Referral Service Center

FEMA"s US Fire Administration discusses reasons for emphasis upon risks for. Although their emphasis is on fire safety, their concerns have broad applicability.

"Why are People with Disabilities at Risk?

• Decreased mobility, health, sight, and hearing may limit a person's ability to take the quick action necessary to escape during a fire emergency.
• Depending on physical limitations, many of the actions an individual can take to protect themselves from the dangers of fire may require help from a caretaker, neighbor, or outside source.
• People with disabilities are typically fiercely independent and do not wish to alter their lives from those of the general public. However, this can lead them to ignore their special fire safety needs. In some cases, people with disabilities may need the help of a caregiver to practice proper fire safety precautions."

 Who is a HVAC/R technician? 

Americans spend much of their life indoors, using enclosed buildings as homes, offices, and, increasingly, as places of recreation. As a result, we are exposed to air borne pollutants that include chemicals, gases and living organisms such as fungi, mold and insects.

HVAC/R technicians control the quality of air in buildings through the installation, maintenance and repair of heating, ventilation, cooling and refrigeration systems. Many HVAC/R technicians specialize in one aspect of their trade such as heating or refrigeration or air conditioning. Some technicians specialize in specific equipment such as water-based heating systems or compressed-refrigerant cooling systems.

HVAC/R technicians complete formal education and practical training. Academic requirements include a high school diploma or GED, and further education is preferred. Many HVAC/R technicians complete Associate college degrees.

A formal apprenticeship, usually lasting 3-5 years, is required. The U.S. Department of Labor offers a nationally recognized apprenticeship that incorporates theoretical and practical training. Apprenticeships are also sponsored by contractors’ associations, trade groups, employers’ associations, and by labor organizations.

Successful completion of an apprenticeship can result in certification. Certificates vary, and are awarded on the basis of education, experience, and performance on standardized tests. Technical and trade schools offer a preliminary certificate to qualified applicants who are experienced in the maintenance and repair of HVAC/R equipment. Candidates with one or more additional years of experience in the installation of HVAC/R equipment can receive certification of their knowledge within specialized fields.

Some states require licensing. Requirements vary between states, but all successful licensing applicants must pass a competitive exam.

The Environmental Protection Agency (EPA) requires technicians who use refrigerants to pass an exam leading to certification in 1 of 3 areas: 1. small appliances 2. high-pressure refrigerants 3. low-pressure refrigerants. Technicians must conserve, recover and recycle refrigerants, and be familiar with the appropriate handling techniques.

Most HVAC/R technicians work for private companies, and are employed on a full-time basis. More than half of all technicians are employed by building contractors.

Approximately 15% of HVAC/R technicians join a union. 

What do HVAC/R systems do?

HVAC/R systems control indoor air quality. Indoor pollution occurs because of the presence of people, and environmental elements such as temperature and moisture.

The primary cause of indoor air quality problems are sources of pollution that release gases or particles into the air. Living organisms such as molds, fungi and insects can also cause air pollution. Inadequate ventilation increases indoor pollutant levels by not bringing in enough outdoor air to dilute emissions from indoor sources and by not carrying indoor air pollutants outside. High temperature and humidity levels can also increase concentrations of some pollutants.

HVAC/R technicians install, maintain and repair systems that control the climate inside of buildings. HVAC/R technicians are able to repair and replace damaged parts of a HVAC/R system. Many HVAC/R technicians specialize in one aspect of their trade such as heating or refrigeration or air conditioning. Some technicians specialize in specific equipment such as water-based heating systems or compressed-refrigerant cooling systems.

HVAC/R technicians are trained to:

• read and design blueprints
• pump gas and liquid refrigerants
• install, repair and replace filters
• connect wiring to power sources
• connect systems to air ducts, fuel supplies, and water supplies
• test for refrigerant leaks
• test electrical wiring
• reclaim refrigerants, and perform other EPA mandated activities
• solder
• use electrical/mechanical/pneumatic/ equipment, acetylene torches, carbon monoxide detectors, voltmeters, and combustion analyzers

When should HVAC/R systems be installed?

The installation of HVAC/R systems is particularly helpful in buildings that hold groups of people on a regular basis.  HVAC/R can also be a critical element in the maintenance of an old building or a building that is in deteriorated condition.  Researchers at the University of Delaware  recently received a grant to investigate the use of "smart skin" sensors http://phys.org/news/2012-09-carbon-nanotube-composites-health.html, called carbon nanotube composites, to monitor the structural integrity of civilian infrastructure such as buildings and bridges.

