Summary:
This podcast episode features Brandy Archie, OTD, OTR/L, CLIPP, and Emilia Bourland, OTR, ECHM, CFPS, discussing the top three pieces of adaptive equipment they dislike. They explore the reasons behind their opinions, focusing on safety, functionality, and long-term usability. The conversation includes considerations for alternative solutions and emphasizes the importance of choosing the right equipment for individual needs.
Key Takeaways:
- Walk-in bathtubs are often inflexible and may not serve long-term needs, making them a poor investment for most users.
- Suction cup grab bars are unsafe as they can easily detach, posing a significant fall risk.
- Lift chairs, while beneficial for some, can lead to decreased muscle strength and independence if overused.
- Not all adaptive equipment is created equal; it's important to choose solutions that are both safe and functional for the long term.
- Built-in shower benches and non-adjustable shower chairs often lack flexibility and can hinder proper usage.
Transcript:
Emilia Bourland, OTR, ECHM, CFPS
Hi, welcome to Care Lab.
Brandy Archie, OTD, OTR/L, CLIPP
It's Keilab Day everybody, we're glad to be back.
Emilia Bourland, OTR, ECHM, CFPS
We are always, yeah. Care Lab is my, Care Lab Day is my favorite day. It is.
Brandy Archie, OTD, OTR/L, CLIPP
Is your favorite day more favorite than your birthday?
Emilia Bourland, OTR, ECHM, CFPS
I mean, OK, well, I'm taking it. Got to take it in context with other things. So, no, there are lots of days that are more my favorite than CareLab Day. But from a work perspective, like this is a pretty fun day.
Brandy Archie, OTD, OTR/L, CLIPP
Just kidding.
Brandy Archie, OTD, OTR/L, CLIPP
I would agree with you. I definitely like it. And also it's fun to be able to get on my soapbox and nobody can come back to me about it. You guys just have to listen to it.
Emilia Bourland, OTR, ECHM, CFPS
I mean, they can, they can, it just...
Brandy Archie, OTD, OTR/L, CLIPP
Okay, don't. Just kidding, just kidding. Don't come back to me about it. How about that?
Emilia Bourland, OTR, ECHM, CFPS
Yeah, we're going to hear about that in comments now. It's OK. It's OK. Hey, I have a question for you before we start. How many pairs of glasses do you own?
Brandy Archie, OTD, OTR/L, CLIPP
Which life?
Okay.
Brandy Archie, OTD, OTR/L, CLIPP
That's such a great question. I own 20 pairs of glasses.
Emilia Bourland, OTR, ECHM, CFPS
Whoa!
Brandy Archie, OTD, OTR/L, CLIPP (01:09.23)
Yes. So if you need, you need to know all the backstories. So, you know, it has to do with health insurance. And you know what? We might as well talk about health. We might as well talk about it. So I have been wearing glasses and cells in like the fifth grade and maybe, I don't know, high schoolish. My prescription never really changed after it was bad. It just kept being the same.
Emilia Bourland, OTR, ECHM, CFPS
I definitely do.
Emilia Bourland, OTR, ECHM, CFPS
Same, me too, you're the only other person I've ever met who had like same, like just really bad and then stayed the same forever, yeah.
Brandy Archie, OTD, OTR/L, CLIPP
And stay the same. That's just basically stay the same. So, you know, your insurance pays for one pair of glasses every year. And so since they weren't bad, there was nothing wrong with them, but I'm paying for insurance, insurance is I'm going to use it. So I just keep getting different kinds of frames each time. And so then I would just start adding to my collection and my vision hasn't changed, so I just started collecting them. But then I found the, then the whole explosion of like buying glasses online happened and you can buy glasses for $5 a pair and they're fine.
Emilia Bourland, OTR, ECHM, CFPS
Mm.
Yeah.
Brandy Archie, OTD, OTR/L, CLIPP
I don't need bifocals yet. I'm very close though. And so I just started buying glasses. If you gotta wear them, they might as well be cute and match your outfit. So, yeah, that's how it goes.
Emilia Bourland, OTR, ECHM, CFPS
Yeah, yeah. See, same thing for my like vision story, but I have always worn contacts. Like, I put on a pair of glasses when I was 12 and I was like, mm-mm, nope. And so I've been wearing contacts. Yeah, I put them on. I've been wearing contacts since I was 12.
Brandy Archie, OTD, OTR/L, CLIPP
At 12, you were just like, no, I can't do this. And we'll contact you at 12.
Brandy Archie, OTD, OTR/L, CLIPP
Oh wow, I remember the first time I got contact, it took me an hour to put one in my eyeball and I was surely not 12. I was definitely in high school.
Emilia Bourland, OTR, ECHM, CFPS
I don't remember my first time putting contacts in. It was, I'm going to guess it was pretty okay. It probably took me a few times to practice, but no, I was just like, and now I, I mean, obviously I have glasses because you can't just wear contacts all the time. So I have glasses at home, but I have like one or two pairs because I have to spend my insurance money every year on the contacts, which it doesn't cover contacts.
Brandy Archie, OTD, OTR/L, CLIPP
It wasn't traumatic like mine.
Brandy Archie, OTD, OTR/L, CLIPP
It's not text, yes.
Emilia Bourland, OTR, ECHM, CFPS
all the way, of course, it's like a small portion of it. But I just don't feel like, I don't know, I feel all weird when I wear glasses all day. I feel sleepy, is that odd?
Brandy Archie, OTD, OTR/L, CLIPP
No, it's not. I don't think that's odd. It's just that I'm the exact opposite. So when I did switch to, I didn't switch, when I did first get my first pair of contacts, because I play sports and it made more sense to have contacts, I feel sleepy with contacts in my eyes. My eyes feel very tired. And so I only wear them if I have to. So if I'm swimming or if I'm doing something where I feel like I don't want to have glasses on my face, then I will wear contacts, but then they're coming right out and I'm going back to my glasses.
Emilia Bourland, OTR, ECHM, CFPS
Huh.
