THE (HOME) MODS SQUAD!

July 2014 Volume 4, Issue 2

OT Newsletter by SCOPE Access

Another edition of the Home Modification Newsletter for OTs—developed as a resource for OTs across South-Eastern NSW.

“The (Home) Mods Squad” has been put together to provide practical support and information sharing about home modifications and SCOPE Access service provision.

Please let us know if there is a topic that you feel is worthwhile sharing and we will work towards publishing it in the next issue of “The (Home) Mods Squad” newsletter.

IN THIS ISSUE:

⌂ Update from NSW Home Mods State Council

⌂ Display and Demonstration centre in Hamilton Street, Dapto is NOW OPEN.

⌂ WATERPROOFING: the importance and stages involved

⌂ TOILETS and their features

⌂ GRAB RAILS: types of rails and tips for prescription

Head Office and Information Display Centre Dapto

Ph: (02) 4262 4900 Fax: (02) 4260 9494

Milton Office & Rural Builder/OT Service (ROBOT)

Ph: (02) 4454 5739 Fax: (02) 4454 5742

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Ph: 1300 765 887 Email: reception@scopeaccess.com.au

Hot off the press...

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There have been a few changes to the Occupational Therapy positions within State Council.

Sandra Lightfoot-Collins has commenced as the Senior Occupational Therapist, as of the 6th of May, and will be working four days a week. Sandi brings 31 years of experience as an Occupational Therapist, including 17 years within the Home Modification and Maintenance Sector, having held positions as a Service Manager and State Councillor. Sandi also develops and delivers training nationally, as well as teaching within the University of Sydney’s Occupational Therapy Programme.

The focus of Sandi’s position is to develop, expand and provide training for Occupational Therapists who undertake environmental modifications. Training can be tailored to individuals and services needs.

Sandi can be contacted on : Email: ot@nswhmms.org Phone: (02) 9281 26800 Mobile: 0419 937 517

Mary Jackson (Occupational Therapist) remains with the State Council, working on Fridays and she can be contacted on:

Email: mary@nswhmms.org

Both Sandi and Mary will be working on checklist and

resource development

What’s happening at

SCOPE Access?

The demonstration and display centre in DAPTO is open.

Here are some of the items we have on display:

⌂ 1:14 gradient ramp with envirowalk surface

⌂ Wedge ramps (Tyrex and Aluminium)

⌂ 2 Platform steps made out of timber

⌂ Gal pipe and stainless steel hand rails

⌂ Thermo grip tape for hand rails

⌂ Grab rails including combination rails, shower rails, towel rails and a variety of finishes/colours

⌂ Modified kitchen including a variety of storage and accessibility solutions

⌂ Curved stair lift with an automatic hinge at the bottom terminal

⌂ Enclosed, through floor vertical lift with standard viewing panels on both doors

⌂ Accessible bathroom including hob free shower with Stormtech drain

⌂ Hand basins, mirrors and shaving cabinets

⌂ Accessible toilets

⌂ Doors, locks and door handles

⌂ What’s behind a wall? A sneak peak into studs/blocking for grab rails and cavity units.

⌂ Design and accessibility solutions for people with vision impairments

⌂ Rocker switches

⌂ Slip resistant tiles

⌂ Hand held shower units (including those on vertical rails, flow switches or hook systems)

⌂ Taps including (capstan taps, lever taps and flick mixers)

IF YOU WOULD LIKE TO FIND OUT MORE OR

COME AND VISIT THE DISPLAY CENTRE

PLEASE CALL RECEPTION

ON 1300 765 887

TO ARRANGE AN APPOINTMENT

Display & Demonstration Centre

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Aluminum wedge

Thermo

grip

tape

Colour contrast

1:14 Ramp

Combination g/rail

Drop down rail

Hand basin

Hob-free shower recess

Curved stair lift with

automatic hinge

Rocker switch

What’s behind a wall?

