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A red sign in front blue waters and sky with an arrow pointing left and the words Evacuation Assembly Area on the right.

Wheelchair Users’ Ultimate Emergency Preparedness Guide

01/29/2024

The COVID-19 pandemic in 2020 taught us a lot of lessons as a society. Everyone was used to a new life now with social distancing, wearing a mask, having limited supplies and resources due to shortages in essential items, travel bans, and negative impact on mental health. Now more than ever is the time to realize that individuals who use wheelchairs should have a plan in place in cases of emergencies. Our previous blog Preparing for Emergencies When Using a Wheelchair: Healthcare scratched the surface of the basics of how to prepare for an emergency. This blog will share some important tips to ensure that individuals who use mobility devices and all stakeholders such as health professionals, vendors, family members, and society in general, are aware of emergency preparedness for individuals who use mobility devices.

Emergency Plan

It is important to have a list of your health conditions, medications, mobility device specifications, information about exit strategies from your home, and an updated “ in case of emergency” contacts list.  It is also important to share this emergency plan with those you live with and/or people you may communicate with often, especially in case of an emergency (such as building and/or community superintendents).

Communication

If you live with other people or have a superintendent and/or landlord, it is important to inform them of your specific health needs and mobility needs ahead of time. Additionally, in cases where you live alone, it is important to communicate this information with your local emergency services and ask them for directions on who to list as your “in case of emergency” contacts.

Emergency Kit

The following is not an all-inclusive list however, there are some suggestions.  Essential items can be flashlights, blankets, medical supplies, water, non-perishable food items, batteries, a hardwired phone line, extra clothing to keep warm, readily available important documents (especially if related to your health or mobility needs), and medications. It is also important to ensure that items such as fire extinguishers, smoke detectors, carbon monoxide detectors, and any other hazard-related detectors are functioning and up-to-date, and not requiring a replacement. Not directly a part of a kit is your own skill set. Ensure you take courses in first aid and CPR if you can and these are available to you as these could come in use in case of emergency. Survival skills training could also help in case of emergency and perhaps after the emergency has subsided but not entirely cleared, if these are available to you you can take these.

Mobility Devices Maintenance

This suggestion would apply to wheelchairs, scooters, walkers, strollers, and any mobility device.  It is important to regularly maintain your mobility device to ensure it is in safe and functioning condition with no unaddressed issues.

Power Outages

It is important to check ahead in case there are any hydro, internet, and general upcoming power outages, so you can plan by charging your mobility and electronic devices ahead of time, and finding backup batteries and/or generators. This becomes very important during inclement weather conditions: it is important to have portable and/or generator-dependent heating and cooling devices to ensure you can get through the inclement weather conditions safely with hydro and/or power outages.

Seek Information

Sign up with assistive technology, adaptive devices, and any apps that would help inform you of any weather, emergency, health-related, and safety alerts in your region. This way you can plan ahead to stay at home and/or leave the community to go to a safer place ahead of time, and know when it is safe to go back outside when the emergency is resolved. Join groups on social media within your region and network with other individuals who use mobility devices so you can update them and/or receive updates from them in case an emergency happens in your region. 

Home Safety

You may live in a region where certain weather conditions like flash floods, storms, hurricanes, tornadoes, or wind warnings may be common – you may want to find out more information on how to prepare for these specific emergencies to make your home safe (such as ensure all your water, pipes, heating, electricals, or other functioning areas are updated) and know if there are any available basements or underground areas close by to take shelter in. It would be helpful to learn how to turn on and/or turn off switches on your water, hydro, electricity, gas, and/or any other home-related utilities. 

Community Emergency Plan

At times when lots of people live in highly populated settings such as apartments, condominiums, and townhomes, it is essential to have a community emergency plan where everyone is aware of how and where to evacuate (whether it is to the street or the side of the building) and where to access a community shuttle to a shelter and/or community center closeby. If the management and/or superintendents of your area have a community emergency plan evacuation meeting to prepare ahead of time, it would be beneficial to participate in these practice evacuation plans to ensure your safety needs are being met and speak up if these safety needs are not being met. 

Advocacy

Communicate with local authorities,  emergency Services,  social service-related organizations,  advocacy groups for individuals who use wheelchairs,  and any other groups that may help plan ahead and respond appropriately in case of an emergency for individuals with wheelchairs.

Important Documents

Store important documents such as birth certificates, social insurance information, health cards, driver’s licenses, medical records, marriage certificates, wills, and/or other identity/health-related documentation kept safe in a bank locker, or a fireproof, theft-resistant, water-resistant, and other external element resistant case. This would increase the likelihood of being able to take these documents with you in case of an upcoming emergency and/or the likelihood of recovering these documents if they were stored safely and were left behind at home.

References

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Where can Canadians find information about funding programs for assistive technology?

12/18/2023

Assistive technology can be a universal enabler. Assistive technology can help people of all ages living with different disabilities to perform daily activities in their homes and communities. These technologies may be called assistive aids, devices, or products, durable medical equipment, or disability supports. Common examples include grab bars, walkers, wheelchairs, hearing or low vision aids, or medication reminders. Smartphones, tablet computers, and mobile applications are often included as well.

Canadians who may benefit from various assistive technologies may not have access to what they need. While the cost of the technologies is often a barrier to access and use, many Canadians may not know what technologies are available to help, where to find out information about the technologies, and how to acquire them. The numerous programs offered by governments and charities, and the complicated rules and procedures for each program also make it difficult for Canadians to acquire what they need.

The website AccessATCanada (https://www.accessassistivetech.ca/) was designed to help Canadians find information about funding programs for assistive technology. The website was based on research by Dr. Rosalie Wang at the University of Toronto and Dr. Michael Wilson from the McMaster Health Forum, and funded by AGE-WELL. It was created to be a central access point for people who use assistive technology and those who support people to access assistive technology such as health care providers or care partners. Anyone can search the database with over 200 government and charity programs that provide funding and services for assistive technology. The programs cover assistive technology to assist with mobility, sensory (vision or hearing), communication, cognitive, or mental health concerns and include national and provincial or territorial programs (current as of Summer 2020). The creators are looking for additional funding and resources to help maintain and update the website. If you are interested in helping out, please fill out your contact information below.