Emilia Bourland, OTR, ECHM, CFPS
Yeah.
Emilia Bourland, OTR, ECHM, CFPS
Wow, that's so interesting. I just want to point out something that I've always thought is really weird about insurance. So like you have, you've got health insurance, right? And then you also have vision insurance and you've got dental insurance. But like your eyes and your teeth are also parts of your body. So why isn't that covered under regular health insurance? I don't understand.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Yes.
Like that's not part of your health. Yeah.
Brandy Archie, OTD, OTR/L, CLIPP
I don't know anything about the history, but the thing I would guess, so don't come for me if it's wrong, is that people tried to out-cart it, right? They wanted their medical insurance to be cheaper, and not everybody needs glasses, and not everybody cares about managing their teeth. So you should. I agree.
Emilia Bourland, OTR, ECHM, CFPS
Oh, but you should, because dental hygiene really affects all of your body, actually, like deeply tied. Uh-huh. Yeah.
Brandy Archie, OTD, OTR/L, CLIPP
You can have a stroke after having a cavity. Like, yeah. So I agree, but I think it was a... The system wasn't designed for that thing. And then they added it in, but people were like, let's not add it all the way in. That's more cost. Let's just make it an extra thing that they can buy.
Emilia Bourland, OTR, ECHM, CFPS
Mm.
Emilia Bourland, OTR, ECHM, CFPS
I feel like it all just ends up costing so much more that way. Like when you just try to piecemeal things out, you know?
Brandy Archie, OTD, OTR/L, CLIPP
100%! It costs us more. It does not cost health insurers more.
Emilia Bourland, OTR, ECHM, CFPS
Okay, fair, fair. And of course, you know, they gotta make money.
Brandy Archie, OTD, OTR/L, CLIPP
This is healthcare and capitalism. That's, that's how this works. Or it doesn't work. I don't know. Yeah.
Emilia Bourland, OTR, ECHM, CFPS (05:17.31)
Yeah. Or doesn't work. Yeah. Well, that, I don't know, that was an interesting place to get to from how many pairs of glasses do you have?
Brandy Archie, OTD, OTR/L, CLIPP
No, and everything ties back to two things in life, I think. Housing segregation and health insurance. So I can probably draw a through line in just about anything to one of those two topics.
Emilia Bourland, OTR, ECHM, CFPS
Mmm
Emilia Bourland, OTR, ECHM, CFPS
I would have to agree with that actually. Yeah. Okay, what are we talking about today? What are we hashtag gear labbing?
Brandy Archie, OTD, OTR/L, CLIPP
I should, hashtag care lab, the reason it's on my mind to talk about getting on soap boxes is because as two clinicians and professionals, I wanna know about the top three things, top three pieces of adaptive equipment maybe, that you hate. Yes.
Emilia Bourland, OTR, ECHM, CFPS
that I hate. Okay, this is, yeah, I feel strongly about these actually. And can I say before I get started on my soapbox here, it's been a while since we've just done a Brandy Amelia episode. So I'm excited for this. Not that I'm not excited for, I love having our guests on. I think it's awesome to have like more people and more perspectives, but I don't get to soapbox there and you know I love soapbox.
Brandy Archie, OTD, OTR/L, CLIPP
It is.
Brandy Archie, OTD, OTR/L, CLIPP
Yeah.
Brandy Archie, OTD, OTR/L, CLIPP
Exactly, exactly.
Emilia Bourland, OTR, ECHM, CFPS
So, okay, so top three pieces of equipment that I really dislike. Oh, okay, ooh, that's so good. Okay, first one, I really dislike walk-in bathtubs.
Brandy Archie, OTD, OTR/L, CLIPP
Just tell us who you want to start with and let the people listen to the whole thing to hear all of them.
Brandy Archie, OTD, OTR/L, CLIPP
That's my drum roll because that I agree. Please tell the people why you don't like walking tubs.
Emilia Bourland, OTR, ECHM, CFPS
because they only function under a very specific set of parameters. And the parameters that I'm talking about are your parameters as a person. So like you have to be able to fit into a space, you have to be able to perform that transfer. Like the person who is using that tub has to be physically capable of doing a very specific set of things. And at first, when the tub goes in, they might be,
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Emilia Bourland, OTR, ECHM, CFPS
they might be able to do that. But over time, that person won't be able to do that anymore. And so what they end up with is something taking up their bathing space that is completely unfunctional for them and ultimately makes it so they're in a situation where they have to spend a lot of money remodeling or they just can't use that bathroom to bathe at all. And it's just really, it's
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Emilia Bourland, OTR, ECHM, CFPS
It's just really unfortunate because they're very, very expensive. And they don't... Okay, here's the really... Here's what gets me is like they're sold as this thing to solve a safety and functional problem and they actually do the opposite of that most of the time.
Brandy Archie, OTD, OTR/L, CLIPP
Yep.
Brandy Archie, OTD, OTR/L, CLIPP
Yep. Matter of fact, you know what we should do? We should figure out who is the person who originally marketed walk-in tubs and hired them for our businesses. Because the people, I mean like, they were very effective because people call me all the time, like, I need a walk-in tub. I'm like, do you?
Emilia Bourland, OTR, ECHM, CFPS
It's very effective.
Brandy Archie, OTD, OTR/L, CLIPP
I don't think you actually do. That's just the solution that you have seen the most. And so now that you're at a position where you can't step into the bathtub that you have, you are going to go to that thing. But that's not because it's the right thing. That's because it's the thing that you saw the most often. And there are so many problems with walking tubs. I like how you described it as being inflexible. So that you
Emilia Bourland, OTR, ECHM, CFPS
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
And I think as occupational therapists, we're always looking for the thing that is not only right for you now, but will be right for you in the future. And by nature, that means it has to be a flexible solution. And I've hardly ever seen that. Yes, totally.
Emilia Bourland, OTR, ECHM, CFPS
especially in home modification, right? Because if we're spending money on this stuff, it's gotta work now, but it's also gotta work for whatever happens in the future, right? Gotta be flexible.
