Even a small threshold can be a challenge to get over when you’re in a wheelchair, especially with small front casters. A threshold ramp makes the transition a smooth and easy one.
Ramps require less “oomph” and can prevent tripping when using a rollator or walker around the house.
You can either try to build your own ramp or buy a read-made rubber threshold ramp. The rubber ramp can be cut to fit almost any doorway, and it stands up well in harsh outdoor conditions.
Aluminum threshold ramps are also available, at a lower cost than rubber ramps.
Whichever threshold ramp you choose, it should be long enough to make it easy to get over. An abrupt incline is tough to navigate, especially for a wheelchair user with weak arms.
The slope of the threshold ramp should be about 1:12 (1″ height increase per 12 inches of length). For users with more arm strength and for thresholds with less room, the slope can be up to 2:12.
Follow the manufacturer’s instructions to install the threshold ramp. Aluminum ramps are either self-supporting or they need to be secured to the top of the threshold. Rubber threshold ramps can be field fitted with simple cutting tools to fit almost any doorway.
Lifting a wheelchair into a vehicle can be heavy work, but a lightweight wheelchair or an ultralight transport chair will make the job easier. Below are some tips on how to load your wheelchair into the trunk of a car or load into a van with a wheelchair ramp.
Frank Fuerst cared for his wife, June, for 17 years after her diagnosis of Alzheimer’s disease. Below he shares his story, along with tips for other caregivers.
“My wife, June, had early-onset Alzheimer’s. It was only in retrospect that I realized her illness may have started ten years prior to the start of our seventeen-year journey with Alzheimer’s.
“Those ten years were ones that were filled with uncharacteristic actions on her part that she could not explain and I could not understand. Once we realized that something was drastically wrong, we began to search for answers.
“Because she was so young, however, doctors did not consider Alzheimer’s as a possibility. So, we struggled for three years not knowing before we got an accurate diagnosis.
“After a couple more years, a neighbor reported seeing her drive as if she were a suicide bomber. Since she was becoming a danger to herself and others, I took an early retirement. I call the previous five years her independent phase of the disease, not because she was independent, but because I was still working.
“My retirement began a pleasant three years that I call our companionship phase, during which time we did her favorite things. That phase ended all too soon when she declined mentally.
“She became dependent upon me for help with the activities of daily living. Those activities included bathing, dressing, eating, maintaining continence, and moving from place to place.
“That dependent phase lasted for five years. During her final four years, she declined physically. I used a combination of day care, health care workers and nursing homes to give me a break occasionally from caregiving. That allowed me to keep June at home with me for the entire seventeen years.
“During those seventeen years, I became depressed twice. The first time was during those three years of not knowing what was happening. The second time was at the beginning of her dependent phase when I seemed to be assuming new duties constantly.
“In reading the journal that I had been keeping, I could see the frustrations that I experienced. Some time shortly after that, however, I began a major turnaround.
“Both of my parents had been raised on farms, and I inherited their strong farm-practical spiritual beliefs. Revisiting those beliefs through prayer allowed me to stop thinking of Alzheimer’s from my view and start looking at it from June’s view.
“I spent months writing what I imagined her thoughts to be. Then I prioritized those thoughts into a care philosophy that I called ‘care with dignity.’ Providing care with dignity was a major factor in my becoming a kinder, gentler, and more fully developed person.
“After caregiving, I spent two years leading an effort to bring more of the protection of the Chesapeake Bay Act to the streams in my county. After that, I used my journal as a basis of writing the multi-award winning book, Alzheimer’s Care with Dignity. I am currently leading an effort to improve road safety in my area. Looking to the future, I have taken a course on Lay Speaking, and have already given my first sermon.
“If I had a few thoughts to leave current caregivers, they would be these: Reconnect with your spiritual beliefs. Pray for the ability to reach deep within yourself and maximize the talents that you have. Have faith. You can become spiritually, mentally, and emotionally stronger as time goes on.”
Fear of falling is one of the greatest fears for the elderly. Getting out of bed can potentially lead to a fall, but with the right movement and support, there’s no need to fear.
The tips below guide you through the process of getting out of bed and standing up with a cane or walker. If you have had surgery recently or if one side of your body is weaker than the other, you may need to consult your health professional for instructions on getting out of bed.
1. First, make sure your walker or cane is next to the bed, with the walker open and ready to use. If you are using a rollator, make sure the wheels are locked to keep it from rolling away.
2. Slide your body over to the edge of the bed. Use your arms and legs to push yourself closer to the edge.
3. Roll onto your side and swing your legs over the edge of the bed.
4. If your leg or hips are injured or weak, don’t roll onto your side. Just move your legs over the edge of the mattress as you slowly sit up, using your arms for support.
5. Sit on the edge of the bed for at least 30 seconds to regain your balance. Don’t rush yourself, and don’t attempt to stand up if you feel dizzy.
7. Slowly push yourself up until you are standing. If one side of your body is weak or injured, put most of your weight on the stronger side of your body. NOTE: Do not pull on the walker or use it to support your full weight. If the walker tips over, you could easily fall.
8. If using a walker, move your other hand to the walker.
9. Stand still for another 30 seconds to let your body regain balance. When you no longer feel dizzy, you can start walking.
Adjusting the height of the rollator is important to prevent tripping, hunching over, or changing the walking stance of the user.
If the handlebars are too high, the rollator will not provide enough support for the user’s weight. If the handlebars are too low, the user will have to bend too far forward to lean on the rollator. Either way, the user’s center of gravity will be thrown off balance.
Here is how to adjust the rollator to the correct height:
1. Stand with your shoulders relaxed and your arms hanging loosely at your sides.
2. The handlebar height should be at the crease of your wrist when your arms are relaxed at your sides.
3. Loosen the knobs on the outside of the handlebars. For some models, this may be sufficient to allow you to raise and lower the handlebars. If so, move the handlebars to the desired height. Tighten the knobs.
4. If the rollator has bolts that go through the handlebars, remove the bolts and then move the handlebars to the desired height. Re-install the bolts and screw the knobs to the bolts. The knobs should be on the outside of the handlebars. Some frames have a hexagonal hole for the bolt head to fit into. Ensure the bolt head is properly aligned with hole before tightening fully.
Note: The seat height is not adjustable. If the seat is too high or too low, a different size of rollator may be more appropriate. You should be able to sit on the seat with the balls of your feet touching the ground.