About the Guest Author: Rosalie Wang, Ph.D., OT Reg. (Ont.) is an associate professor in the Department of Occupational Science and Occupational Therapy at the University of Toronto. Her research focuses on developing, evaluating, and implementing technology to enable daily activity participation and social inclusion of seniors and people with disabilities. As an AGE-WELL investigator, she co-led a national project on enhancing equitable access to assistive technologies.

References

Other article link: http://publications.rehabmagazine.ca/publication/?m=1929&i=664629&view=articleBrowser&article_id=3703754&ver=html5 

Usability testing of the website: https://formative.jmir.org/2022/11/e36949

Jurisdictional scan (data): https://agewell-nce.ca/wp-content/uploads/2019/01/age-well_jurisdictional-scan_2017_June-30_FINAL.pdf

Overview of research: https://journals.sagepub.com/doi/full/10.1177/08404704221113742

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Travel Smartly with Mobility: This Holiday Season, We are Going Places!

11/27/2023

Learn all about how you can travel smartly with mobility this holiday season.

Traveling has always been an option for people through various modes of transportation, such as trains, planes, cars, buses, and public transit. In order to travel smartly with mobility, we must first understand what are the things that often stand in the way. Let’s talk about some of the common accessibility challenges for individuals with mobility needs when traveling.

Inclusive facilities:

Facilities around the world are required by law to meet local accessibility standards; however, not all the latest standards meet the actual needs of mobility users sufficiently. While some hotels and motels have wheelchair accessible rooms and bathrooms, as well as accessible parking spaces and entrances, other accommodations may be overlooked. Examples include visual cues for texture, depth, inclination, and elevation changes. Some facilities may lack updated accommodation and inclusion standards, such as wheelchair ramps, elevators, universal signage, or alternative methods of communications (Braille, voice commands, etc.). Refer to reviews, ratings, and pictures of the facilities as second opinions when selecting for the most inclusive facilities to visit.

Mobility traveler-friendly traveling methods:

The mode of transportation itself may pose barriers for individuals who use wheelchairs. Airlines may mishandle wheelchairs, leading to damage. Narrow spaces, like tunnels and tubes from the platform to the plane during boarding and vice versa, can be hard to navigate.

Most traditional escalators are not designed for wheelchair drivers to self navigate. Trips and falls on those escalators are be extremely dangerous. Always use the elevator if possible. And be extremely cautious with taking the escalators in wheelchairs. For even when it seems like the escalators are just wide enough for the device to fit, always remember that your device needs enough leeway to move around as it enters a surface in constant motion.

Mobility-friendly Restrooms:

A picture overview of the tiny common airplane toilet that is too tight for mobility users to navigate and use.

Restrooms on trains and airplanes may require navigating through narrow hallways and have too tight of a space inside for mobility users to move around. Wide-body airplanes tend to be a better option accessibility-wise since they provide more toilet and aisle spaces. Some airlines also have more accommodations than others. Uniform airport designs that lack in accessible signage can also make restroom identification difficult. Navigating crowded areas to reach restrooms can also be challenging.

Mobility device arrangements during travel:

Similar to baggage and luggage, mobility devices need to be stored with care for proper protection when in transit. In fact, scratches and bumps to mobility devices can easily cause more serious function-related damages that can singlehandedly hinder the rest of the trip. Avoiding unwanted surprises, make sure you are aware of the best storage option for your devices in transit as well as the related local regulations ahead of boarding time to make the necessary arrangements for assistance. Consider using tagging technology (e.g. AirTag) to help track your mobility device in the event that it is lost or misplaced in transit.

Emergencies:

Emergency exits and evacuation routes can be hard to find in large busy places like airports and train stations. Individual mobility users can face difficulties accessing oxygen masks and inflatable slides during emergencies. Consider traveling during less crowded hours or days for less hassled environments.

Travel smartly with mobility:

  1. Plan in advance: Contact the transit companies for more accessibility-related information so you can make more informed choices on which airline/train/bus to book tickets from.
  2. Label Appropriately: Label mobility devices and associated adaptive devices for careful handling. Use bright colors for attention.
  3. Track your device: Tracking technology can help with locating lost or misplaced mobility devices.
  4. Arrive Earlier: Arriving early is always a good choice when traveling. It gives you more time to navigate the check-ins and baggage areas with ease.
  5. Legislation and Rights: Google local traveling legislation on accessibility and visitor’s rights. Remember to take photos/videos to document the devices’ condition before checking your devices in with third party caretakers during transit.

The above solutions for individual mobility users alone are not sufficient. We firmly believe in the transformative power of collective change. We need to raise awareness of the above challenges faced by mobility travelers nowadays so that everyone can understand the crucial role accessibility plays in making essential transit facilities truly inclusive around the world.

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A young woman with a big smile in wheelchair outdoor looking beyond the frame.

Look Beyond the Price Tags: Making Smart Mobility Purchases Using Essential Buyer Awareness

10/22/2023
An elderly lady with fully white hair in wheelchair giving a thumbs up to her care giver standing next to her. Both smiling at each other.

You’ve probably heard the saying “buyer beware” before. It’s that feeling you get when you’re shopping for something, like clothes. You start thinking about the occasion, the weather, and whether it’s the right color for the season. You also wonder how long you can wear it comfortably. But no matter how much you think things through, sometimes things just don’t turn out as expected, and you end up feeling like you made the wrong choice. And this common struggle with sufficient buyer awareness becomes especially relevant and impactful when it comes to the mobility device market. It cannot and should not be the end users’ sole responsibility to try and figure it all out. And Braze is here to help every end user who may feel lost with all the essential information they should look out for when shopping for mobility devices.

Adaptive and assistive technology can really change the game for people who use wheelchairs, making a big difference in their quality of life, independence, and mobility. This blog isn’t about saying, “be careful, you’ll run into problems no matter what.” Instead, it’s shedding light on the often overlooked value with proactive measures that can be taken to boost buyer awareness in order to make informed choices that best serve the buyer’s interest.

And the first step to optimizing buyer awareness is asking the right questions to best understand your options, just in case you face issues with your wheelchair or other assistive devices. When you’re getting a wheelchair, it’s important to ask the right questions to make sure it’s the right fit for your needs and preferences.