Brandy Archie, OTD, OTR/L, CLIPP
Exactly. You know, the thing that I say about, do you wanna know something that's real terrible? I care a lot about, you're like, yes, definitely. I care a lot about education, right? And I talk a lots of places and do continued education classes and when I do one about home modifications, you should know, and I talk about.
Emilia Bourland, OTR, ECHM, CFPS
Yes. Obviously.
Brandy Archie, OTD, OTR/L, CLIPP (09:53.13)
Like the definition of what a home modification is. We talk about structural changes, things you add to the house and things that you can take away from the house. All of those are home modifications. And this is completely unprovoked by this CU topic, but right in the middle of there, when I talk about structural changes, I talk about walk-in tubs and how much I don't like them. And I step on my soapbox every time I give that top, even though nobody has asked me that because I feel like it's my personal responsibility.
Emilia Bourland, OTR, ECHM, CFPS
I'm sorry.
Brandy Archie, OTD, OTR/L, CLIPP (10:18.89)
to be the anti-marketer for walk-in tub, because there's been so much of it that I'm like, y'all didn't even ask me to talk about walk-in tubs, but I'm gonna tell you, because you're sitting here and you ain't got nothing else you can do, but listen. And so that at least you recognize your mind. And I'm gonna wash you clean of this idea that a walk-in tub is what you need, because every person, I don't say things without having no experience. I won't judge something if I haven't used it.
Emilia Bourland, OTR, ECHM, CFPS
Mm.
Emilia Bourland, OTR, ECHM, CFPS
Right. You're mine. You're mine right now.
Emilia Bourland, OTR, ECHM, CFPS
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
So the reason I have come to this conclusion, in addition to what you've said, is because every person I've ever worked with who's had a walk-in tub has not been able to use it for long enough to justify its cost. And so the average walk-in tub starts at $10,000, right? And I'm in the Midwest where the prices are the lowest. So they go up from there. And it's crazy, yes. And...
Emilia Bourland, OTR, ECHM, CFPS
That is bonkers.
Brandy Archie, OTD, OTR/L, CLIPP
So yeah, if you get it when you're completely healthy and your mobility is fine and you use it for 15, 20 years, then it might be awesome for you. I'm not gonna say it's wrong for everybody, but mostly people get it when they already have mobility issues. And because it's an inflexible situation, I can't do anything to change it. I can't add a grab bar to it. I can't put you a different chair. I can't do anything in there to help you get it unless you get the right one up front. And...
to be somewhat fair, there is maybe one style of walk-in tub that could be effective, maybe, if you get the one that the door swings out and it kicks the whole side of the tub and it's made for you to transfer from a wheelchair over to the seat. That one with grab bars already built in could work for you. So if you're dead set on having it.
Emilia Bourland, OTR, ECHM, CFPS
That's fair.
Emilia Bourland, OTR, ECHM, CFPS
as long as you always have the strength and the trunk control to sit upright and scoot over and do that transfer.
Brandy Archie, OTD, OTR/L, CLIPP (12:10.44)
to scoot over.
Brandy Archie, OTD, OTR/L, CLIPP (12:14.07)
because both of us could give you multiple recommendations for the stuff you already have that would allow you to be able to, if not buy it now and use it continuously, get rid of the other thing that you bought and buy the new thing if you don't have the trunk control or if you have a change and you didn't have to spend $10,000 to do it. So, yes.
Emilia Bourland, OTR, ECHM, CFPS
Mm-hmm.
Emilia Bourland, OTR, ECHM, CFPS
Let me define trunk control for just real fast here, because obviously like that's like a therapy term that we use a lot, but basically it just means sitting balance, just means the ability to control your upright, the upper part of your body, whether or not you're sitting up or laying down. So, you know, the easy way to think about it is, do you have the sitting balance? Do you have the ability to be upright in order to like control your upper body?
Brandy Archie, OTD, OTR/L, CLIPP
Yes.
Emilia Bourland, OTR, ECHM, CFPS
while you're standing or sitting or whatever it is. So that's trunk control. Cause it's your trunk.
Brandy Archie, OTD, OTR/L, CLIPP
Yeah.
Brandy Archie, OTD, OTR/L, CLIPP
and you control it. I think they can infer. Exactly, exactly.
Emilia Bourland, OTR, ECHM, CFPS
and you control it. That's right. Fancy pants. Okay. Yeah, the other thing that I agree with you 100% on all parts. The other thing that I have often found is the fact is a lot of times the seal doesn't stay, doesn't stay on there very well. So they can end up leaking over time and then can be difficult to have them repaired.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Emilia Bourland, OTR, ECHM, CFPS
It's just like, it's just kind of messed. And here's the thing, if you have mobility issues and you still want to be able to take a bath in your bathtub, there are actually much more affordable, flexible products that you can use to do that really well and really safely that don't cost you thousands of dollars and that very effectively allow you to get down and soak in the tub. I recommend those all the time actually. They are great.
Brandy Archie, OTD, OTR/L, CLIPP
Yep.
Brandy Archie, OTD, OTR/L, CLIPP
Yep, automatic sublifts, they're awesome. Yeah, exactly, exactly. So.
Emilia Bourland, OTR, ECHM, CFPS
Mm-hmm.
So like, that's a problem we can solve without having construction and there's no construction involved in tub lifts, right? You take, you put them in, you take them out. It's not, no, no thing.
Brandy Archie, OTD, OTR/L, CLIPP (14:17.87)
Mm-mm. You can take them out.
Mm-hmm. Yep, totally.
Emilia Bourland, OTR, ECHM, CFPS
I mean, it's a thing, but it's like a little thing compared to a big thing. Yeah. Which a much smaller price tag, yeah. And they are something that works longer for more people because again, a lot of times you can even get to them from a wheelchair as long as you have the control to get over there, you can do that transfer over onto it from a wheelchair, you know, and it still prevents you from having to step over to the side of the tub.
