision, including: the ages of you and your family, the height and size of wheel chairs and their users, the average amount of passengers and cargo, and the most frequent parking situation for you, including home parking and garage layout.


These considerations will further impact the type of modification that your vehicle needs, which include either side- or rear-entry. One choice is not better than the other; however, your lifestyle will impact the choice that you make. Side-entry vans will grant the wheel chair user access to the middle and front of the vehicle, meaning that they can either ride in the passenger position, or possibly drive the vehicle, themselves. This conversion isn't recommended for individuals who do not have adequate room to load and unload from the side of their vehicle. Rear-entry entry grants the wheel chair user access to the rear and middle of the vehicle, but won't allow the user to ride in either the driver or passenger positions. This conversion is typically recommended for wheel chair users who will not be positioned in the front of the vehicle, and for people who have limited room from loading and unloading from the vehicle.

Additionally, assistive driving devices are available for individuals who experience physical limitations, preventing them from driving a vehicle in a conventional fashion.

Check our inventory for more information about the accessible vehicles that are available for purchase.

Click here to check out Braun Ability's top ten considerations for buying a mobility vehicle.


Author:
Kyle Romano

Staying On Budget, And Finding Affordable Options For Accessible Vehicles

Whether you are a parent of a special needs’ child, or an adult with changing abilities, our needs constantly vary. Since this process can be difficult and scary, we’re here to offer you some guidance. Purchasing your first, accessible vehicle may be intimidating; however, it doesn’t have to be! The following tips are designed to steer you through this process, no pun intended.

The first and most important step, is to find an accessible vehicle consultant or specialist. This person will guide you through the entire process, and help you figure out your best options. Depending on your stage of life, and the age of your children, you may have specific needs. The right choice should be cost-effective at the present, and continue to save you money in the future. This step might seem daunting, but finding the right vehicle is more affordable than you think.
Transportation Considerations For Parents

As a parent of a child with special needs, finding a transportation solution can be one of the most polarizing problems. As your child grows and his/her world expands, there are four, primary life stages to plan for. When shopping for the right vehicle, always think about the future. When your child is young, he/she will grow, eventually needing a larger and heavier wheelchair. Naturally, this means that he/she will need more space. To ensure that you get the most out of your investment, it’s key to limit the number of tweaks to any, adaptive equipment. This foresight will save you time and money. By planning, your consultant can often skip some steps. This step is so important because it will ultimately save you money.

As their children grow, most people follow this path of vehicle ownership:

  • Young Child: Car or SUV
  • Child: Large SUV or Minivan (unmodified)
  • Pre-teen: Van with Hitch or Turney seat
  • Teen/Young Adult: Accessible Van with a built-in ramp

Young Childhood

Since young children are small, people often continue to use their original vehicles. As they grow, a large percentage of children with disabilities will likely use custom wheelchairs. Whether they use power or manual wheelchairs, these devices require more space. Additionally, these wheelchairs may have adaptive features, which are needed for optimum seating and positioning. If that’s the case, these wheelchairs will be larger in size.

Your child’s therapists’ may also recommend special, adaptive walkers, and/or bath chairs. Due to health-related needs, this equipment will need to accompany your child on vacations and family trips. Finding space for, and transporting this equipment, can be tricky. It can be especially challenging if there are other children in your family; however, before jumping to a larger vehicle, consider the next stages of your child’s life. Some vehicles can be adapted as your child grows, whereas some can’t. For this reason, it’s extremely important to work with an accessible vehicle consultant or specialist. That way, you can make an educated decision, regarding your current and future needs.


Childhood

A growing child takes up an increasing amount of space, and may require a minivan or large SUV to accommodate their changing needs. The medical equipment your child needs may become larger and heavier. Most parents will have the body strength and flexibility to transport this equipment without modifying their vehicle with special hitch, ramp, or lift; however, you’ll want to pause and think about this decision.

