Microsoft Word - energy conservation techniques for daily living.docx

Adaptive Equipment and Energy Conservation

Techniques During Performance of Activities of

Daily Living

Problem: A wide range of diagnosis can affect the performance of activities of

daily living (ADLs). The performance of these activities; feeding, dressing, and

bathing to name a few are an essential part of our daily lives. An individual’s

ability to function in daily activities is often dependent on physical and cognitive

health. The use of adaptive equipment and energy conservation techniques can

make all the difference in making these important daily tasks possible and effect

one’s perception and quality of their life.

Adaptive Equipment

Adaptive equipment is used to improve functional capabilities. Adaptations can

assist someone in their home or out in the community, ranging from longer, thicker

handles on brushes and silver wear for making them easier to grasp to a powered

wheelchair. Below is a chart including various diagnosis and examples of adaptive

equipment that could greatly benefit individuals experiencing similar

circumstances. The equipment listed will promote functional independence as well

as safety during performance of ADLs.

Diagnosis

Adaptive

Equipment

Rationale for Equipment

Price

Range

Website/Resourc

e Link to Purchase

Equipment

Joint

Replacement

(THA/TKR)

Reacher

This assistive device can help in

accessing spaces that may be

hard for the individual to reach

otherwise. Frequent sitting and

standing (bending more than 90

degrees) are not recommended

for individuals with a recent

joint replacement. This tool will

allow the individual to grasp an

object further away without

movement of lower extremities.

$5.50 -

$330.00

https://www.healthpro

ductsforyou.com/p-

featherlite-

reacher.html

Sock aid

After having a joint

replacement, it is very

important to limit a large range

of motion at the hip/knee.

Putting on socks requires

bending and reaching, however,

using a sock aid can greatly limit

the range of motion required

when performing this task;

sliding the sock over the sock aid

and lowering it to the floor using

attached ropes. Sock aids can

greatly ease dressing tasks after

a joint replacement.

$7.00 -

$55.00

https://www.healthpro

ductsforyou.com/p-

adult-wide-style-sock-

aid.html

Long

handled

shoehorn

Many times, when putting shoes

on it is convenient to bring your

foot closer to you to make the

task easier, however, after a

joint replacement, it is

recommended to avoid stepping

backwards, crossing your legs,

or bending more than 90

degrees at the joint. A long-

handled shoehorn is medically

necessary to ensure

unnecessary movements are

minimal.

$1.50 -

$24.00

https://www.healthpro

ductsforyou.com/p-

complete-medical-get-

your-shoe-on-plastic-

shoehorn.html

Raised

toilet seat

Minimizing bending the

operated joint is extremely

important after having a joint

replacement surgery. Using

adaptive equipment to limit

range of motion at the hip/knee

will allow for adequate time for

healing and reduce risk of injury.

$20.00 -

$300.00

https://www.healthprod

uctsforyou.com/p-

drive-premium-seat-

rizer-with-removable-

arms.html

Bathroom

grab bars

This assistive device can provide

support and stability for an

individual after a joint

replacement. Maintaining

balance during bathing by using

grab bars with textured handles

will greatly increase safety and

decrease fall risks on slippery

surfaces.

$20.00 -

$150.00

https://www.healthpro

ductsforyou.com/p-

carex-textured-wall-

grab-bars.html

Unsteady

Gait

Tub

transfer

bench

Shaking and poor balance are

common symptoms of

Parkinson's disease, **** .

Individuals who easily have loss

of balance need extra support to

compensate for the energy that

is constantly being used during

tremors and shaking. A tub

transfer bench will provide the

additional support that is

necessary during bathing.

$30.00 -

$3,700.00

https://www.healthpro

ductsforyou.com/p-

lumex-imperial-

collection-transfer-

bench.html

Walker

A walker can have a profound

effect on stability for individuals

with walking difficulties.

Stiffness is often another

common symptom that occurs

with unsteady walking, making

this assistive device medically

necessary. A walker can act as a

support for functional mobility

while greatly increasing safety.

$45.00 -

$500.00

https://www.healthpro

ductsforyou.com/p-

graham-field-lumex-

two-button-adult-

folding-steel-

walker.html

Tremors

Weighted

utensils

The heaviness of weighted

utensils reduces the effect of

tremors by steadying the hand.

Also help with lack of

coordination by providing more

sensory feedback. Significantly

smoother movements make it

easier to scoop up food and

bring it to the mouth. This

assistive device is medically

necessary during self-feeding for

someone with tremors.