Brandy Archie, OTD, OTR/L, CLIPP
Compared to a big thing with a much smaller price tag.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Yep, $500. That's a mic drop, exactly. I'm not saying that everybody can't afford $500, but it is certainly more affordable than a $10,000 walk-in tub. Yep.
Emilia Bourland, OTR, ECHM, CFPS
Mic drop.
Emilia Bourland, OTR, ECHM, CFPS
Yep, absolutely. Okay, what's your number two?
Brandy Archie, OTD, OTR/L, CLIPP
Okay, my number two is, drum roll please, suction cup grab bars.
Emilia Bourland, OTR, ECHM, CFPS
That was my number two.
Brandy Archie, OTD, OTR/L, CLIPP
I mean, great, we're on the same page. There's a reason we do this together. Uh.
Emilia Bourland, OTR, ECHM, CFPS
Yeah, there. Okay, why is that your number two?
Brandy Archie, OTD, OTR/L, CLIPP (15:27.37)
Because it's also a thing that people, oh wait, I have a lot of reasons. First of all, first of all, it is unsafe. It says on the package it's unsafe, but you don't ever read that. It says not made to support your weight. What are you gonna grab bar for if it's not to support your weight? Because you want it to support you so you don't fall. That was the whole point of putting the grab bar in. Am I right?
Emilia Bourland, OTR, ECHM, CFPS
You're, you are right, yes.
Brandy Archie, OTD, OTR/L, CLIPP (15:56.13)
I don't care if it has a red tag, green tag thing to tell you that the seal is on there or if it's some other fancy thing or if it's longer or shorter. I don't care. The suction cup grab bar is not going to stay on the wall. And if you're not intentional about checking it every single time you need to use it,
then there's gonna be a time in which you try to rely on it and it's gonna come off the wall and you're gonna go to the floor. And like, I'd rather you not have anything actually than have that because at least you'd be careful enough to do the best you could to get out and like hold the wall or something else. But when you rely on that and it comes off the wall, then like, what can you do with that?
Emilia Bourland, OTR, ECHM, CFPS
Yeah, I give that kind of example all the time. Like this is actually the kind of thing that can cause a fall. Because if you are relying on something that's not secure, same thing with like a towel rack. A towel rack is not a grab bar, right? It's only in the drywall. You can't rely on a towel rack to hold your weight. So if you are using it, same as a suction cup grab bar, and it becomes loose, then maybe you weren't off balance before. Maybe you were just holding onto it, you know, just as...
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP (16:48.83)
Mm-hmm. Not.
Emilia Bourland, OTR, ECHM, CFPS
as habit or to like steady yourself a little bit. But then it comes out of the wall or the suction cup grab bar comes off of, you know, whatever it was stuck to. And now you are thrown off balance and then you do fall.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Exactly. It's doing the exact opposite of what it's supposed to do. The exact opposite. And for the towel racks, like I've seen towel racks come out of the wall from where they're attached to. I've also seen towel racks break in half in the middle. And so like the thing is attached well, but the thing that holds the pole that holds the towel, it's also not supposed to hold your weight. It's supposed to hold the weight of a towel and that breaks. And so, they were like, oh, I have a place to hold. That's not a place to hold. It's just not.
Emilia Bourland, OTR, ECHM, CFPS
Mm-hmm.
Emilia Bourland, OTR, ECHM, CFPS
Mm-hmm.
That's right.
Brandy Archie, OTD, OTR/L, CLIPP
And there are grab bars that have towel racks on them and it can be installed in a safe way. So yes, you don't have to lose your towel place, but you can put in something that's gonna be secure. But the one thing that I will say is because like, there's always a caveat. If you have a shower insert and it's fiberglass or plastic, you really can't screw in a grab bar into it because you risk cracking it.
especially if there's an inch of space between the fiberglass and where the drywall is at. And so if you need a place to hold on to and you have that kind of shower,
Brandy Archie, OTD, OTR/L, CLIPP
I'm not even going to say it because I don't want to be recorded in history for forever, but there are other ways to consider having a safe place to hold on to. For example, the insert doesn't always, usually doesn't go past the tub or past the tile or the flooring. You can put a grab bar right outside of that insert and at least have a holding place to hold on to step in. You can put a chair in that has an armrest to sit on, but just don't use a suction cup grab bar.
Emilia Bourland, OTR, ECHM, CFPS
I also think in those kinds of situations like the floor to ceiling, yes, thank you so much, transfer poles, those can be really great in those kinds of situations where you can't mount anything to the wall for one reason or another. So yeah, because obviously a lot of this, where a grab bar can go does depend on...
Brandy Archie, OTD, OTR/L, CLIPP
Yes, transfer port.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Emilia Bourland, OTR, ECHM, CFPS
the layout of your bathroom. It depends on the construction materials in your bathroom. There are more things to consider, unfortunately, sometimes than just where we want it to be. So again, that's why it's important to say, OK, well, if we can't do it one way, what are the other options that we have? And working with someone who, like an occupational therapist, who actually understands what those other potential solutions could be so that you're not having
Brandy Archie, OTD, OTR/L, CLIPP
Sure.
Brandy Archie, OTD, OTR/L, CLIPP (19:27.07)
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Yes.
Emilia Bourland, OTR, ECHM, CFPS
It's always a balance in home modifications, right? We want to make sure that we're creating spaces that in the long term are going to be, that now and in the long term, are gonna be safe and functional spaces for people. A lot of times though, the fact is that budget is a huge consideration. So we have to come up with options for how that's gonna be done. It can't be...
Brandy Archie, OTD, OTR/L, CLIPP
Yes.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Emilia Bourland, OTR, ECHM, CFPS
you know, for everyone ripping out everything and redoing it is not always an option. So you want to have someone who can tell you, okay, here's this option for this budget, here's this option for this budget, and then here's this option too. Whichever one of these choose, whichever one of these you choose, and it can be based on your preference or your budget, but whichever one you choose, these are all good workable options for you.