Navigating Wheelchair Adaptations and Considerations

White puzzles with one empty slot where a blue puzzle piece with wheelchair icon in white held by a hand to be in the motion of fitting inside of that slot.


Which wheelchair are you using?

If it’s a manual wheelchair, you need to be cautious about adding certain extras because there might not be enough space for them. For instance, you can attach backpacks or oxygen tanks to the wheelchair, but there might not be room for other assistive and adaptive devices. On the other hand, if you have a power wheelchair, there’s generally more space on the base and around it, allowing you to add more adaptive and assistive devices as needed.

How can you adjust your wheelchair?

Some wheelchairs are designed to tilt or stand, while others can lean forward and backward. When you’re looking for assistive and adaptive devices, you have to consider where you can mount them safely without causing any damage due to the wheelchair’s movements.

What’s the weight limit of your wheelchair?

This is crucial for safety. If you only use the wheelchair for your own mobility, it’s pretty straightforward. But if you have oxygen tanks, backpacks, additional medical equipment, or any assistive and adaptive devices, they can quickly add to the weight. This extra weight might affect how easily your wheelchair moves and turns.

Do you have a warranty or insurance?

If you do, it’s essential to know the duration and what it covers. This information is vital in case your wheelchair gets damaged from regular wear and tear or due to the addition of adaptive and assistive devices and medical equipment.

Assessing Wheelchair Technology Compatibility

Men in suit sitting on the further side of the table speaking to the men in shirt sitting in a wheelchair across.

1. Is your wheelchair tech-friendly?

  • Do you know if your wheelchair can work with modern technology, or if it would work better with newer technology? It’s crucial to understand your mobility goals and find user-friendly tech that fits those goals. Think about compatibility for safety and financial reasons. Tech that doesn’t match your wheelchair might be risky, and you wouldn’t want the hassle of returning or replacing it.

2. Is wheelchair tech user-friendly?

  • Are you familiar with the tech or need some training? Consider your comfort level. How long will it take to get the hang of using this technology? Is customer support available when you need it? Can you connect with other users to learn from their experiences? These factors play a role in your confidence and safety using the technology.

3. Is wheelchair tech accessible and affordable?

  • Do you know if there’s any financial help to get the tech you need? Be aware of alternatives if you can’t get funding. Also, find out if there are upcoming upgrades for the technology. If it’s necessary, you might have to buy it right away. But if you have a temporary solution, waiting for an improved version could be worthwhile.

4. Can you test the tech before buying?

  • When picking technology for your mobility device, it’s not just about whether it fits the device; it’s also about whether it fits you. So, find out if you can try the tech before purchasing it. This can help you gauge how you feel about using it – whether it’s safe, easy, or tricky to handle.

Selecting with Awareness for the Optimal Mobility Solutions

As you can see, there are many things to be aware of when it comes to buying mobility devices that are the best fit for your specific circumstances. To be an informed buyer, you should ask the manufacturer of your wheelchair, the makers of the adaptive/assistive devices, vendors, assistive technology professionals (ATP), clinicians, and fellow wheelchair users:

A wheelchair and mobility devices showroom with carpet floor and white ceiling.

1. Who Covers Damages?

  • Does the wheelchair manufacturer handle damages to the wheelchair, or is it the adaptive/assistive device manufacturer’s responsibility? Maybe the vendor, ATP, or clinician can help. It’s essential to know who can assist you if you encounter any issues with your wheelchair or technology-related adaptive/assistive device.

2. Which is the Best Fit for Me?

  • After you’ve shared your mobility needs, strengths, and goals with these professionals, you can ask them whether a particular wheelchair or technological assistive/adaptive device is a good match for you. If it’s not, find out how you can customize it to better suit your needs.

3. Do the Second Opinions Check Out?

  • There are various events and online groups related to mobility where you can get advice and insights. These gatherings may have researchers who can answer questions like how a specific wheelchair or technological assistive/adaptive device was developed, considering factors like the user’s needs, the environment, past and future technologies, and any identified issues that could affect users and society.

The A5 Method Plan

Quick Tips text box popping out of a phone with Braze Mobility checklist held in the hand of a wheelchair user.

First and foremost, a big congratulations for making it this far. You are already more informed as a buyer! And to celebrate that, here is the A5 Method Plan, designed by Braze just for you, that summarizes the five essential steps to follow for cultivating the necessary buyer awareness around mobility devices and related technological adaptive and assistive products over time:

  1. Assess – Figure out your mobility needs, strengths, and goals.
  2. Advocate – Make your needs and goals clear.
  3. Advice – Seek advice from healthcare professionals, family, accommodation experts, vendors, manufacturers, and fellow mobility device users.
  4. Analyze – Try out products and make informed choices before buying.
  5. Approve – Buy with confidence and peace of mind, knowing you’ve followed all the necessary steps!

Whether you’re curious to learn more about buyer awareness in general or eager to get the help necessary to start making informed decisions about your mobility devices right away, enter your email below to get your own handy A5 Checklist!

Let’s work together to ensure your mobility needs, strengths, and goals are met, and you can confidently approve your choices with peace of mind. Your journey begins with us – take the first step and request your A5 Checklist now!

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Wheelchair Safety with Integrity: Enhancing Mobility through Solidarity

09/24/2023

In a world where the power of perception often shapes our understanding of others as well as ourselves, it’s crucial to embark on an exploration of wheelchair safety in solidarity with promoting inclusive mobility that values integrity and wellness beyond physical needs. Debunking prevailing social myths surrounding the capabilities of individual mobility device users, we hope to illuminate a path to break free from the biases that might negatively impact individuals’ self-perception and driving potential.

Emphasizing the functional strengths of individual mobility devices users, we will delve into how various factors – education, interaction, and societal attitudes – can profoundly influence the safe use of mobility devices, whether for the better or worse. In doing so, we hope to shift the focus away from individuals’ diagnoses and/or functional limitations to pay more attention to their current capabilities.