HVAC/R systems regulate the ventilation of gasses and particles into the air, a critical issue in building construction and maintenance and in medical illness. Indoor pollution occurs because of environmental elements such as temperature and moisture. People are another source of air pollution and, also, vulnerable to its toxic effects. Radon, a toxic gas that forms in the soil and leaks into buildings, follows cigarette smoke as the second leading cause of lung cancer. HVAC systems are especially useful in buildings without access to adequate natural ventilation.  Such buildings are frequently located in inhospitable climates and in industrialized areas.

Air quality can be improved by taking precautions that include:

• eliminating obvious sources of pollution
• decreasing the growth of mold and other pollutants by venting rooms with a lot of moisture, such as bathrooms
• opening windows and doors to increase ventilation if the weather isn’t humid
• running an air conditioner while the vent is turned on
• using  exhaust fans that remove pollutants to the outdoors when cooking, washing dishes, cleaning and running the clothes dryer
• regularly changing filters on heating and air conditioning units
• using a gauge to regulate indoor humidity to 30%-60%

Natural ventilation is helpful but inadequate in many buildings. HVAC systems are important because the signs of air pollution, such as mold and fungi, are frequently not observed for long periods of time. The medical consequences of air pollution, and their impact upon the performance of workers and students, are often not readily apparent.

HVAC systems should be evaluated during the preliminary phase of building design because HVAC equipment can impact variables other than air quality. For example, functioning HVAC systems may require adjustments in the equipment and material that regulates building acoustics.

HVAC systems are an important factor in the direct and indirect costs of building maintenance. Costs that can vary as the result of air quality include:

• medical care of building inhabitants because of illness related to air pollution
• legal liability for harm sustained by building occupants as the result of poor air quality
• absenteeism from work or school because of illness related to air pollution
• impaired standards of performance when present at work or school because of poor health and discomfort associated with air pollution

Where are HVAC systems used?

The U.S. Department of Labor reports that most HVAC/R technicians work in homes, schools, hospitals and other medical facilities, offices, buildings and factories.

Air borne pollutants in buildings include:

• radon: radioactive gas that enters buildings through contact with soil
• second-hand smoke from burning tobacco
• combustion pollutants: gases, particularly carbon monoxide and nitrogen dioxide, created from burning materials
• volatile organic compounds: chemicals in many building maintenance supplies, furnishings, and dry-cleaning

Why are HVAC systems helpful to people with physical disabilities?

The United States Environmental Protection Agency (EPA) documents the significance of indoor air quality in individual health, and The World Health Organization provides clear evidence of its role in public health. HVAC/R systems are helpful to people with disabilities for the many reasons that this equipment favorably influences the environments in which people live, work and socialize. The EPA reports that HVAC/R systems are a positive factor in health, work and school performance. Good air quality is positively correlated with health, productivity and comfort. Conversely, poor air quality can result in the development and exacerbation of medical problems and can interfere with function. More than one million Americans struggle with chronic obstructive pulmonary disease.

For those individuals who have a direct or indirect interest in property, it is important to recognize that HVAC/R systems protect the structure of buildings. They control the adverse impact of environmental agents, such as mold spores, that damage building materials. One compelling example of the relationship between the structural condition of buildings and indoor air quality and has been documented in reports from the EPA, the General Accounting Office, and the National Center for Education Statistics of the Department of Education.  The substandard air quality that has been documented in many of our public school buildings appears to be associated with the physical deterioration of older schools following budget cuts. The average age of an American school is 42 years, and 75% of these schools were built before 1970---during a period of time when there was neither modern knowledge of environmental pollution nor government regulations based upon such knowledge.

Indoor air quality ranks among the top environmental risks to public health, globally and in the United States.   The World Health Organization attributes 2 million premature deaths annually to the indoor use of solid fuels such as wood, animal dung, crop waste and coal. Almost half of the world’s children who die before the age of 5 are killed by pneumonia that results from indoor air pollution. More than 1 million people die annually from another lung disease associated with indoor air pollution, chronic obstructive pulmonary disease.