Brandy Archie, OTD, OTR/L, CLIPP (20:14.55)
Bye.
Brandy Archie, OTD, OTR/L, CLIPP
Yes, yes, that's I feel like that's so important is and I will go back to the walking tub thing it's like thinking the only way to solve the problem is to buy a walk-in tub and then you Muster up all of your money and you do the thing and then it ends up not working well for you there's always more than one way to do something and it's all there always is and I know when it comes to safety or your parent or You want to make sure you have give them the best that doesn't always mean you spend the most money
Emilia Bourland, OTR, ECHM, CFPS
Always.
Brandy Archie, OTD, OTR/L, CLIPP
the biggest thing. And it could mean that maybe a certain kind of shower chair is just the right thing for now because you know in the future you're going to change something else. And this works for now, we're going to do that and we'll make a new plan when the new plan comes up. You know, like, it's okay to not do the biggest thing. You just need to do the right thing. And suction cup grab bars are not the right thing.
Emilia Bourland, OTR, ECHM, CFPS
Mm-hmm.
Emilia Bourland, OTR, ECHM, CFPS
They're not the right thing. I can't tell you how many times I have ended up just recommending someone thought they needed a whole new shower and I said, no, you just need a tub bench. Right? You don't need to do a multi-thousand dollar remodel. You can just spend like 50 bucks.
Brandy Archie, OTD, OTR/L, CLIPP (21:42.39)
Facts! Exactly! Totally!
Brandy Archie, OTD, OTR/L, CLIPP
Yeah, yeah, exactly. And I mean, if you, and this is, I have said that same thing. I'm like, now, if you did really want to get a bathroom remodel, great. Remodel the bathroom. Here's what you could do. That's if that's your goal anyway, is to remodel the bathroom. Great. But if that wasn't your goal, your goal is safety to get in and out of this tub. Here's a way different solution.
Emilia Bourland, OTR, ECHM, CFPS
Yeah, here's what we can do, but...
Mm-hmm. Yeah, yeah.
Emilia Bourland, OTR, ECHM, CFPS
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
So yeah. Okay, so...
Emilia Bourland, OTR, ECHM, CFPS
But the moral of the story is suction cup grab bars are not grab bars. I'm not sure what they are or what they're for, but they're not for safety. It is inevitable that suction is going to fail at some point. And that is not the purpose of a grab bar. A grab bar should be bomb proof so that you can rely on it. You should never have to second guess it.
Brandy Archie, OTD, OTR/L, CLIPP
They're not.
Brandy Archie, OTD, OTR/L, CLIPP
at all. That's the reason it is there. Oh, and section cup grab bars on those inserts, they have broken the fiberglass or pulled it off.
Emilia Bourland, OTR, ECHM, CFPS
Mm-hmm.
Emilia Bourland, OTR, ECHM, CFPS
Oh yeah, yeah. Oh, okay, then I will drop this. That is another thing to think about. I have also often seen suction cup grab bars being placed on like glass shower doors or glass shower walls. Let's say the suction cup stays mounted to that shower door wall. That glass wall or that glass door was also not built to hold your weight. It is not mounted in such a way to hold your weight.
Brandy Archie, OTD, OTR/L, CLIPP
Oh yeah.
Emilia Bourland, OTR, ECHM, CFPS
It is mounted to hold up its own weight. Water splashing on it. So that is not going to hold you, even if the suction cup grab bar stays on there. If you go down, that thing is coming down on top of you. I have unfortunately seen that happen to folks, not while I was actively there, obviously, but that has actually happened to clients of mine. And that is no bueno, no bueno. So just know.
Brandy Archie, OTD, OTR/L, CLIPP
Thanks for watching!
And that's it. Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Yep.
Brandy Archie, OTD, OTR/L, CLIPP
Yeah. Also on the topic of grab bars in general, in the same way that people like, Oh, I need this thing. People often say, Oh, I need grab bars. And I'm not against grab bars. Like the real ones that you screw into the wall. I'm not against them, but it's not the, it doesn't, it's not usually the first answer that I say, because like you said, there are a lot of barriers to putting one in and you, you can't just slap it up anywhere. Right. And the place that we might want to have it might also not be a place that's possible to screw it in.
Emilia Bourland, OTR, ECHM, CFPS
Yeah, yeah.
Brandy Archie, OTD, OTR/L, CLIPP
safely. And because of all those barriers, I like to think of other things first before going to the grab bar route, because often there are other ways to provide safe places to hold on to things without screwing in a grab bar.
Emilia Bourland, OTR, ECHM, CFPS
Mm-hmm.
Emilia Bourland, OTR, ECHM, CFPS
There you go, cherry on top. Boom.
Brandy Archie, OTD, OTR/L, CLIPP
Boom.
Emilia Bourland, OTR, ECHM, CFPS
Okay.
Brandy Archie, OTD, OTR/L, CLIPP
Okay, so what is your third thing? Because I took your second thing. You might as well keep going.
Emilia Bourland, OTR, ECHM, CFPS
Okay, that's fair. Yeah, Brandy. Jeez. So my third thing is the reclining chairs that lift, the lift chairs. I lift chair to test them.
Brandy Archie, OTD, OTR/L, CLIPP (24:56.35)
A lift here. I'm surprised by this. So tell us why.
Emilia Bourland, OTR, ECHM, CFPS
I am surprised that you are surprised, and I'm really looking forward to hearing what you have to say about it, because I have a feeling you'll probably change my mind a little bit because you are very smart. But here's my thing about them. I don't think that they're inappropriate 100% of the time. They're not. There are definitely groups of folks who can really benefit from having a lift chair. I'm thinking specifically about like...