Now, your child’s world is expanding with school, after-school activities, play dates, and other, fun outings! You are both getting older. With increased age, comes the risk of back injury and other, overuse syndromes. These maladies could be hazardous to your health, and could even affect your family’s wellbeing. Positive attitudes in the home environment cannot be overstated, which requires everybody remain healthy!

Consider the number of times per day that you will be lifting and bending to assist your child. How many times per week? In addition to lifting your child in and out of the vehicle, by transporting his/her custom manual wheelchair, you put excess strain on your body. What does this mean? Each time that you and your child get in and out of the vehicle, you may have to disassemble or assemble the wheelchair. If a clinician deems that your child is most-suited for a power wheelchair, then a built-in ramp would make it easier to load and unload from your vehicle. These ramps, or even lifts, are among the most popular choices of mobility transportation. Again, it is important to explore your options with an accessible vehicle specialist.

Pre-teen years

During this age, most parents will either add a power lift or built-in ramp to their vehicle. At this point, your child’s equipment will too cumbersome and heavy to lift; therefore, you will run a higher risk of sustaining injury. If you have already purchased a van or SUV, and it can’t be modified, a replacement vehicle will be your only option. Again, planning ahead can help determine the best time to make such a purchase, which will best-fit your current and future budget. Ensuring that you get the most out of your investment is key. By limiting the number of necessary tweaks, you’ll ultimately save more time and money.

Teen/Young Adult Years

Since your child is nearing adulthood, most families consider purchasing a van with a built-in ramp. This option allows for easy on and off loading.

Other Things To Consider:

If You Are Looking To Upgrade Your Ride For Yourself Or A Family Member

Since their humble beginnings, wheelchair accessible vehicles have come a long way. Technology is constantly improving, and accessible vehicles are no exception. For individuals and families living with disabilities, they have quickly become powerful and reliable pieces of equipment. Having access to your community is so important for maintaining independence and a high quality-of-life.

Key things to remember when it’s time to shop:

1. Your Family’s Size

When shopping for a new or used accessible vehicle, one of the most important factors to consider is the overall size of your family. For example, a larger family of five or more children, would need a lot of space. So much, in fact, that they would require a full-size van. The smaller your family, the more likely you are to consider an adapted minivan. Do not forget to compensate for extra guests, caretakers, or friends you may need to accommodate.

2. Your Or Loved One’s Health Condition
Barring the size of the wheelchair, you’ll also need to consider health conditions. Depending on the severity, certain health equipment may always need to travel with you. A rear-entry vehicle may make it easier to load and unload equipment. Compared to side-entry vans, rear-entry removes the need to maneuver wheelchairs and other equipment. With these vehicles, everything rolls into position from the back of the van.

Aside from wheelchair size and additional equipment, knowing your family size and daily lifestyle can affect your choice of vehicle.

If you or a family member use a powered scooter for mobility, there are many lift options that can be added to your vehicle. While in the community or on vacation, these lifts can help you maintain your active lifestyle!

If it is difficult to enter or exit either the driver’s or passenger’s seat, there are adaptive vehicle seats. These chairs swivel and lower for easy and safe transfers in and out of your vehicle, for you or your loved one, too!
3. Finding the right accessible vehicle consultant

Today, accessible vehicles have a number of options. Custom Mobility is a NMEDA Quality Assurance Program dealer. Dealers like us can help answer your questions and confirm you are getting the best solution for your family. Custom Mobility has dedicated and experienced, accessible vehicle specialists. They are always happy to answer your questions, and guide you through the decision process.

The National Mobility Equipment Dealers Association (NMEDA) is an advocate for mobility and accessibility for drivers with disabilities.

Finding and buying a wheelchair-accessible vehicle can’t be rushed. This purchase can potentially redefine your daily experiences, your health, your child’s independence, and the lives of those around you. For these reasons, it’s critical to learn the right, and best, way to shop for a mobility vehicle.