Indoor air pollution is a direct and indirect cause of medical illness that can be associated with disability. Illnesses that can be caused by indoor air pollution include lung disease, kidney disease, cancer, heart disease and diseases of the central nervous system. People who are disabled from medical illnesses that are unrelated to air pollution may become more susceptible to the effects of indoor air pollution.  People who have disabilities spend longer periods indoors than people who do not have disabilities. The EPA estimates that indoor pollution is

present in 2-5 times greater quantities than outdoor pollution. Recent medical research in a group of 19 diabetic subjects revealed that inhaling ultrafine particles was correlated with an elevation in two biological markers associated with heart disease, activated platelets and von Willebrand factor. These data suggest that inhalation of ultrafine air particles may contribute to the development of cardiovascular disease.

All people are vulnerable to the effects of air pollution, but there are factors that make some individuals particularly vulnerable.  These factors include age and medical status. People with medical problems are one of the three groups in the United States whose members are most vulnerable to the effects of air pollution. Children and elderly people are also particularly vulnerable. Significantly, members of all three groups spend a great deal of their time indoors.

When compared to adults, children’s bodies process more pollutants per pound of weight because of their small size.  Babies and young children also engage in behaviors that increase their exposure to environmental pollution.  Babies explore their worlds by placing objects in their mouths.  Children play on the floor. It is sobering to realize that schools are a major source of indoor environmental pollution for approximately 53 million American children.  The EPA reports that 20% of American schools have substandard air quality, and approximately 25% of American schools have inadequate ventilation. Our children spend approximately 1,300 hours in school annually. School teachers and other employees spend more time. The significance of indoor air quality can be quickly grasped when considered within the context of childhood asthma, a disease that is associated with exposure to air borne allergens.  Almost 8% of school age children suffer from asthma, the leading cause of school absenteeism due to chronic illness.

Indoor air pollution ranges from the presence of substances that are easily recognized as toxins, such as pesticides and volatile organic compounds, to substances such as perfume and cleaning products that are frequently used without concern.

One good reason to use HVAC/R systems is that this equipment can decrease air borne pollutants that spread infectious disease and act as toxins. Air pollution is associated with many acute and chronic illnesses including:

• allergies
• asthma
• cancer
• carbon monoxide poisoning
• central nervous system disease
• cough
• eye irritation
• fatigue
• headache
• heart disease
• kidney disease
• Legionnaire’s disease
• liver disease
• nose and throat irritation

Allergic reactions that are potentially life-threatening have been attributed to the presence of natural contaminants, like peanut dust. Anecdotal information, and some researchers, suggest the existence of a chronic, serious condition called Multiple Chemical Sensitivity (MCS).
http://phys.org/news/2012-09-carbon-nanotube-composites-health.html

Who is a pharmacist?
Pharmacists are licensed professionals who are trained to dispense medication and to offer information on its use.
Most pharmacists work in private businesses. Clinical pharmacists work in healthcare facilities, such as hospitals and nursing homes, and are directly involved in patient care related to medication. Pharmacists in healthcare settings can also participate in research and education. Consultant pharmacists provide information to organizations that range from insurance providers and pharmaceutical manufacturers to the Centers for Disease Control and Prevention (CDC).
Following college, pharmacists begin their preparation for a degree as a Doctor of Pharmacy (Pharm.D.). This degree is received from an accredited school that provides 4 years of classroom education and supervised clinical experience in pharmaceutical settings. When awarded the Pharm.D., a pharmacist is eligible to take the competitive exams that precede licensure. Licensure is required for pharmacists in all states.
What do pharmacies do?
Pharmacists are trained to safely provide medications. They perform the following tasks:
• fill prescriptions
• verify instructions from physicians
• asses drug interactions
• assess the appropriateness of medications for medical conditions
• offer information on proper use of medication, including side effects, to patients and healthcare providers
• provide guidance in general health issues such as diet, exercise and stress management
• comply with government guidelines concerning public safety
• communicate with insurance companies and complete insurance forms

Where do pharmacists work?
Pharmacists work in a variety of settings. Approximately 85% are employed by retail stores such as:
• pharmacies
• grocery stores
• department stores
• general merchandise stores
Pharmacists also work in medical offices, outpatient healthcare facilities, and nursing homes. Approximately 23% of pharmacists work in public and private hospitals.