Brandy Archie, OTD, OTR/L, CLIPP
Sure.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Emilia Bourland, OTR, ECHM, CFPS
Folks with ALS can be a good example. Some people with spinal cord injury, that's not complete. That can be another good example. However, they are so well-marketed to go back to this idea of like, you know, the walk-in tub, they're so well-marketed that people think that they need them inappropriately way more of the time than they're actually needed appropriately. And what happens is you say, oh, you know,
Mom or dad is having some trouble or I'm having some trouble getting up or down from my chair. It's getting a little bit harder. I'm going to get one of those lift chairs that I see on TV all the time and then I won't have trouble getting up anymore. So then what happens is you get this chair. It's a chair that you're in all the time. It does all the lifting for you and very, very quickly you can no longer get up from other surfaces. So it prevents you from using your muscles and it makes you weaker.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Emilia Bourland, OTR, ECHM, CFPS
And before you know it, you can't get up off the toilet by yourself. You can't get up and down from the dining room table chair by yourself. You can't get in and out your car by yourself. And it becomes a really big problem, again, when it's used inappropriately. And the vast majority of the time, I think it's done inappropriately.
Brandy Archie, OTD, OTR/L, CLIPP
Thank you.
Brandy Archie, OTD, OTR/L, CLIPP
I think that's a very fair assessment. And, but I think, let's see, I've also seen the other side. This is a nuanced situation, which I'm glad we're talking about it. I've seen the other side in which people are calling the fire department to come get them up because they cannot get out of their chair and they don't have a lift chair. And they stay sitting there.
Emilia Bourland, OTR, ECHM, CFPS
Okay, because I was a little nervous there.
Brandy Archie, OTD, OTR/L, CLIPP
all day because they know it takes all of their energy to try to get up and they get up and they fall because they used it all from just getting up and they're stuck sitting that chair until their daughter comes over to help them out. And I've seen that so many times that I am a little bit more proactive with saying, is there a way for us to get you a chair that lifts up? And so I think what you're saying is fair because if you don't use it, you lose it, right? But if you've already lost it and I can't get it back.
or it's hard to get it back, I'd rather you be safe. So I think that's why you said using it appropriately is really important. And the other thing is you don't have to use it. So let's say you're being proactive. Well, let's say you see your dad struggling to get out of the chair, you see a lift chair on sale, you buy, you get it for him. Okay, that might not be terrible, but you also don't have to lift the chair all the way up and just walk out of the chair.
Emilia Bourland, OTR, ECHM, CFPS
Yeah.
Brandy Archie, OTD, OTR/L, CLIPP
you can lift it up only if you try and you struggle and then you want some help, or you can use it to go up just a little bit and then you get yourself up the rest of the way. Because it is important to keep moving your body. You know, like I've had clients whose bedrooms are upstairs and it takes them some good amount of energy to get up there. And you know, we've talked about, okay, we move our bedroom downstairs or what some other ways. And like, you know, I actually wanna do the stairs because that is my exercise for the day. And you know, as long as it's safe for them to do it, yes, we should do it as often as possible.
because you need to use those muscles or you might not be able to. But I also don't want you to fall down the stairs. Right. And so like that's where judgment comes into play and that there's no like blanket answer that's right for everybody all the time. You know, because I have met therapists that are like, I never recommend a lift chair ever. I'm like, well, I don't know.
Emilia Bourland, OTR, ECHM, CFPS
Yeah, yeah.
Emilia Bourland, OTR, ECHM, CFPS
Mm-hmm.
Emilia Bourland, OTR, ECHM, CFPS
There's always there's almost always going to be a scenario where you could find that you will recommend Things even that you don't like accept suction cup grab bars Except that that's a no all the time. I think for me, it's really important to understand that caveat that like if someone cannot get stronger or It's gonna take them a really long time to get stronger They're working on getting stronger and they need a safe solution in the meantime
Brandy Archie, OTD, OTR/L, CLIPP
except that, that's a no all the time.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Emilia Bourland, OTR, ECHM, CFPS
Like I'm okay with that, but what I'm not okay with is saying, oh, well here's an easy button. We're going to go do it like this. And then before you know it, you actually have a really problematic situation that can cause falls that does cause decreased increased ability where suddenly you're having to have someone come in and help when maybe all that person really needed was like 12 sessions of therapy.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP (29:35.85)
Yeah, that's totally true.
Brandy Archie, OTD, OTR/L, CLIPP
of your people. Yeah. Before you went and bought that lift chair, totally agree with that. Yeah, absolutely. I think it's just like food, for example. Food, we need food, we must eat. But if we eat too much food, it causes problems, right? You can have some sugar if you're not diabetic, and that's okay, but if you eat a lot of it all the time, that's really bad. And so like, it's a similar thing. I think we like the simplicity of black and white situations, but in real life, most situations are not black and white, and you need to have some judgements to serve.
Emilia Bourland, OTR, ECHM, CFPS
Mm-hmm.
Emilia Bourland, OTR, ECHM, CFPS
Yep.
Emilia Bourland, OTR, ECHM, CFPS
Mm-hmm. And I think that also brings up why it's so important to get, like work with someone who can provide that education around what the recommendations they're making are. So for example, let's say you have one of these lift chairs and you are also working on getting stronger. Just having someone say to you what you just said, Brandy, hey, you can use this, but only use it as much as you actually need to. You know, or you could use this. Let me show you how you can actually use this to help.
Brandy Archie, OTD, OTR/L, CLIPP
Yeah.
Emilia Bourland, OTR, ECHM, CFPS
assist your rehab process, right? That's really different than it just being plopped into a home where I guarantee you 99.9% of the time, people are not thinking, well, I could only go up halfway. They're just using the dang thing, you know? So having education, working with someone who's really thoughtful about how these decisions, even though they seem really small, they can have huge impacts on your life. I just can't overstate the importance of doing that.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Yeah, exactly.
Brandy Archie, OTD, OTR/L, CLIPP
Yeah, totally. I totally agree with that. Of course.
Emilia Bourland, OTR, ECHM, CFPS
All right, well, what's your third?
Brandy Archie, OTD, OTR/L, CLIPP (31:21.29)
This is a hard question because those are my...
Emilia Bourland, OTR, ECHM, CFPS
I'm glad that we had different thirds, aren't you?