Take this short quiz from BraunAbility to narrow down this process!

At Custom Mobility, we are more than happy to find the perfect vehicle for you.

Author:
Mary Carol Peterson

Wednesday, October 16, 2019

Mobility Products and VA Benefits:How To Get Help

If you are a veteran and were injured during a conflict, or if you are getting older and have trouble getting around, you may be eligible for help from the Veteran’s Administration. To get help for new equipment, here’s how it works:

  1. First, start by making an appointment with your primary care physician, at your local VA Center. He/she will refer you to a VA clinician, who will determine the kind of mobility device you qualify for. This decision is based on an evaluation of your mobility needs.
  2. After the equipment evaluation is complete, the clinician will research mobility products. He/she will then determine the most appropriate option for you. His/her choices will maximize your independence, and will be discussed with you. Many times, the clinician will work with a manufacturer’s representative, who has products that are available for you to try at a wheelchair clinic.
  3. Once the decision is made, the equipment will be ordered. This entire process could take between 3-6 months.
  4. After the equipment is received, you will recieve instructions on proper use of the equipment. Afterward, you’ll return to the VA for any additional, follow-up care. In the Tampa Bay Area, the VA will ask Custom Mobility to deliver the product to you. At this time, we’ll send one of our specialists, who will complete the delivery and demonstrate the set-up process.

What mobility equipment is typically covered?
In most cases, the VA will either give you a wheelchair or a power scooter. There are some instances where you might be entitled to a VA grant that will cover other equipment. This includes a lift for your car, so that you can transport your wheelchair or scooter. If a lift is recommended for you, the Prosthetics Department will order it, and refer the installation to a qualified contractor. Custom Mobility is a local, installation contractor for the Tampa Bay Area, and can complete the work in about two hours. After we have completed the installation process, we’ll provide instruction on using your new lift.

In some situations, an adaptive vehicle may also be considered. Once you have received this kind of grant, driving rehab. programs will train and get you accustomed to entering, exiting, and driving your vehicle. To increase your safety and independence at home , modification grants may also be available. These grants could cover: adding a ramp, widening interior doorways, and/or installing grab bars in the bathroom. All of these examples can make a huge difference to your life. Veterans, who meet these qualifications, may receive as much as $60,000 to make their homes more accessible.

How is the product serviced and/or repaired after delivery?

If you need repairs, parts, and/or service for your equipment, the process is similar. First, you would call your primary care physician, who will write a script for a consult. If you are local to the Tampa Bay Area, a Custom Mobility representative can evaluate your equipment. If you specifically request this service,we can send a quote to the VA for authorization . Why? Custom Mobility has a full-service team of on- staff, repair experts , a full inventory of parts, and a designated work area, to complete the work in a timely manner.

To obtain mobility equipment, financial assistance can be challenging to figure out. Here are some additional resources to help you along this journey:



Author:
Mary Carol Peterson

Exploring the Stables: A Day At Quantum Leap Farm

As a soon-to-be physical therapy student, I have always been interested in hippotherapy, which uses horses as a unique form of physical therapy and rehabilitation. Recently, I got the chance to visit Quantum Leap Farm, a therapeutic riding center in Odessa, FL. Here, people with disabilities, and of all ages, can come and reap the benefits that horseback riding has on the mind and the body. After watching my friend Bryanna, during her therapeutic riding session, I was able to interview the director and founder of the company, Edie Dopking. From her, I learned a bit more about this form of riding, and what it is all about.

Unlike most horse farms, which specialize in pediatrics, Quantum Leap Farm has a wide variety of clientele. For founder and executive director, Edie Dopking, Veterans are among the original population of interest . Because multiple members of Dopking’s family are affiliated with military, this was a huge population of interest. When asked why she started this company, she went on to describe her background in horse riding, and work at similar therapeutic riding companies. When working with other farms, she questioned why the benefits of horse riding were only geared towards children. By starting her own non- profit organization, she decided to branch out to a larger population. In addition to serving a larger variety of demographics, Edie Dopking also went on to explain the larger variety of services and programs, offered at Quantum Leap Farm.