In our previous blogs, we explored surprising technological factors such as seating, programming and configurations, and drive controls: 3 Reasons for Accidents with Wheelchairs that Might Surprise You (Technological Factors) as well as key environmental barriers from accessibility, weather to traffic: Safeguarding Wheelchair Users: Unveiling 3 Key Environmental Barriers that Impact the Safe Use of Wheelchairs that all contributed to the safety of wheelchairs. With this third blog breaking down the significance of education, interaction, and societal attitudes, we invite everyone to perceive the safe use of mobility devices as an opportunity for assistance rather than a problem demanding solutions.

1. Mobility Education and Experience

1.1 Mobility Training Communication

It is essential to shift the conversation surrounding the training for individuals with disabilities from a focus solely on what they cannot do to a recognition and emphasis on what they still can, as this perspective encourages a more positively balanced view on their mobility potential, especially with proper use of mobility devices and adaptive technology. To elaborate, when individuals are learning about overall functionality of their bodies which is essential to their safety with mobility devices, they should be asked questions such as “which body part(s) do you find you use the most and are most helpful?” rather than only questions like “which part of your body do you struggle with the most in your everyday life and routine when you try to use mobility devices?”.

These two seemingly similar questions actually carry contrasting implications. One question emphasizes heavily on the individuals’ needs for the solutions proposed based on their reported limitations. This passive focus, in another word, implies that the individuals must depend on factors outside of their control to make their decisions for them. The other question, on the contrary, leaves the decision-making power within the hands of the individuals by simply highlighting all the functional capabilities they still have, allowing them to understand and recognize the available solutions in a much more dignified manner. The latter one is often more difficult to achieve because it requires not just telling, but also educating the individuals more in depth about their circumstances in order to arrive at the right decisions on their own.

1.2 Self Awareness and Training for Mobility

To build the self awareness needed to fully take control of one’s safety as well as realize one’s mobility potential in the long run, one should familiarize oneself with the diverse spectrum of functional abilities that impact one’s mobility:

Cognitive Ability

Cognitive ability is the way we think. It is all about our ability to focus, memorize, multi-task, and make decisions. It impacts our attention and interpretation of the world around us. If an individual has impacted cognitive ability, it is likely they will need more training and repetition of tasks involving their mobility device in their home and outdoor settings, to ensure they have the ability to safely make decisions about when to go faster, slower, change direction, and/or stop their wheelchair. Additionally, if decision-making is impacted due to cognitive impairment, it is best to steer clear of doing multiple tasks at once while driving the mobility device, as the individual might not be able to focus their attention on safety if they are distracted.

Fine Motor Ability

Fine motor ability is the way we move and use our fingers, hands, feet, and toes to complete tasks. Individuals with impacted fine motor skills may need more therapeutic intervention to maintain or enhance their level of functioning to better use their fingers and hands. In this case, training in alternative drive controls such as sip-n-puff, chin/tongue switch, and head array would be helpful – anything that can be used in place of a joystick that requires finger and hand movement. 

Gross Motor Ability

Gross motor ability is the way we move and use our head, neck, shoulders, arms, trunk, hip, and legs to complete tasks and navigate the world around us. Individuals with impacted gross motor skills may be receiving ongoing rehabilitation to maintain or enhance their current functioning and might be able to move their body to a certain degree while using their mobility device.

Visual Ability

Visual ability is the way we see the world around us. It is how clearly we see, how far we can see, how much depth we can recognize, what colors we see, and what textures we can recognize. Spatial ability is how we use all of this information to help us navigate in relation to our environment. Together, these are termed visual-spatial ability. Therapeutic interventions involving eye movements, hand-eye-coordination, and depth perception can help with rehabilitation. Training on adaptive technology and assistive devices that may help to “see” the world around them, past the point of their real visual field, could help in operating mobility devices safely. 

1.3 Experience with Mobility Devices

More time spent using a mobility device provides more experiential learning opportunities for individuals to become more aware of their bodies in relation to their surroundings, leading to safer use of mobility devices. Overtime, more experienced individuals learn to understand how to navigate various terrains in various weather conditions. They learn what areas in their homes are harder to navigate and which public spaces are accessible to mobility devices. They also have a better idea of how they can balance, go faster, go slower, or stop entirely while navigating known terrains ( the environment blog in this safety series discusses this in more detail). All in all, individuals who have more experience with their mobility devices can better advocate for improvements that will make their community more accessible and inclusive.

Individuals can learn to use their assistive devices and adaptive devices better, through use of these alongside their mobility device. Additionally, their ability to solve problems and later, build confidence in mobility device use increases as well. For example, the individual is not only aware of their own strengths, but the features of their assistive and adaptive technology, and the combination of both helps the individuals learn to be a safer mobility device user. Our technology blog in this safety series explores this further. Overall, their quality of life and self efficacy increase through experience of terrain and learning of technology.

Solution:

It is important to provide training on cognition, fine motor skills, gross motor skills, and visual-spatial skills to clinicians, vendors, families, and anyone else who works with individuals who use mobility devices. This knowledge can help stakeholders understand the goals and strengths of individuals who use mobility devices, so recommendations and opportunities can be made to fit well with these individuals. They can also learn more about the strengths-based approach and person- and family-centered care. This would help view needs as goals and view functioning as strengths. Experience working with mobility devices over time will assist with understanding accessibility more as well.

2. Societal Attitude

It is important to understand what societal attitudes, perceptions, and acceptance is when it comes to mobility devices and individuals who use them.  Although accessibility and disability may seem like universal concepts, the level of acceptance society displays varies.

Can societal attitudes of independence have an impact on how society views users of mobility devices and ultimately, how users of mobility devices view themselves? Can cultures where independence is highly valued view disability as more devastating perhaps, when compared to cultures where interdependence is supported?  Is it possible that individuals who use mobility devices from independence-valuing cultures view themselves as being more in need of accessibility than individuals who use mobility devices from interdependence-valuing cultures?

A journal article published in the Scandinavian Journal of Occupational Therapy suggests that societal attitudes of disability impact whether individuals who use power mobility devices either feel included or excluded in society. The issue is not just societal attitudes, it runs deeper.  The way society feels about individuals who use mobility devices can impact the way that individuals who use mobility devices view themselves. 