Brandy Archie, OTD, OTR/L, CLIPP (31:26.01)
I am glad because then we get to talk about more stuff. I think that, let's see, my biggest one is walk-in tubs, suction cup, grab bars, and the other thing that I really don't like is, here it is. These are lesser used, but since we're on the topic of lift chairs, it's these inserts that you put into a chair that's supposed to have spring assist to lift you up.
Emilia Bourland, OTR, ECHM, CFPS
Yeah.
Emilia Bourland, OTR, ECHM, CFPS
Okay, I know what you're talking about.
Brandy Archie, OTD, OTR/L, CLIPP
And I think they're a misnomer because people think that they're going to lift them all the way up and it actually doesn't do that. And when you sit on it, you're also like, just to be, you're not trying to get up. You're just sitting on it. It puts you in a, I shouldn't say it that way. It puts you in a forward position. Um, which is where you can get forward. If you're not careful and you don't have your feet underneath you. And you know, it's kind of like a cheaper alternative to a lift chair, but
Emilia Bourland, OTR, ECHM, CFPS
where you can tip forward.
Emilia Bourland, OTR, ECHM, CFPS
Mm-hmm.
Emilia Bourland, OTR, ECHM, CFPS
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Also depends on your weight and like nobody is giving you any context about this when you see it on Amazon or you See it somewhere else like they don't work good, but they still have for sale and it's like not all pieces of adaptable equipment are Made equal or are even solving a real problem in a good way. I think It's trying to solve a real problem getting out of chair, but it don't
really work for most people. And how are you gonna know that until you try it or you've had experience with it? And so that's the thing I don't like, because then you spend money on something that you didn't need to spend money on when things are already expensive. See our episode about financial planning. So that's my third one. We think about that.
Emilia Bourland, OTR, ECHM, CFPS
So I'm mostly with you. I would say especially it depends on almost the individual one and how well it functions. I've seen a lot of them that they're kind of clunky and they get stuck or they won't work or you know. This is kind of technical but a lot of times in like seating and thinking about safe seating and good positioning for function during seating, as therapists we think about the position of the pelvis.
Is it tilted forward? Is it tilted backward? And so those definitely change the tilt of the pelvis, which substantially changes the way that the rest of the body functions. If you kind of, we won't get too much into the technical details, but I think it just basically makes sense if you think that the whole body can only move based on where its center is stabilized to a certain extent. So when you change how the center is stabilized, it changes how well you can do pretty much everything else.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Thank you.
Brandy Archie, OTD, OTR/L, CLIPP (34:01.09)
Mm-hmm.
Emilia Bourland, OTR, ECHM, CFPS
And it also can cause other kinds of issues with like joint pain and stuff like that. But so like the clunkiness of them and sometimes they don't always work really well, they change people's positioning. I also, I will say that I, again, there are some scenarios where I think that they can be helpful to help maintain function for longer. Again, I think sometimes ALS.
can be a situation where that's true if someone is really working to be able to maintain their ability to get up and down for as long as possible, then having that boost in there can be helpful. So actually, my grandfather-in-law, who passed years ago now, he had a disorder that was similar to ALS, not quite, but he used one for years to help himself get up and down and up and down. And it wasn't my favorite thing.
Brandy Archie, OTD, OTR/L, CLIPP
Mm.
Emilia Bourland, OTR, ECHM, CFPS
Especially like, you know, sometimes when you're in OT and you've got family members doing something that you don't love You don't love it But I had to sit on my hands about it because at the end of the day there wasn't really another way for him To do it and he was so fiercely independent and he like fought for every Bit of walking that he could possibly do, you know, it was really important to him. So so in those cases
Brandy Archie, OTD, OTR/L, CLIPP (35:02.61)
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Mm.
Brandy Archie, OTD, OTR/L, CLIPP
Yeah.
Emilia Bourland, OTR, ECHM, CFPS
You know, here's the other thing that I would add to that though, is you do have to be so careful with these things because they are not mounted to anything. You're just setting them in a chair. They can slide, they can slip, they cannot be in the middle of the chair. You got to be so, so careful with them in order to make sure that you don't have an accident due to that piece of equipment.
Brandy Archie, OTD, OTR/L, CLIPP
Yes.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Emilia Bourland, OTR, ECHM, CFPS
And really, ideally, you kind of want someone to be there with you, almost holding on at a certain point when you're getting up, because you don't know how fast it's going to launch you. You don't know if those springs are going to get stuck or not. And again, it's not mounted to anything, so it can slip, it can slide, it can not be in the correct place, and that can cause a really big problem. So overall, I would say, like, not my favorite. But again, in certain circumstances, I get it. I get it.
Brandy Archie, OTD, OTR/L, CLIPP
Yep.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Yeah. Any, do you have any bonus ones that you want to throw in before we end?
Emilia Bourland, OTR, ECHM, CFPS
Um, I probably, not, not that I'm on the spot. Do you?
Brandy Archie, OTD, OTR/L, CLIPP
No, I don't. Those are those. Those are my biggest ones for real, because those are the ones that we encounter the most often. I mean, I'm sure there's a few things that, oh, wait, I do have a bonus one. I have a bonus one. Why does anybody make a shower chair that doesn't have adjustable legs? I do not understand that. I do not understand that because you have no idea the height of the person. And even if it's a beautiful looking chair, like
Emilia Bourland, OTR, ECHM, CFPS
Okay, okay.
Emilia Bourland, OTR, ECHM, CFPS
Oh, that's silly.
Brandy Archie, OTD, OTR/L, CLIPP
Those are the kind of the worst ones. The ones that are like teak and they don't have adjustable legs and they look nice. They're surprisingly low. You would think that they, if you're gonna not make the legs adjustable, that you make it the height of a real chair, like a dining room chair. But they don't make it like that. And I don't understand that. And so like that's my other pet peeve. Don't ever buy a shower chair without adjustable legs.