The services offered at Quantum Leap Farm vary, based on your interests and goals. Therapeutic riding focuses on horsemanship, learning riding skills, and disciplines. Hippotherapy is a form of physical, occupational, or speech therapy, that uses the movements of a horse to improve a client’s mobility and functionality. Unlike therapeutic riding, hippotherapy focuses more directly on the physical needs of the client, and is recommended, or referred, by a PT, OT, or speech therapist. In addition to physical, therapeutic benefits, Quantum Leap Farm offers specific services, geared toward mental health. For instance, the program At E.A.S.E stands for: Equine Assisted Self Exploration. From company retreats, to bolstering the recovery of traumatic injury in our veteran population,, to family therapy sessions, these services allow a wide-variety of people to find themselves, while finding a love for horses.

The health benefits of riding also vary based on the service in question. Each session and service is tailored to the needs of a specific client, similar to that of physical and occupational therapy. Among other benefits, therapeutic riding focuses on improving balance, coordination, self-confidence, and stamina . Depending on the specific needs of each client, Hippotherapy can improve muscular strength and endurance, posture, range of motion, proprioception, and much more.

When discussing the medical benefits of therapy, it is nearly impossible to leave out the mental and social benefits that come with it. Therapy is multifaceted, and although health professionals are quick to focus on numbers and physical changes, the mental and social benefits can be just as influential. Those that ride here, don’t simply develop a deep connection with their horse; additionally, they build a meaningful connection with the community of people that come out to ride!

Want to learn more about therapeutic riding and hippotherapy?

Click here to visit Quantum Leap Farm’s website.


Click here to learn more about the benefits of riding.

Author:
Kailee Sylvester

Park It! Seat Cushions and Your Health

When somebody mentions a seat cushion to you, what are the first thoughts that run through your mind? I imagine that most people think of comfort, right? While comfort is important, wheelchair users and their physicians need to consider much more. Let’s explore the importance of choosing the proper seat cushion.

There is a large range of seat cushions, all meant to serve a wide variety of populations. How complex can it really get? It’s easy to forget that wheelchair users don’t merely “sit” on these devices. We live on them.

So, how do you determine the “right” seat cushion? That decision isn’t made by a single person; instead, you decide on a solution with your therapist or Assistive Technology Professional (ATP). Since your needs are unique to you, your therapist or ATP will need to consider a variety of factors, including: activity level, habits, nature of limitation and condition, practicality, age, diet, and hygiene care. For additional information regarding the importance of seating, take a look at this blog post: https://www.custom-mobility.com/blog/take-a-seat.


For wheelchair users, there are four, main types of seat cushions: foam, gel, air, and fluid. Each of these solutions can be drastically different, and may offer solutions for particular populations of users.

Chances are that, if you’ve seen a wheelchair cushion, it was made of foam. Therapists and ATP’s like these cushions because they tend to be less expensive, less complex, and lightweight. Foam is perfect for offering a stable, seating surface. Often, these cushions are practical solutions for individuals don’t require much intervention in the realm of seating and positioning. They usually have have the same level of density throughout the entire surface area. Foam cushions also rest on a contoured base and offer multiple levels of foam, with a variety of firmness levels.These cushions are common amongst manual wheelchair users, who often transfer from their wheelchairs to: cars, other chairs, and even the floor.



I actually use a gel cushion, which is made from a more compact material than foam cushions. This variety offers a nice, malleable surface for pressure points to rest. Sitting on top of the gel reduces shearing forces and cools the skin. While the gel is malleable, the inner material doesn’t move around as well as the filling of fluid cushions. I’m pretty active and transfer from my wheelchair a number of times throughout the day. In my particular case, I required a solution that would allow me to remain active, but needed more support than a foam cushion could provide.