DAPTO

Water Proofing

Bathrooms are the primary wet area within a house and it is important that the bathroom environment is

correctly waterproofed in order to reduce the risk of structural damage occurring as a result of

dampness, condensation or water leaks.

When it comes to waterproofing requirements, the Building Code of Australia (BCA) as well as Australian

Standard 3740 (1994) outline the minimum requirements for waterproofing residential bathrooms. To provide

the best insurance against water damage, it is advisable to go beyond the minimum requirements – that’s the

rule of thumb which SCOPE Access follows. When completing a major bathroom modification, all of the walls

within the shower recess are waterproofed as well as the entire bathroom floor.

There are 5 basic steps that make up the waterproofing process:

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Step 1

All

surfaces are

fixed securely

& are clean &

dust free.

Step 2

Bond breaker

sealant, water

bar & angles

are applied as

required.

Step 3

Primer is

applied.

Step 4 & 5

Two coats of

waterproofing

are applied.

In a recent test of this process, Heidi (SCOPE’s resident

garden gnome) showered for 8 hours and our builders were pleased

to report there were no water leaks past the

Stormtech trench & water bar at all.

Heidi was also smiling the whole time!

TOILETS and their features

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As OT’s we often recommend grab rails or equipment to make it safer or easier for a client to use

their toilet, but what if we are recommending a whole new toilet?

Your OT Assessment will help you to determine features that will suit your client. These are some of the

features you may need to consider:

⌂ The height from the finished floor surface to the top of the toilet seat

⌂ The set-out of the pan (measured from the rear wall to the front of the

toilet pan)

⌂ The distance from the adjacent wall to the centre of the cistern/pan

⌂ Type of seat (including the seat profile and material)

⌂ The type and position of flush buttons on the cistern

⌂ The strength/weight capacity of the toilet and materials used

⌂ Colour contrast

T i p s f o r c o n s i d e r a t i o n w h e n p r e s c r i b i n g a n e w t o i l e t :

The toilet ‘suite’ consists of both the toilet pan and the cistern. The suite can either be close coupled or a linked

suite:

A close coupled suite will have a fixed connection between the

pan and the cistern, which results in a fixed (or small variation) set-

out of the front of the pan from the rear wall e.g. 620mm. This may

be a suitable prescription for ambulant persons, especially where

circulation space is limited. The cistern will be closer to the users

back when they are seated, which can give some individuals a

sense of security. Close coupled suites can also be easier to clean

on the outside, as all the pipes may be encased in a ceramic

structure.

A linked toilet suite is the most commonly provided toilet suite

by Home Modification services, as it allows the toilet pan to be set-

out at a chosen distance from the cistern. A linked toilet suite may

be suitable for a person who completes side-transfers from their

wheelchair onto the toilet. They can also provide greater carer

access to back of the person using the toilet. Linked toilet suites

may also be useful when a person is using a mobile commode chair

with tilt-in-space and/or large wheels for self propelling.

Cistern

Toilet pan

Rear wall

Close coupled suite

Linked toilet suite

‘Bedding’ is the term used to describe how the toilet pan is fixed to the floor. In the past, concrete bedding was

used, but these days plumbers prefer to use silicone to bed in the modern products. Unfortunately, it is not possible

to adjust the height of the toilet by altering the bedding. Instead, our builders will chose a toilet pan and seat based

on the height specified by the OT.

Seat height: OT specifications should indicate toilet height as a measurement to the top of the seat (from the

finished floor). Always specify a height range (eg. 410mm-430mm), as it is rare to get a perfect match. Ensure that

you have considered the clients current and future equipment when prescribing toilet seat height. Clearance may be

required to facilitate equipment, such as a commode moving over the top of the toilet. NOTE: Manufacturers tend

to measure to the top of the toilet pan! SCOPE Access builders take this into consideration when piecing together

the puzzle of toilet pan + seat = ideal height for client.