Emilia Bourland, OTR, ECHM, CFPS
Okay.
I've, you've inspired me, I got a bonus one now too. So this isn't necessarily like a piece of equipment per se, but it's like a thing that people do. I'm really not a fan of built in shower chairs or like built in benches. Cause again, they're not flexible. They end up taking up the space of the actual piece of equipment that will likely be needed at a certain point. So it makes it so you can't use the correct equipment and the shower becomes unusable.
Brandy Archie, OTD, OTR/L, CLIPP
Yes.
Brandy Archie, OTD, OTR/L, CLIPP
Oh yeah.
Brandy Archie, OTD, OTR/L, CLIPP
Mm-hmm.
Emilia Bourland, OTR, ECHM, CFPS
Also, they're usually too low. People just end up putting a bunch of stuff on them. And I have met very few people whose bottoms actually fit on most built-in tab benches.
Brandy Archie, OTD, OTR/L, CLIPP (38:10.04)
Yep.
Brandy Archie, OTD, OTR/L, CLIPP (38:18.29)
I don't understand the thought process behind all of these that got put in the 80s. That's I think pretty much the way they're so little. And if it's going to be a shelf, why does it need to be that low? And if it's going to be for my butt, why does it need to be that low and that small? So like, what was intended for a plant? I don't understand. Like, yeah, I think.
Emilia Bourland, OTR, ECHM, CFPS
They're so small, no one's butt fits on those.
Emilia Bourland, OTR, ECHM, CFPS
Yeah.
Emilia Bourland, OTR, ECHM, CFPS
Yeah, I don't know. A plant.
Brandy Archie, OTD, OTR/L, CLIPP
just look at them and I'm like, who decided that this was okay to do? Nobody, this doesn't work for anybody or anything. You know? Yeah. So yeah.
Emilia Bourland, OTR, ECHM, CFPS
Yeah, yeah. So that would be my bonus one is that, is that those built-in, you know, shower benches. What I do think if something has to be built in is a good potential alternative is those ones that flip up and down from the wall because you can get them out of the way and then the space is still flexible. It's all about flexibility.
Brandy Archie, OTD, OTR/L, CLIPP (39:06.73)
Yeah.
Brandy Archie, OTD, OTR/L, CLIPP
Yep. Only challenge with those is making sure that you have the right place to install it. Like pretty much you can only put it in one place, right? On the back wall and in the middle so that you can flip down and use the shower. But if your studs are not there, you can't put it in. And so that is the challenge with using those. It's not as, I guess I'll call it user-friendly or able to be used by most people. I like to, like, for example, I asked Sammy,
Emilia Bourland, OTR, ECHM, CFPS
Uh-huh.
Yes.
Emilia Bourland, OTR, ECHM, CFPS (39:39.01)
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
The things that we have in the store are able to be used by most people. And that way you don't have to figure out like, is this right for me? And I'm like, mostly it's right for you if you fit this criteria. And that one is just one of those things that's like, you need to be able to find your studs and your studs need to be in that exact right place. And then sure, it's awesome.
Emilia Bourland, OTR, ECHM, CFPS
Mm-hmm.
Emilia Bourland, OTR, ECHM, CFPS
Well, and then you also have to be able to reach your shower controls from there too. So if you've got a really big shower, you've got to be able to mount it somewhere where you're actually going to be able to reach your faucet and the shower head and all those other things too. Otherwise, again, you're sitting way far away from where the actual water is and you've got to make some tough decisions about how you're going to manage that.
Brandy Archie, OTD, OTR/L, CLIPP
Yeah.
Brandy Archie, OTD, OTR/L, CLIPP (40:13.39)
Mm-hmm.
Brandy Archie, OTD, OTR/L, CLIPP
Absolutely. I've definitely seen that happen. I'm like this is like this is the kind of person that maybe they have this big old shower And they have the flexible the money to spend to make it look nice and install one these flip down But it don't even make sense to put a flip down in because you're gonna be all the way back here and you have to go Over here turn on the water. And so I still think you should just buy a chair and that way you can move it
Emilia Bourland, OTR, ECHM, CFPS
All the time.
Emilia Bourland, OTR, ECHM, CFPS
Yeah, just a good shower chair. There's a lot to be said for just a good, regular old shower chair. There you go. All right, this was a fun episode.
Brandy Archie, OTD, OTR/L, CLIPP
good luck to you.
Brandy Archie, OTD, OTR/L, CLIPP
Thanks.
Brandy Archie, OTD, OTR/L, CLIPP (40:56.39)
It was. Sub boxes are great to get on.
Emilia Bourland, OTR, ECHM, CFPS
Alright y'all, if you enjoyed this episode, if you found anything valuable or educational about our conversation, please make sure that you are s- huh? What? We're stupid. We're s-
Brandy Archie, OTD, OTR/L, CLIPP
Or stupid. If you think our idea was bad, tell us about it too.
Emilia Bourland, OTR, ECHM, CFPS
Well, I was going to say that they should subscribe, but definitely. But yes, no, I think, hey, put it in the comments. Put it in the comments. We'll check it out. We'll do our best to respond as appropriately as we possibly can. But yes, please make sure, if you enjoyed this episode, please make sure that you are subscribing to it wherever you are listening or if you're watching it on YouTube that you are subscribing to the channel. That way you can make sure to get updates about when the next episode drops.
Brandy Archie, OTD, OTR/L, CLIPP
I'm going to go ahead and turn it off.
Emilia Bourland, OTR, ECHM, CFPS
And also please share this with other people that you think might benefit. Sometimes it's really hard to have a conversation about these things, but you can share a podcast and it's a good way to open the door or maybe get someone's wheels turning. And definitely make sure that you are liking this and I'm gonna stop rambling now.
Brandy Archie, OTD, OTR/L, CLIPP
Sure.
Brandy Archie, OTD, OTR/L, CLIPP
Like and subscribe. See you next time.
Emilia Bourland, OTR, ECHM, CFPS
Like and subscribe. See you next time.
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