Air cushions fit a very specific need. While they are the most unstable variety of seat cushion, they do offer low-impact pressure relief. What’s nice about air cushions, is that they tout an adjustable level of firmness. This quality can be great if the user’s needs change, in relation to seating and positioning; however, their upkeep may be a little more involved. It might be more difficult to maintain air pressure. They are also susceptible to puncturing, which can deflate the cells in the cushion, and leave the individual without pressure relief.

Fluid-based cushions are widely used, and are often confused for their gel counterparts. They don’t require the level of maintenance necessary to maintain air cushions. When it comes to relieving pressure areas, fluid cushion are as efficient as air cushions. While the user sits on top of gel, they are enveloped by fluid. This feature is perfect for individuals that need to be immersed in their cushions, which offers a unique form of supporting the body.

To get the longest life out of your seat cushions, which is usually about two years, maintaining them is vitally important. Your cushion will last longer if it is kept away from fluids, which can be even easier if you use an incontinence cover. For those who use foam, gel, and fluid cushions, it’s a great idea to perform a regular check for tears, rips, or any, other kind of wear. For people who use air cushions, it’s probably a good idea to make daily check of the air pressure.
At first, this information may be a lot to take in. Over time, this knowledge will certainly become second nature. If you are experiencing any difficulty concerning your seat cushion, or if you have general questions, please feel free to give us a call at: (727) 539-8119.











Author:
Kyle Romano


From Wheelchair To Accessible Vehicle

A picture of three boys, standing shoulder-to-shoulder. The middle child is a power wheelchair userAt Custom Mobility, we serve a diverse population of wheelchair users. A large portion of our customers are from the pediatric side. It is common for us to provide a person with her/his first wheelchair, and to continue serving that client for her/his entire life. So, how does this process start, and where does it end? At what point, during this process, should you consider an accessible vehicle? The easy answer to these questions, is that it’s different for every person.

When I was three years old, Custom Mobility put me in my first, power wheelchair. That was twenty-seven years ago. Since then, our company has garnered a great deal of understanding about wheelchair fittings and positionings. When fitting somebody for a wheelchair, whether she/he is a new or returning client, or whether she/he is seeking a power or manual chair, everything begins with an evaluation. At this stage, either a Physical or Occupational Therapist, and a member of our sales team, meet to determine the needs of the wheelchair user. A physician must then write a prescription for the necessary equipment, which is submitted to funding sources, such as insurance companies, Medicaid, and/or Medicare. They either issue an approval or denial, based on their own criteria, justifying the cost of the equipment as “medically necessary” to the individual.

Once an individual is properly seated in a wheelchair, life begins to change. Family members and friends must adjust to a new lifestyle. Wheelchairs present many opportunities to new users, including an increased ability to explore the world, as well as positive health benefits; however, if you don’t have an accessible vehicle, many obstacles will begin to pop up. How will you get your son to a doctor’s appointment? How will you take your daughter to school? How will you take your children to social events? It’ll either be difficult or impossible to accomplish these tasks, without access to an accessible vehicle.

A picture of two boys, playing with a basketball in a yard. An able-bodied boy is on the right, wearing a red shirt, tossing the orange and white basketball to another boy using a manual wheelchair.Since it can be cumbersome to receive funding for a wheelchair, most people assume that they can’t afford an accessible vehicle, and give up before starting to explore their options. When purchasing an accessible vehicle, there are a few ways to reduce its cost. Firstly, pre-owned, accessible vehicles are available. The price is significantly lower, than if you were to purchase it, outright. Manual entries present low-cost options. While these vehicles require a person to manually open the accessible door, and physically unfold the ramp, the cost is significantly lower.
A BraunAbility SUV, with its rear, passenger door ajar, and its ramp deployed. In the background are a number of mountains, covered in green trees.
Accessible vehicles become necessary because, over time, wheelchair users grow. As the person grows, there are significant concerns, regarding the health and safety of caregivers and parents. The heavier an individual gets, the more difficult it gets to perform a safe transfer from wheelchair-to-vehicle. It becomes significantly more likely for the parent or caregiver to sustain a transfer-related injury. Once this happens, the wheelchair user is less likely leave the house on a regular basis, which can lead to a sedentary lifestyle for both the wheelchair user and family/caregiver(s).