When do you need a pharmacy?
Licensed pharmacies are reliable sources of high quality medication that is developed and distributed in compliance with strict government standards.
Despite the high quality of medications that are dispensed by pharmacists, all medications can be associated with side effects. Some of these side effects may be no more than mildly annoying, while others can cause a serious medical problem. Side effects are more likely to occur when you start or stop using a medication, and when there is a change in dosage. Licensed pharmacists are easily accessible sources of information concerning the side effects of the medications as well as other issues related to your health. Pharmacists provide helpful health habit counseling. The Journal of the American Pharmacological Association documented the role of community pharmacists in the provision of effective, proactive counseling in smoking cessation. (J Am Pharm Assoc (2003). 2010 Sep-Oct;50(5):568-74.) Pharmacists are also reliable sources of information about medication brands and equipment.
Why are pharmacies helpful to people with disabilities?
Pharmacies can be more than a reliable source of medication. Pharmacies also provide opportunities for relationships with pharmacists. “Pharmacists Can Make A Difference” is the title that the National Center for Immunization and Respiratory Diseases chose for a podcast about a pharmacist who provides counseling about the appropriate use of antibiotics.
Pharmacists can be especially helpful to people with chronic illness and disabilities who take more medication than average. Pharmacists offer information about general issues related to medication. They also serve as an informal “medication alarm” when, for example, a doctor makes an error in a prescription or two doctors write individual prescriptions for medications that shouldn't be taken together. The Centers for Disease Control and Prevention emphasizes the role of pharmacists in the protection of public safety through the use of linked computers to report, and receive reports, of adverse and ineffective medications.
Transportation is difficult for many people with disabilities. Your pharmacists’ “office” can be easily reached by telephone, and information will be promptly available to you without an additional charge. In the event that a disability is associated with an illness that requires an unconventional medication, pharmacists are licensed to compound and dispense these medications in 49 states, Puerto Rico and Washington D.D..

Who is a locksmith? 

A locksmith protects people and property through the design, installation, rebuilding and repair of security systems. Locks can offer mechanical and electronic protection for residential and commercial properties, and for cars.  Many locksmiths specialize in lock management for key controlled security systems, using key duplicating machines or installing  keys by code. Others use software to design and install electronic alarm and surveillance systems.  Professional locksmiths can adjust their work to manufacturer’s templates and industry specifications. They are also trained to design and install custom made locks and security systems.

There are no educational requirements for locksmiths, although there are several avenues to education. The traditional “classroom” for locksmiths involves months to years of experience at the side of a professional locksmith. On –the- job training can be supplemented by academic courses and by demonstrations of practical skills. Correspondence courses are offered by community colleges, vocational schools and professional organizations. There are formal schools for locksmiths that lead to the licensure and bonding that is required in some cities and states. This process can involve the successful completion of a competitive exam and a background check that includes fingerprints.

Certification by the Associated Locksmiths of America (ALOA) sets a standard for accomplishment as a locksmith.  Certification requirements include classroom education, practical training, and a passing grade on a certification exam.  There are three levels of ALOA certification:

• Certified Registered Locksmith
• Certified Professional Locksmith
• Certified Master Locksmith

Opportunities for continuing education are offered to locksmiths through the ALOA and other professional organizations, locksmith schools, and lock manufacturers.

What does a locksmith do?

Locksmiths are trained to use traditional manual and power tools that include lathes, drills, grinders, lock picks and bypass tools. Computer technology has been integrated into security systems, and software has been added to the tools used by locksmiths.

The Associated Locksmiths of America reports that locksmiths perform a variety of simple and complex tasks, and are trained to:

•  Install, modify and repair locks, deadbolts and other mechanical or electronic locking devices
• Repair locks by cleaning and adjusting internal mechanisms and replacing damaged parts
• Design and custom makes repair parts
• Remove a key that has broken off in a lock
• Fit a key by code
• Rekey locks
• Make duplicate keys or cards
•  Generate or program new keys/cards
•  Respond to emergency calls to unlock vehicles, homes and businesses
• Install and service electronic access control systems and closed circuit television systems
• Educate customers concerning locks that are appropriate to the customer’s purpose
• Install and services safe for home and commercial use
• Provide service for bank vault doors, time locks, safe deposit boxes and teller equipment

Where do locksmiths work?

Locksmiths work in residential and commercial buildings. A majority of locksmiths are either self-employed or employed in the private businesses of other locksmiths.