$3.00 -

$22.00

https://www.healthpro

ductsforyou.com/p-

adjustable-weighted-

utensils.html

Scoop

dish

Tremors can have a profound

impact on coordination and

control of the arms and hands. A

scoop dish can be used to avoid

food being pushed off the edge

of the bowl and prevent spills

during feeding and eating. This

adaptive equipment is

important for feeding to be an

independent task.

$6.00 -

$40.00

https://www.healthprod

uctsforyou.com/p-bl-

scoopy-scoop-dish-

plate.html

Chronic,

progressive

illness

Power

wheelchair

An electric wheelchair is an

assistive device that can give the

individual a sense of

independence when

complications increase. Electric

wheelchairs are highly

adjustable to patients’ specific

needs and can assist with

pressure relief, postural

alignment, sitting tolerance, and

independent repositioning. This

adaptive device will increase

independence and safety. A

power wheelchair is capable of

adjusting to specific needs of

the individual, making it a

medical necessity.

$1,700.00 -

$19,638.00

https://www.healthpro

ductsforyou.com/p-

golden-tech-alante-

power-wheelchair.html

Ramp

Progressive muscle weakness

and paralysis are symptoms that

are sometimes seen at end

stages of debilitating illnesses. A

ramp is an assistive device

which is often placed over stairs

or uneven surfaces. A ramp is

medically necessary to allow an

individual using a wheelchair to

get in and out of their home.

$30.00 -

$500.00

https://www.healthpro

ductsforyou.com/p-

pvi-portable-mutlifold-

ramp.html

Hospital

bed

Treatment options are often

limited for progressive diseases,

making the comfort and safety

of the patient a top priority.

Without a hospital bed there is

an increase for complications to

arise such as bedsores,

thrombosis, pneumonia (due to

lack of upright position), UTI,

and osteoporosis, making a

hospital bed necessary for a

chronic, progressive disease.

$50.00 -

$1,500.00

https://www.healthpro

ductsforyou.com/p-

graham-field-patriot-

hospital-bed.html

Arthritis

Electric

can

opener

An electric can opener can make

it both safer and easier for

getting the lid off a can. By using

this assistive device an

individual with arthritis will

avoid putting the extra tension

and stress on their bones. It is

medically necessary to prevent

exacerbations and discomfort,

which cause intense stiffness

and discomfort in the joints.

$25.00 -

$57.50

https://www.healthpro

ductsforyou.com/p-

black-surecut-electric-

can-opener.html

Long-

handled

sponge

This assistive device will limit

the need to reach when bathing.

Arthritis symptoms including

joint stiffness, pain, and

inflammation make the long-

handled sponge is medically

necessary to support

independent grooming and

bathing for an individual with a

limited range of motion.

$3.50 -

$31.00

https://www.healthpro

ductsforyou.com/p-

complete-medical-i-

got-your-back-long-

handle-round-

sponge.html

Rocker

knife with

built up

handle

The rocker knife requires less

pressure than a regular utensil

when cutting food, the built-up

handle will add less stress on

inflamed or weak joints.

Arthritis is especially prevalent

in the hands and fingers; this

assistive device is medically

necessary for self-feeding and

independence.

$3.00 -

$24.00

https://www.healthpro

ductsforyou.com/p-

essential-medical-

rocker-knife-with-

large-handle.html

Low Visual

Acuity

Contrast

tape

Outlining edges of counter tops,

steps, coffee tables, doorways,

and bathtubs/showers with blue

tape makes them easier to

distinguish. Without contrasts,

the likeliness of falls and

accidents are increased.

Contrast tape is medically

necessary to ensure safety of

individuals with decreased visual

acuity.

$19.95 -

$75.00

https://www.maxiaids.

com/low-vision-

reflective-tape-black-

and-yellow-striped

Bump dot

stickers

This adaptive tool with give the

individual tactile cues to hit

appropriate buttons when using

the microwave, oven, stove,

remote, or phone in their home.

Without these stickers, turning

on the wrong burner on the

stove or setting the temperature

too high on the oven is much

more likely, making them

medically necessary for safety.

$10.00 -

$30.00

https://www.amazon.c

om/Mixed-Bump-Dots-

Sizes-

Colors/dp/B00II5TM6

Portable

electric

magnifier

A portable electric magnifier will

allow the individual to read

labels, prescriptions, and

appointment dates. This device

can be used easily in the home

by either laying it flat over the

surface and sliding it along to

read or slide camera over the

text with the screen set up

behind the material being read

and read off the device screen.