Author:
Kyle Romano

Driving With A Disability

An image of a vehicle and high tech, adaptive driving solutions. Behind the steering wheel, a joystick is located on the left side and a throttle mechanism is located on the rightThe front doorbell rings, and I already know who's there. I rush to answer it. In my haste, my arm slips on the dark surface of my wheelchair's joystick and - WHACK! Before I can slow down, the wheelchair's seat smacks into the door.

"One second!" I yell at the surface of the whitewashed wood. Leaning forward, I reach upward with my neck, and begin to turn the key with my chin. As the lock pops open, I use my left arm to turn the door handle, and open the portal to the outside world. Today, is the first day of the rest of my life, a new beginning, the day that I meet my destiny, or whichever cliché I should use. I take a breath, and say "Hi" to my driving instructor.

When we accomplish milestones, or have profound experiences, those memories usually latch themselves to our brains. We can remember exactly what we tasted, what we saw, what we smelled, what we felt. Every sensation is as clear as the moment that we experienced them. The short account above, shows how I felt, before driving for the first time.

I guess that most people start driving around the ages of fifteen or sixteen. Well, at least that's the way it works in Florida. Though most teenagers count down the days until they get their licenses, I didn't. All of my friends started to drive. Even my brother, who is a few years younger than I, bought his first car when he was sixteen. Here I was, at eighteen years old, without a car. And I didn't care.

Looking back, it bothers me that I was so apathetic about driving. As a quad-amputee, and as a power wheelchair user, I kind of assumed that I'd always need a chauffeur. I had never known another wheelchair user, who could drive a car. Even if I had, I couldn't wrap my mind around my own ability to drive. I'd ask myself: "How does a car work?" I figured: "With a steering wheel, a gas pedal, and a brake pedal." The next thought that jumped into my mind, was: "How am I supposed to use a steering wheel, a gas pedal, and a brake pedal, without hands or feet?" Judging by my peers, I should've been ecstatic about driving; instead, every time I thought about it, negative musings about my limitations would begin to creep into my mind. At first, it would leave me feeling depressed. Before long, I felt nothing.
A silver mini van with a ramp that has deployed onto a brown surface, inlaid with pebbles. The image is a close-up of the ramp, taken from the ground.
At the end of my senior year in high school, that started to change. In preparation for college, I began meeting with Vocational Rehabilitation. That was the first time that I learned about electronic controls, and how they can be used to operate a vehicle. This moment was pivotal for me, because I started to get excited. Who cares that I was twenty-one, instead of sixteen. The cliché, "Better late than never," seemed apropo.

Before getting the opportunity to drive, I graduated high school. I started attending community college, and quickly realized how limited I was. Without a mode of independent transportation, I felt isolated. Firstly, I was a college student, who was driven to class by his mom. Secondly, college students often hang out after class, form after-hours study groups, and engage in other, school-related activities. The former, left me feeling too dependent and childish. The ladder, because my parents had work, and because my brother was still in high school, quickly became a logistical nightmare.

A black, Toyota Sienna Braun Rampvan. It's rear passenger door is opened, and its ramp deployed.After an arduous process, everything finally started to work. I was approved for driver's training, did an initial assessment with a driving coach, and purchased a minivan. Upon the conclusion of some initial testing, my instructor ordered the appropriate devices, which were then installed in my vehicle. Before I could even get my license, I was required to complete about twenty to thirty hours of training. Though the devices were easy for me to use, they took a bit of time to get used to.