We have to be mindful to make sure that our attitudes of disability, mobility devices, and accessibility are equitable and fair so we can create a more inclusive society for everyone. Explicitly, negative bias may look like individuals saying insensitive things about disabilities. Implicitly, this bias may play out in the way that spaces are designed, policies are created, and health related evidence-based practices are researched. Some individuals may not be familiar with the challenges faced by wheelchair users and may lack awareness or understanding of their needs. This can result in barriers that make it harder for wheelchair users to move around comfortably and safely.  

Solution:

Providing more advocacy related campaigns, social media posts, and education can help people understand whether society is being inclusive of individuals who use mobility devices  or if there is more work that needs to be done to enhance accessibility of society by changing attitudes towards disability and accessibility.

3. Interaction

Individuals using a mobility device have either used these as a child or they come into contact with using a mobility device in their adult life. Skills like navigation, learning a skill, using our senses, identifying problems, and using creativity to solve these problems develop not just through our training in mobility devices and the experience we have with mobility devices. Rather, it goes beyond that – the training and experience works through the element of interaction. Interaction is when the individual can make changes to their mobility device, environment, and/or themselves in response to their experience with the mobility device and associated technology, their own goals and strengths, and their environment.

For example, when an individual uses their mobility device and their adaptive devices and technology in their daily routine, they may realize they need to alter their mobility device (such as adjust their seating), their routine (perhaps to low-traffic times), the devices and technology on the mobility device (perhaps adding backup cameras or blind spot sensors), and/or their own training (perhaps needing more information or training on certain aspects).  Check out our blog on The Prevention of Wheelchair Collisions to understand more about the value of experience, training, and your role in how to use mobility devices safely.

Solution:

The three blogs in the safety series highlight the importance of the technological, environmental, and personal aspects of safe mobility. We must understand the individual and their needs not in isolation, but view the goals and strengths of the individual in relation to their current mobility device, environment, training, experience, technology, and support available through relevant stakeholders (such as clinicians, vendors, and family). 

In summary, the goal of this entire blog series was to shed light on the factors beyond the individual’s diagnosis and functioning, and to increase opportunities for independent mobility. The purpose of this blog series therefore, is to take the strengths-based approach to improving quality of life. Just as one must not just speak of health in the presence of illness,  one must not speak of accessibility only in the presence of disability, otherwise we will only work to make this society more accessible if and when there is a disability. 

References

Mortenson, W. B., Miller, W. C., & Hardy, T. (2009). Ready to roll? Wheelchair use in residential care. . Disability Health Research network: UBC Okanagan. http://www.dhrn.ca/page.php?pageID=181

Widehammar, C., Lidström Holmqvist, K., Pettersson, I., & Hermansson, L. N. (2020). Attitudes is the most important environmental factor for use of powered mobility devices – users’ perspectives. Scandinavian journal of occupational therapy, 27(4), 298–308. https://doi.org/10.1080/11038128.2019.1573918

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Alt Text "A corner of a white wall showing floor boards that have been removed due to wheelchair damage, with pine colour wood exposed under the damage along with the metal corner beam exposed under the damage."

3 Reasons for Accidents with Wheelchairs that Might Surprise You (Technological Factors)

07/17/2023

Safety is a prevalent issue related to wheelchair use, with one study highlighting that 55% of wheelchair users reported experiencing at least one collision, and 17% reported experiencing two or more collisions within a three year period. You can read our earlier blog article on the prevalence of wheelchair collisions for additional statistics. Here is a quick view of the consequences of wheelchair collisions and accidents.

A computer generated 2-dimensional mid-wheel drive black wheelchair with beige seating beside black text reading 'powered mobility device users' from Edwards and McCluskey, 2010 and Gavin and Dreschnack, 2015. Orange 20% statistic beside a computer generated icon of a red star with 6-points and yellow outline with black text reading 'experienced at least 1 major collision within the past year'. Blue 33% statistic beside a computer generated broken black rectangle with black text reading 'result in damage to mobility device'. Blue 11% statistic beside a computer generated icon of a light blue hospital outline with a red cross with black text reading 'result in hospitalization for injuries due to collision'. Black text reading 'cost of medical bill $25000-$75000 and duration of stay 4-8 weeks long'
Computer generated mustard yellow and sage green background with black text title reading 'The impact of powered wheelchair accidents to residential institutions' by Mortenson et al. 2005. 2-dimensional computer generated icon of beige house with red door and roof beside orange text reading '82 powered wheelchair users and black text reading '142 residents' 2-dimensional computer generated icon of tan brown bandaid surrounded by a blue circle beside black text 'personal injuries involving worker's compensation' 2-dimensional computer generated icon of grey rectangle with blue cracks throughout surrounded by a blue circle beside black text reading 'damage to property 16 incidents of property damage within 1 year' 2-dimensional computer generated icon front view of red car with yellow lights and black wheels' surrounded by a blue circle beside black text reading 'automobile accidents'

So why is it that individuals who have demonstrated their abilities sufficiently enough to be prescribed a wheelchair experience these challenges? At the other end, is it really the case that individuals who are currently being excluded from powered (motorized/electric) mobility device use are too “unsafe” to drive? As a researcher mainly working with individuals with cognitive impairment, I knew there was little research that offered insights into the skills required to use a powered wheelchair. There is even less research to support the misconception that those with cognitive impairment cannot use or learn how to use a powered wheelchair. Despite this, individuals, specifically with cognitive impairment, are given few opportunities to trial and learn how to use a powered wheelchair.

How can we be sure that we are giving everyone a fair chance at independent mobility? In addition, are we viewing mobility as not just a way to get from point A to point B, but also as a necessary tool for learning and development in general.

7 years ago, when I had just started my company Braze Mobility, I walked into the home of a potential client, Wade Watts, and was taken aback by the amount of damage in his home. While I had seen safety often being the reason cited for long-term care residents being denied access to powered wheelchairs, I was not aware of the prevalence of accidents in the community. Despite the fact that Wade is skilled enough to be able to navigate even the most challenging environments, I noticed baseboards had been ripped off many of his walls. He even had to remove a couple of doors because of the damage to his doorways.