$200.00 -

$500.00

https://www.healthpro

ductsforyou.com/p-

bierley-shoppa-

portable-electronic-

magnifier.html

Energy Conservation

Energy conservation techniques is a less physical way of adapting the way daily

activities within the environment. Making simple adjustments to daily routines can

improve energy efficiency, and ultimately conserve energy throughout the day.

Energy conservation techniques can be applied to any aspect of life; at home,

work, leisure, and even rest/sleep. The 6 P’s below are important to keep in mind

to help conserve energy.

Energy Conservation Techniques - 6 P’s

1. Prioritize: Set realistic goals and prioritize daily

activities

2. Plan: Break down task into stages

3. Positioning: Sit down and take rest

breaks, avoid prolonged movements and

tiring posture.

4. Pace yourself: Allow extra time to complete an

activity and don’t rush

5. Positive attitude: Concentrate on all the things you

can do

6. Pursed lip breathing: Inhale through nose,

exhale through mouth

https://www.bfwh.nhs.uk/wp-content/uploads/2018/02/PL721.pdf

The areas of feeding, dressing, and bathing are assessed as examples of

applying ideas of energy conservation techniques to everyday life:

Eating & Feeding

§ Plan ahead and avoid rushing

§ Schedule meal prepping throughout the week

§ Organize grocery list by aisle

§ Shop at less busy times

§ Sit when preparing meals

§ Make use of electrical appliances; blender, dishwasher, etc.

§ Use grocery cart for support

https://www.ucsfhealth.org/education/tips-for-conserving-your-

energy

Dressing

§ Lay out clothes before getting dressed

§ Sit down to dress and undress

§ Minimize leaning over to get dressed. Bring

foot up next to you to get socks on, fasten

bra in front then turn it to the back.

§ Consider the type of clothing; a t-shirt instead of a button up or

pants with an elastic band instead of buttons

Bathing

§ Use a shower organizer to decrease

reaching

§ Make use of electrical tools; toothbrushes,

shavers, etc.

§ Toothbrush with built up handle

§ Sit during bathing and take rest breaks

https://www.detroitseniorsolution.org/meals-on-wheels-mow

Solutions for bathing with low endurance

Bathing at regular intervals (at least 1-2 times per week) is necessary for seniors to maintain skin

integrity, reduce the risk for skin breakdown and infections, eliminate body odor and to maintain

hygiene. Biological aging is associated with declines in neuromuscular and cardiovascular

systems, and this can impact activities of daily living (ADLs) due to an impaired capacity for

work (Cadore et al., 2014). Low endurance can be exacerbated by cardiopulmonary or

cardiovascular disease, cancer, autoimmune diseases, and other unspecified etiologies.

Participation in ADLs such as bathing can be limited or require assistance from a caregiver to

complete due to many factors including decreased endurance. An estimated 2% of the adult

population requires some assistance to complete ADLs, with 12% of adults over 75 requiring

assistance (Adams et al., 2012). The lifetime probability of experiencing a disability in at least 2

ADL areas is as high as 68% for people over the age of 65 (Adams et al., 2012).

The following information can assist to maximize independence with showering and bathing to

minimize the physical effort required.

Assistive devices

Shower chair and handheld shower head. Remaining seated on the bench while showering

will reduce the overall effort required for showering.

https://www.youtube.com/watch?v=KXCPlrQ682c

Long handled sponge will reduce the overall effort by requiring less bending and reaching to

efficiently and effectively wash all areas of your body

https://www.youtube.com/watch?v=Iar-gwBeVGA

Activity modifications

-Reduce standing time: sitting requires less energy so complete as much of the bathing activity

while seated as possible including undressing, drying off, dressing,

-Keep items within reach: utilize ledges in shower or install shelving in shower to store

supplies such as shampoo, soap and conditioner. Keep your towel and any other necessary

supplies within reach so you can remain sitting to retrieve them.

-Temperature: heat can exacerbate fatigue, reducing the temperature of the water can help you

conserve energy for other bathing tasks

Impact on Occupation

Implementing these energy saving modifications can help you to maximize your

independence and safety with bathing tasks.

Example: An older individual who lives alone may be unable to safely bathe themselves due

to low endurance. Utilizing the shower chair along with other modifications will allow this

person to safely and effectively complete the bathing task on their own without the

assistance of a caregiver.

Safety

Safety is the number one concern during bathing activities. If you feel unsteady, have had a

recent fall or loss of consciousness please consult your primary care physician prior to

implementing any new techniques.

Consult

If your cause for low endurance is unknown, discuss it with your primary care physician to make

sure it is not something more serious. Speak to your primary care provider about any additional

challenges low endurance may cause and request an occupational therapy home evaluation to

learn more energy conservation techniques.