So, what does the vehicle actually look like? Well, I drive a 2016 Toyota Sienna, which has a Braun® conversion. With a power, foldout ramp, as well as dropped floor, I can independently enter and exit my vehicle. A back-up camera makes it easier to see behind my van, and prevents me from straining my neck.

A Q'Straint wheelchair securement systemSince I'm a quad-amputee, and my limbs are so short, I use an EZ Lock to secure my wheelchair. By grabbing a pin located on the undercarriage of my wheelchair, the EZ Lock will hold my chair in place. What's even better, is that it doesn't need to be fastened by straps or tie-downs, which means that I can do it, independently. To lock my chair, all I need to do is drive over the device, which will grab the pin. A button on the ceiling will release it.

After fastening my chair, I transfer onto a table. I walk on the transfer table and hop into the captain's chair. On its headrest, are three buttons. By pressing the ones on the left and right, the chair will turn around, and bring me closer to the driving controls.

A captains chair, rotated about 120 degrees, butting up to a transfer table
To drive, I use a few products, made by a company called EMC. For gas and break, I have what's called an L-Series controller. Pushing the device forward, will give the vehicle gas, while pulling backward will apply the break. To steer, I have an X-Series controller. It will steer the vehicle either left or right, by pushing the joystick in the respective directions. The button in the center of the headrest, operates a device called a DigiTone. If the button is pressed and held, it will emit a series of eight notes, which are a musical octave. Each note corresponds to a specific function. For example, I use the DigiTone to use the following functions, in order: left turn signal, right turn signal, dimmer switch, horn, windshield wipers, etc. I also have a VIC, or Voice InterActive Controls, which will let me use my voice to utilize any of the aforementioned functions. I have it as a back-up, in case the DigiTone ever fails.

I've tried to be concise in conveying this information. The system that I use to drive is pretty complicated, so takes a bit of time to do so. While it's easy to be star-struck by all of the buttons, levers, and joysticks, there's an oversight that's easy to make. The fact that I can drive, at all, seems a miracle, in-and-of-itself. As I stated at the beginning of this post, I had always assumed that I couldn't.

Before we say goodbye, let's work through a few, key points. This equipment is expensive. In fact, it's very expensive. Unlike most, other products, Assistive Technology is considered to be medical-grade. In terms of quality, products must meet a number of different requirements, and/or have a variety of certifications, before they can be sold. It can be expensive for manufacturers to get these certifications. To make a long story short, this process drives up the cost for consumers.

Assistive Technology falls into an odd category, because it... well, assists people with disabilities. It helps us do things, or accomplish tasks, which would otherwise be impossible. Statistically speaking, people with disabilities are amongst the most impoverished people, in the world. Some of us need AT to lead happy, healthy, and productive lives; however, since it can be very expensive, how can many people with disabilities afford it? Assistive driving controls seem to be an extreme example, but are they, really? What's the alternative to driving? If you live in a city with a bad, public transit system, it means stagnating, remaining unproductive, being confined to your home.

For more information about BraunAbility® vehicles, which we have available for purchase, click here to take a look at our inventory.

For more information on Vocational Rehabilitation and their services, click here.

For more information regarding Electronic Mobility Controls, and their devices, click here.