Alt Text "A corner of a white wall showing floor boards that have been removed due to wheelchair damage, with pine colour wood exposed under the damage along with the metal corner beam exposed under the damage."
Baseboard damage caused by powered wheelchair

In fact the more wheelchair users I spoke to, the more I realized how commonplace property and wheelchair damage are. One of my clients, Herman Witlox, is another wheelchair user who is extremely skilled at using his device, and explains “I can turn [my wheelchair] through a few millimeters of clearance…I can [drive] up two 2 by 4s into the side of the vehicle – that’s a pretty narrow path to keep on course”. Despite this, he shared that

“2 or 3 dents in the wall a day [was] normal. I just [learned] to live with it”.

By Herman Witlox

Through my decade-plus-long research in the mobility space and more than 7 years of providing mobility solutions, I have witnessed a plethora of barriers in accessing and maintaining safe and independent mobility. Exploring these barriers in depth for each individual user can ensure that we identify solutions that address their specific needs.

"A beige wall, pine colour wood floor, with a brown wood door, floor board, and doorway frame, showing wheelchair damage horizontal scrapes on the wall, floor board, door frame, and door"
Doorway damage caused by collision with powered wheelchair

When I get an inquiry from a therapist or a caregiver about a client who is “driving into things” and I ask the question “why?”, the reasons are often unclear or unknown. I have heard the phrase “they are just a terrible wheelchair driver”, many times from frustrated spouses or other family members who have had to pay for all the damage. However, in my experience, this reason is rarely true.

Most non-wheelchair users, including some therapists that prescribe the technology, don’t realize that operating a wheelchair, especially a powered one, can be extremely difficult. In this blog series, we break down the challenges in 3 areas: technology, environment, and client. By examining each of these individual areas, we aim to provide a more holistic view of safety-related pain points and barriers in wheelchair use. In this first article in the blog series, we highlight factors that are technology-specific.

Seating

A graphic illustration of a misaligned, skewed spine of the wheelchair user as a result of improper seating.
Spine misalignment while seating in a wheelchair

Seating is of utmost importance in allowing the user to navigate effectively and comfortably. An individual can experience pain with wheelchair use, independent of their current diagnosis and functioning. When a comfortable, dynamic (movable) seating option is available and positioned correctly for the user, it can reduce the user’s pain by avoiding sliding, slipping, and sudden movements that can all cause injury. In addition, seating adjustments can improve safe and efficient operation of the wheelchair by ensuring that the drive control (the mechanism used to operate a powered wheelchair) is visible and within reach. A RESNA position paper provides insight on the seating-related challenges faced by wheelchair users and associated recommendations. Permobil provides a helpful seating and positioning guide. Additionally, Michelle Lange provides insight into some factors that come into play when considering seating in this Decision Making Tree

Even when an optimal seating configuration is selected, the backrest of the wheelchair typically creates a massive “blind spot”. If you have never used a wheelchair and don’t believe me, try sitting in a regular office chair and try to look at the floor behind you (without turning the chair or the seat if you’re in a swivel chair). This is challenging if not impossible for just about anyone, regardless of your upper body mobility. So, it is not surprising that most wheelchair users cannot easily see what’s behind them.

Braze Blind Spot Sensors can be used as a tool to enhance spatial awareness in these blind spots around the wheelchair, and have helped clients like Wade, Herman and hundreds of other wheelchair users. In a recently published 3rd-party peer-reviewed study where existing powered wheelchair users were asked to detect objects in the rear using their standard methods (such as shoulder-checking), the participants detected low stationary (static) obstacles with only 44% accuracy. When participants used the Braze Blind Spot Sensors, their accuracy in detecting these obstacles increased significantly to 96% and they were able to do so in significantly less time. The sensors significantly increased the users’ accuracy in other scenarios as well including detection of higher and moving (dynamic) obstacles in the rear.

"Blue title reading 'Low Static Obstacle with computer generated 2-dimensional side view of women wearing an orange tank top, black pants, and black shoes in a blue and grey power wheelchair with black wheels. Computer generated orange statistical data inside a circular orange-grey arrow beside orange text reading '96% accuracy' beside 'Braze Sensors Time 2.6 sec' and blue statistical data inside circular blue-grey arrow beside blue text reading '44% accuracy' beside 'Baseline Time 7.1 sec'

Power Wheelchairs Programming and Configurations

Sideview of a powered wheelchair driver driving on a downhill sidewalk.
Powered wheelchair driving down a sidewalk

Powered wheelchairs can reach relatively high speeds, and if users are not familiar with their speed and acceleration capabilities, they may lose control, leading to collisions or tipping over. Rapid acceleration or sudden stops can catch users off guard and result in accidents, as the user’s entire body or parts of their body can make a jerk-like movement because of this change in speed. Appropriate adjustments can be programmed by a wheelchair provider or manufacturer rep in collaboration with the therapist to ensure user needs are met. The wheelchairjunkie provides information on various programming aspects such as speed of acceleration, deceleration, and turning, and how they impact the powered wheelchair driving experience.

The rear-end view of a wheelchair where there is medical equipment of an oxygen ventilator machine that is hanging from its back, hindering the driver's rear visibility.
Rear visibility hindered by medical equipment
The rear-end view of a wheelchair where there are accessories of an orange backpack and a black and neon yellow cane that are hanging from its back, hindering the driver's rear visibility.
Rear visibility hindered by accessories

In addition, certain wheelchair configurations can compromise the user’s rear, peripheral, and even front visibility. For example, a user who needs to be in a tilted position while driving will typically have an altered field-of-view that limits their ability to see objects that are lower to the ground. Accessories like oxygen tanks, backpacks, custom leg and footrests, and communication devices that increase the space taken up by the wheelchair can also block the user’s view of obstacles in their environment, making them more likely to have accidents. Bariatric wheelchairs (engineered with a heavier weight capacity and broader seats than standard wheelchairs) can pose additional challenges due to wider wheelchair dimensions, making navigation in tight spaces particularly challenging. Wheel drive configurations (front-, mid- and rear-wheel) can also have an impact on maneuverability, as explained in this article by Permobil. For example, certain types of wheel drive configurations are better for textured pathways while others are better in navigating tighter spaces.

Braze Blind Spot Sensors have helped clients in all of the above scenarios by providing feedback regarding the location and proximity of objects in the environment, thereby increasing spatial awareness in areas that are not directly visible to the client. They can also help new wheelchair users learn the extremities of their wheelchair as they figure out how to maneuver in various spaces with their wheel drive configuration.