Seat profiles can be either:

⌂ Rounded —not dissimilar to a donut

⌂ Flat—as is often the case with timber toilet seats

⌂ Contoured—with either a high or low profile

This is a very important consideration as clients will have a preference related to familiarity as well as postural

comfort. Some seats sit on top of the pan, and other curl around the edges. Rubber or resin surfaces on the

underside of the seat can help to keep the seat stable. Normally the seat is attached to the toilet pan with bolts &

wing-nuts. If your client places a twisting force (torsion) on the seat during transfers, you may want to consider

recommending a strong fixing with a low profile seat. If your client is able to, ask them to try out a few different

types of seats. They may be able to do this at friends’ houses, public toilets or showrooms. This will give them an

idea of their preference. Keep in mind —the type of seat can affect the overall height of the toilet.

Cisterns are available in ceramic or plastic. This may be a consideration for someone who rough-handles their

equipment and could potentially crack a ceramic cistern. Cisterns can also be slimline or standard. In-wall cisterns

are not normally recommended in private homes, due to access for maintenance.

Flushing controls are an important consideration particularly when upper

limb function is compromised. Standard controls are normally flush or level with

the top surface of the cistern. For many clients, flushing controls that sit proud

of the cistern are much easier to use. Consider manual dexterity and strength, as

well as visual, perceptual and cognitive abilities.

As always it is best to ask your client to simulate the task of using the toilet. This includes the sit-stand transfer

(or wheelchair commode transfer), and for the males, standing use (if relevant). Toilet hygiene including catheterisation

is also an important consideration. If task simulation is not possible, explore with client/family to get the most

detailed information about the task and any issues they have. Include relevant information in your OT Specifications.

TOILETS and their features

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More information can be found at:

www.caroma.com.au www.reece.com.au www.tradelink.com.au www.aurorasales.com.au www.ilcnsw.asn.au

Round profile Contoured profile

Standard flush Buttons sit proud

GRAB RAILS

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STANDARD GRAB RAILS

Standard diameter is 32mm.

Standard single bar lengths (in mm):

300, 450, 600, 750, 900, 1200

Modular rail systems can be custom

made to a particular length

STANDARD FINISHES: (in stock)

highly polished

SMOOTH FINISH:

brushed (aka: Satin)

FIRM GRIP (aka: Peened) - this has a sand-like texture for

added slip resistance and a popular fit within showers.

DIAMOND EMBOSSED (aka: Diamond cut) - for added

slip resistance and a popular fit within showers.

OTHER FINISHES: (available on request)

BRASS & CHROME POWDER COATED (aka: coloured)

SLIDER RAIL

This rail has a sliding bracket which

can be adjusted to pick up the stud

position. Available in 750mm and

1000mm rail length.

For your consideration when measuring up / recommending grab rails:

⌂ When prescribing a horizontal rail indicate the required height setting from the finished floor to the TOP of the

rail.

⌂ When prescribing grab rails for a bariatric person it is important to:

⌂ Note this on the works request as this will allow the builder to prepare (i.e. source screws with a thicker gauge

and investigate extra screw points to the available studwork)

⌂ Consider using a modular rail system incorporating an extra section of rail. This will allow an additional

attachment point and ultimately spread the load.

⌂ Grab rails need to be fitted to studs. When prescribing a horizontal rail near the corner of a room: start the rail

from the actual corner. There is more chance of a stud in this position than 100-200mm out from the corner.

⌂ When recommending an angled rail (e.g. to wall beside toilet) and unsure as to the exact position of studs:

measure the position of the person’s “optimum grab point” and request that the rail be fitted to studs and pass

through this position. This will allow the builder to use a modular system and meet the prescribed need.

TOWEL/GRAB RAIL

Towel rail that can be

modified and fitted to the

underside of any length grab rail

for dual functionality.

“GLOW IN THE DARK“ RAIL

Can help with way finding. Custom made to suit

requirements, starting from a minimum length of

350mm. The location of the glow strip needs to be

specified in relation to the grab rail orientation.

OFFSET RAIL

This rail gets fitted to the framework and arks

around into the door opening. Facilitates reach

and use when approaching from front-on and/or

either direction. Available in 560mm length only.