Stock photo courtesy of BraunAbility®

Author:
Kyle Romano

Thursday, October 10, 2019

Combining Riding Perspectives

An image of a young woman, who is wearing a blue helmet and riding a white horse. They traverse a sandy floor, within a covered riding area, followed by a lady.When discussing therapeutic riding, or just therapy in general, it’s hard to talk about medical benefits without talking about mental and social benefits. Based on their experiences, people have different perspectives on disability. As a result, people focus on certain aspects of disability more than others. In this way, health professionals, or future health professionals, like myself, tend to focus on the numbers. We tend to favor this kind of data, because they are physical changes that we can see and record. We tend to favor this kind of data, because they are physical changes that we can see and record. On the other hand, the riders aren’t worried about a 2% increase in range of motion. These individuals are more interested in their new abilities, and how they change their: feelings, interactions, and perspectives. Disability isn’t something that can be viewed as purely medical, or purely mental. In reality, it is a bit of both.
A woman is shown in blue, standing next to a dark horse with white legs, holding the reigns
Arriving at a place like Quantum Leap Farm, you can expect to deal with a few dirt and gravel roads. When you pull in, you see everyone getting ready in the stables. If you happen to get there a little early, you may be able to go over to the stables to hang out with the horses. One of the riders, Bryanna, says that it is “a great way to get your mind in the right place. Connecting with the horses allows you to focus an disconnect from the stress of the outside world.” Once your horse is chosen based on their experience and temperament, and the horses are ready to go, they will be lead out of their stables, and into the covered arena. There, you get to ride.


Two, brown saddles are shown next to each other
Each horse is “tacked up” based on the riders ability and needs. For example there are two main types of saddles: western and english. The western saddles (pictured left) have what is called a horn, which allows you to hold on if you need to. English saddles (pictured right) are your traditional saddle, and are used by people that can fully support themselves. Some people will use a surcingle, which is basically a pad with handles, to get more contact with the horse for a more challenging ride and a better stretch. As far as reins are concerned, most people either use a bridal, or snap reins, depending on their ability to control themselves and the horse.
A woman is receiving assistance to transfer from her wheelchair onto a horse's saddle. Two people are standing next to the horse, watching the transfer, while another person watches in the foreground
Once they have the saddle and reins they need, instructors will help you mount the horse. Depending on your level of experience, or how comfortable you are with the horse, this process can vary. As shown, some use a lift, while others may use a type of stepping stool to give them a bit of a boost.

The rider, wearing a pink shirt and blue helmet, is standing on a transfer platform to the left of the horse. She is bending over and resting a hand on the horse's neck. An individual is assisting her, standing next to her on the platform. Another individual is looking up at them, from the ground belowAfter you are on your horse, to get comfortable with the horse, and to help you learn the basics of riding, you start by taking a few laps around the arena. Whether it be to learn or master a new skill, work on core strength, practice a new pace, or more, every session has a bit of a different focus. Some lessons will also be done in groups, where riders cans play games or do other activities together. One of Bryanna’s favorite group activities was creating synchronized routines, almost like dancing! Within that hour-long session, you could end up doing obstacle courses, practicing different riding positions, going from a walk to a trot, or stretching, and doing upper-body exercises while riding. Each session is what you make of it, and like that of most therapies, it is molded to your wants and needs. Feel free to speak up!

Posters that describe events happening on the farm.This farm has created a riding community. I emphasize the word “community” for a reason. Riding brings people together, allowing the able-bodied to interact with people with disabilities. It also allows people with disabilities to meet and network, with other people who have disabilities.
Bryanna rides a white horse with light grey spots. It's being led by somebody outside of the picture's frameWhen talking to Bryanna, she said: “In considering my own experience, coming to the farm was the first time I had really interacted and with and formed relationships with people facing similar struggles to myself. In addition to this, we connected further because we shared a mutual love for the horses and the programs that help us to achieve so much. The staff which work at the farm are also incredibly supportive towards all the participants. They always encourage us to do our best and not to focus too much on our mistakes because every rider makes them regardless of ability. It is comforting to have their support and I think of everyone at the farm as my second family.”

Click here to get involved and learn more about Quantum Leap Farm.
Find Quantum Leap Farm on Facebook
Click here to learn more about therapeutic riding and the Professional Association of Therapeutic Horsemanship
Click here to learn more about hippotherapy through the American Hippotherapy Association at 

Images courtesy of: https://www.equisearch.com/articles/english-vs-western-riding-17557

Author:
Bryanna Tanase
On the left of the frame, a brown horse looks at the camera. On the right of the frame, Bryanna extends a hand toward the horses face, kissing him on the nose