Drive Controls

Powered wheelchairs are typically driven using a joystick. However, some users might be unable to operate a wheelchair with a joystick and require the use of “alternative drive/access controls” or “specialty control interfaces”. Alternative drive controls allow a user to control and drive the wheelchair without a joystick, using other parts of the body such as the chin, tongue, mouth, for example. Numotion provides some details of these alternative drive controls. It might be necessary to trial various drive controls in order to find the best fit for the client that allows them to operate a powered wheelchair safely.  Michelle Lange provides decision-making trees for joystick and non-joystick driving methods. Here is another resource from mo-vis that sheds light on how to find a good fit between the user and drive controls. 

A wheelchair driver squeezing through a narrow doorway with very little clearance on both sides.
Wheelchair squeezing through narrow doorway

While alternative drive controls provide increased opportunities for independent mobility, devices such as head arrays, sip and puffs, and eye gaze require the user to face forward while driving, potentially limiting their spatial awareness. I once saw a client who is a skilled head array user, but certain environments required her to navigate doorways backwards. As she would try to back up through the door and shoulder-check to make sure she was centered, she would inadvertently activate her head array (which detected her head movements as designed) and zig zag through the doorway hitting the sides multiple times.

Braze Blind Spot Sensors can be used in conjunction with alternative drive controls to enhance spatial awareness of obstacles around the wheelchair. In addition, the multi-modal alerts (visual, audio, and vibration) can be used by clients to help center themselves in tight spaces like doorways and elevators to improve their navigation skills, even when moving backwards. This feature can greatly improve powered wheelchair usability, considering 40% of powered wheelchair users in a study reported difficulty with steering tasks, especially while navigating through doorways and elevators.

"Computer generated pale yellow background on left side with orange text statistic reading '40%' and black text reading 'of clinician's patients or clients who use powered wheelchair have difficult with steering tasks' by Fehr, Langbein, & Skarr's (2002) above a 2-dimensional icon of joystick with black circle, pine rod, and beige base beside a red 'X'. Mint green background on right side with an icon of a black outline side-view wheelchair above blue text statistic reading '61-91%' and black text reading 'of wheelchair users predicted to benefit from "Smart Wheelchairs" by Simpson (2008)"

Take-Aways

Challenges related to seating, programming/configurations, and drive controls can be addressed in various ways, including some of the suggestions in the references provided. It can be helpful to discuss these with the wheelchair provider and therapist when getting a new wheelchair in order to facilitate a better fit between these factors and the user. Some useful considerations when purchasing a new powered wheelchair can be found in our earlier blog article.

Braze Blind Spot Sensors are helpful smart wheelchair technology to help mitigate some of the challenges related to spatial awareness that are often exacerbated by seating, wheelchair configurations/accessories and drive controls.

This blog is related to challenges in wheelchair operation that relate specifically to the wheelchair user’s technology. There are also factors related to the environment and the user that can present safety issues, but I will go over these in the next articles.

References/Citations:

Nilsson, L., & Kenyon, L. (2022). Assessment and Intervention for Tool-Use in Learning Powered Mobility Intervention: A Focus on Tyro Learners. Disabilities, 2(2), 304–316. MDPI AG. Retrieved from http://dx.doi.org/10.3390/disabilities2020022

https://0201.nccdn.net/1_2/000/000/184/61f/Dynamic-Seating-decision-making-tree.pdf

https://hub.permobil.com/wheelchair-seating-and-positioning-guide?hsCtaTracking=a441268d-99eb-45d7-9720-7773f158b694%7C79195703-8467-4542-b4ff-2cfbca0b8929

Lange, M. L., Crane, B., Diamond, F. J., Eason, S., Presperin Pedersen, J., & Peek, G. (2021). RESNA position on the application of dynamic seating. Assistive technology : the official journal of RESNA, 1–11. Advance online publication. https://doi.org/10.1080/10400435.2021.1979383

Pellichero, A., Best, K. L., Routhier, F., Viswanathan, P., Wang, R. H., & Miller, W. C. (2021). Blind spot sensor systems for power wheelchairs: obstacle detection accuracy, cognitive task load, and perceived usefulness among older adults. Disability and rehabilitation. Assistive technology, 1–9. Advance online publication. https://doi.org/10.1080/17483107.2021.1983654

Mortenson, W. B., Miller, W. C., & Hardy, T. (2009). Ready to roll? Wheelchair use in residential care. . Disability Health Research network: UBC Okanagan. http://www.dhrn.ca/page.php?pageID=181

https://hub.permobil.com/blog/power-wheelchairs-where-is-my-drive-wheel-why-does-it-matter#:~:text=The%20location%20of%20this%20drive,%2C%20and%20rear%2Dwheel%20drive.

https://www.numotion.com/products-services/adults/power/alternative-access-controls#:~:text=Alternative%20Access%20Controls%20include%20head,is%20attached%20to%20your%20wheelchair.

https://0201.nccdn.net/4_2/000/000/076/de9/joystick-decision-trees.pdf

https://0201.nccdn.net/1_2/000/000/0d7/f97/non-joystick-driving-methods-decision-making-tree-text-reference.pdf

https://www.mo-vis.com/news/blog-series-how-formalize-selection-process-drive-controls-electric-wheelchair-users

Fehr, L., Langbein, W. E., & Skaar, S. B. (2000). Adequacy of power wheelchairs

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Two VA therapists standing in front of a Veteran that's using a power wheelchair.

VA collaborates to improve safety of power wheelchair users

01/16/2023

Over 425 participants tuned in over two days to see 19 external health care innovators, entrepreneurs and start-ups pitch their early-stage solutions for the chance to collaborate at VA’s annual Innovation Experience, a collaboration challenge to find innovative ideas to solve VA’s biggest health care challenges.

Gulf Coast VA completed its collaboration with Braze Mobility to further design and develop an innovative navigating blind sensor system for power wheelchair users.

Read the entire article here.