Community resources

-Find a handyman to install handheld shower head, shower seat, shower shelving and other

ageing in place essentials: https://handymanconnection.com/

-Loan closet to get equipment at low or no cost https://loanclosets.org/michigan/wayne

-Purchase equipment: http://www.binsons.com/site_search.html and search for desired item

References:

Adams, P. F., Kirzinger, W. K., Martinez, M. E. (2012) Summary health statistics for the U.S.

population: National health interview survey, 2011. Vital Health Statistics, (10)255, 1-110.

Cadore, E. L., Pinto, R. S., Bottaro, M., & Izquierdo, M. (2014). Strength and endurance training

prescription in healthy and frail elderly. Aging and Disease, 5(3), 183-195.

Resources

Meals on Wheels: An alternative option for meal prepping and cooking at home is

having healthy meals brought right to seniors’ homes fully prepared!

https://www.detroitseniorsolution.org/meals-on-wheels-mow

HelloFresh: A service such as Hello Fresh, if able to prepare their meal at home.

This can be helpful in ensuring the quality of their meals and eliminate the task of

grocery shopping and having unhealthy choices. Both Meals on Wheels and Hello

Fresh are examples of energy conservation techniques for meals.

Michigan Assistive Technology Program (MATP): This program works with other

organizations in Michigan to provide demonstrations to people who have

disabilities to help to compare and contrast adaptive equipment options, so they are

able to make informed decisions.

https://navigator.autismallianceofmichigan.org/item/michigan-assistive-

technology-project/

Online Tools - https://atxchange.org/ : An online site people can donate or sell

adaptive equipment of all kinds (provided through MATP). Equipment ranging

from power wheelchairs to computer monitors and software are available.

Further Professional Assistance

Dementia is a progressive disease and staying physically active has a big impact on

the well-being of the individual experiencing dementia. Physical, occupational, and

recreational could greatly benefit someone with a physical disability.

-Physical therapy: Increase strength, endurance, and safety for the individual;

making a daily exercise program and providing specialized care.

-Occupational therapy: Help in assisting in ADLs and provide continuous

support with compensatory strategies and adaptive equipment, including those

listed above, to increase meaningful activities quality

of life overall. Feeding and eating can also be

assessed if swallowing issues are present.

-Recreational therapy: Provide leisure and

recreational activities for the individual as well as

assist in identifying leisure pursuits and hobbies to

promote physical activity.

Improving Occupational Engagement – Further Considerations

Treatment approaches relating to adaptive equipment and compensatory technique

strategies can be applied to anyone’s daily life to make a task easier. If a client had

a physical disability such as limited range of motion both adaptive equipment and

compensatory strategies could be very useful. For example, after a hip surgery

using an elevated toilet seat or shower chair for safety and to avoid falls could be

very beneficial. Energy conservation techniques that could be used would be to sit

down during dressing activities and take their time completing daily tasks.

An individual’s ability to function in daily activities is often dependent on physical

and cognitive health. Finding personal strategies within the environment to

conserve energy paired with the use of necessary adaptive equipment can make all

the difference in making these important daily tasks possible and effect one’s

perception and quality of their life.

Age-related Changes Related to Adaptive Equipment and

Energy Conservation Affecting Occupational Performance

• Reaction time: Slower thinking process and body movements.

• Proprioception: Potential postural instability and falls; changes in joint-

position sense during movement.

• Balance: Postural control is disturbed by changes in sensory, motor, and

central nervous system function, and affected by a decrease in sensory cues

and reflexes.

• Dizziness: This is the most frequent complaint of older adults over 75 years

old. Being dizzy occurs due to lack of coordination or integration of

movement within the sensory system.

• Motor activity: Posture, movement, gait, and reflexes are altered with aging.

• Orthostatic hypotension: Change in position from laying down to standing

causes a decrease in blood pressure, causing feelings of dizziness or fainting.

This condition is typically caused by lack of blood to the brain resulting in

pooling of blood in the lower extremities.

References

Barney, K. F., Emerita, C., & Perkinson, M. A. (2018). Cognitive Impairment, Dementia, and

Occupational Therapy Interventions. Kempf, C., Schwarz, L. R., Desai, A. K., Perkinson,

M. A. (Eds.), Occupational therapy with aging adults: Promoting quality of life through

collaborative practice. (pp. 245–265). Elselvier.

Online Home Healthcare and Healthy Living. (n.d.). Retrieved from

https://www.healthproductsforyou.com/