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Logos of U.S. Rehab and Braze Mobility announcing their new partnership

U.S. Rehab Signs Partnership Agreement with Braze Mobility

06/10/2022

June 10, 2022 (Waterloo, Iowa)

U.S. Rehab, a division of VGM & Associates, announced it has signed a partnership agreement with Braze Mobility Inc. to make the innovative Braze Blind Spot Sensors for wheelchairs available to its members nationwide. 

Braze Mobility Inc. has created the world’s first blind spot sensors that can be added to any manual or power wheelchair and transform it into a ‘smart’ wheelchair. The patented technology automatically detects obstacles and provides feedback to the user through intuitive lights, sounds, and vibrations. This technology can help prevent accidents resulting in property damage, wheelchair damage, and injuries that can lead to hospitalization. 

In addition, Braze Blind Spot Sensors can potentially widen access to power wheelchair use to those who might currently be unduly excluded. The company’s solution is based on over a decade of user-centered research with wheelchair users, which has been published in several peer-reviewed articles. 

“U.S. Rehab is extremely excited about this new partnership. This is a growing market and it is a great opportunity for our U.S. Rehab members, ” said Greg Packer, President, U.S. Rehab. “We strive to continually bring partnerships to our members that are beneficial for them, and their customers.”   

“We are really excited to partner with U.S. Rehab and be able to work with all their members across the country, many of whom we have already had the pleasure of working with”, said Dr. Pooja Viswanathan, CEO, and co-founder of Braze Mobility. “We strongly believe in empowering users by increasing their spatial awareness while leaving them fully in control. Our approach is resonating with clients who value their independence. This partnership will allow many more manual and powered wheelchair users to access the Braze Blind Spot Sensors so they can navigate their environments boldly, independently, and safely.” 

Physicians, therapists, and customers should contact their local VGM member for more information on this exciting technology. 

About VGM & Associates: VGM & Associates is the nation’s largest and most comprehensive member service organization (MSO) for post-acute healthcare including DME/HME, respiratory, sleep, wound care, complex rehab, women’s health, home modifications, and orthotics and prosthetics providers. Over 2,500 providers with nearly 7,000 locations rely on VGM to connect them to valuable resources every single day. For more information, visit www.vgm.com

About Braze Mobility Inc.: Based in Toronto, Ontario, Canada, the company was founded by Dr. Pooja Viswanathan, who has incorporated over a decade of smart wheelchair research into state-of-the-art technology that improves accessibility and independence for people with physical disabilities. Braze Mobility is dedicated to increasing independence, safety, and overall quality of life for people living with mobility challenges. The team at Braze Mobility engages with end-users throughout the design process to create accessible and innovative technologies that are affordable and easy to use. The company currently sells its technology in North America and will be launching its products overseas soon. For more information, visit www.brazemobility.com.

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Photo showing a U.S. Veteran wheelchair user navigating a indoor obstacle course, and a staff member kneeling to take a photo of the veteran.

Central Arkansas VA to be flagship for mobility safety program

06/01/2022

A snippet from the article written by Chris Counts at Kark.com:

The Central Arkansas Veterans Healthcare System is researching new ways to make wheelchairs and mobility chairs safer for Veterans.

The organization is one of seven Veterans Health Administration sites, and the flagship site, in doing so.

In a partnership with Braze Mobility, Inc., 20 Veteran patients are participating in the development of a terrain analysis system to help wheelchair and mobility chair users navigate outdoor environments safely and independently.

Read the entire article here.

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Sunrise Medical partners with Braze Mobility in Canada

Innovative Braze Blind Spot Sensors for QUICKIE Users across Canada

02/09/2022

February 9, 2022
Toronto, Ontario, Canada


Officials at Braze Mobility Inc. and Sunrise Medical Canada announced their partnership today. This new collaboration will make Braze Mobility’s blind spot sensor technology available on the QUICKIE line of power wheelchairs.

Braze Mobility Inc. has created the world’s first blind spot sensors that can be added to any manual or power wheelchair and transform it into a ‘smart’ wheelchair. The technology automatically detects obstacles and provides feedback to the user through intuitive lights, sounds, and vibrations. This technology can help prevent accidents resulting in property damage, wheelchair damage, and injuries that can lead to hospitalization. In addition, Braze Blind Spot Sensors can potentially widen access to power wheelchair use to those who might currently be unduly excluded. The company’s solution is based on over a decade of user-centered research with wheelchair users, which has been published in several peer-reviewed articles.

“Sunrise Medical Canada are very proud to be partnering with Braze Mobility,” said Mike Longo, Senior Director, Commercial Operations. “This partnership will give us first-to-market OEM access to their innovative, blind spot sensor technology on our industry leading line of Quickie power wheelchairs.  Client safety and independence are core values at the heart of our mission of “Improving People’s Lives”.  We are excited to be working closely with the team at Braze on delivering this goal for our customers in Canada.”

“We are thrilled to be partnering with Sunrise Medical Canada,” said Dr. Pooja Viswanathan, CEO and founder of Braze Mobility Inc. “We have really enjoyed working with the Sunrise team to provide Braze Blind Spot Sensors to QUICKIE users across Canada, helping them navigate boldly, independently, and safely.”

Anyone interested in seeing demonstrations of the technology in Canada should contact their local Sunrise Medical Representative.

About Sunrise Medical: Committed to improving people’s lives, Sunrise Medical (https://www.sunrisemedical.ca) is a world leader in the innovation, manufacture, and distribution of advanced assistive mobility devices and solutions. Distributed in more than 130 countries under its own 17 proprietary brands, the key products include manual and power wheelchairs, e-mobility products, motorized scooters, seating & positioning systems, and daily living aids. Operating in 18 countries, Sunrise Medical group is headquartered in Malsch, Germany, and employs over 2,200 associates worldwide.

About Braze Mobility Inc.: Based in Toronto, Ontario, Canada, the company was founded by Dr. Pooja Viswanathan, who has incorporated over a decade of smart wheelchair research into state-of-the-art technology that improves accessibility and independence for people with physical disabilities. Braze Mobility (http://www.brazemobility.com/) is dedicated to increasing independence, safety, and overall quality of life for people living with mobility challenges. The team at Braze Mobility engages with end-users throughout the design process to create accessible and innovative technologies that are affordable and easy to use. The company currently sells its technology in North America and will be launching its products overseas soon.

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