The U.S. Department of Labor Bureau of Labor Statistics reports that the following industries have the highest rates of employment:

•  Investigation and security services
• Colleges, universities and professional schools
• Local government
• Elementary and secondary schools
• State government

The median national hourly wage for a locksmith is $17.63, and the median annual wage is $36,680.

When should you hire a locksmith? 

Locks are complex and, often, expensive mechanisms that perform the critical function of protection. The use of a professional locksmith increases the chances that a lock will work effectively, and reduces the chances that a lock will be damaged during the process of repair. Most importantly, a locksmith can offer professional guidance in the selection of an effective lock that is appropriate for its purpose.

Why are locksmiths important for people with disabilities?

Locksmiths provide protection against violence and theft, insecurity that threatens all of us. The National Crime Victimization Survey(2007) found that 34% of all American crimes were characterized by serious violence. In 2010, the FBI documented reports of 1, 246, 248 violent crimes. 62.5% of these crimes were aggravated assault. Violent robberies were committed in 29.5% of the reported cases. 6.8% of the victims were raped. 1.2%  were murdered. The National Rehabilitation Center reports that more than half of long-term patients in hospitals and residential facilities become patients as the result of crime.

Data reported by the United States Justice Department’s Office for Victims of Crime (OVC) confirms the vulnerability of people with disabilities to violent and non-violent crime. . People with disabilities report 2.3 million property crimes including home burglary, auto theft, and theft of other property. The OVC reports that people with disabilities are 4-10 times more likely than other people to be the victims of crime. In 2007, the Bureau of Justice Statistics of the United States Department of Justice documented the report of 716,000 non-fatal violent crimes against people with disabilities who were over the age of 12.  These crimes included simple assault, aggravated assault, robbery, rape and other sexual assaults.  Non-fatal violence against people with disabilities is approximately 1.5 % higher than comparable violence committed against people who do not have disabilities. Rape and other kinds of sexual assault occur more than twice as frequently when the victim has a disability.

Reports of crime against people with disability are widely believed to be underestimates. Surveys indicate that more than 50% of people with disabilities don’t report their victimization to law enforcement and don’t request other kinds of help, including treatment. 

Who is a housekeeper? 

A housekeeper is an employee or independent contractor who is responsible for cleaning and other maintenance in a personal residence, business or institutional setting.

What activities does a housekeeper perform?  

Housekeepers, also known as maids, clean and organize interior spaces on schedules that are determined by the housekeeper and the employer.

A housekeeper knows how to safely and effectively use cleaning products. Housekeepers also maintain the equipment necessary for their job.  This equipment usually includes mops, dusters, brooms and vacuum cleaners.

Standard cleaning tasks include :

• Dusting
• Vacuuming
• Dry and wet mopping of floors
• Cleaning glass surfaces
• Making beds
• Laundry
• Polishing brass, silver, wood
• Collecting and removing garbage

Housekeepers also perform administrative tasks.  These services can involve the supervision of  employees , anticipating needs for supplies, and identifying problems with household equipment.

In homes, housekeepers may provide services other than cleaning.  In young families, these services usually involve meal preparation and child care. Housekeepers can also serve as formal or informal companions to adults, and as drivers for people who have disabilities.

Where do housekeepers work?

Approximately 1/3 of American housekeepers work in private homes.

The Bureau of Labor Statistics of the U.S. Department of Labor identifies the following industries as having the highest levels of employment:

• Traveler Accommodations
• General Medical and Surgical Hospitals   
• Buildings and Dwellings
• Nursing Care Facilities
• Geriatric Care Community Facilities

The states with the highest level of employment are:

• California
• Florida
• Texas
• New York
• Illinois

The  national median hourly wage is $9.32, and the national median annual wage for a housekeeper is $19,390.

When should a housekeeper be hired?

Housekeepers should be hired if your physical capacities make it impossible to accomplish necessary household work. Although different people have different standards, housekeeping is an essential activity because it creates an environment that is sanitary and safe.  Housekeeping is manageable if performed regularly, but the necessary tasks can become unmanageable if ignored for long periods of time. Prior to hiring a housekeeper, it is helpful to organize and prioritize. Think “outside the box”.  For example, removing---rather than vacuuming--- scatter rugs may not be a standard housekeeping task, but it may protect you from falls. The regular replacement of carbon dioxide and fire alarm batteries can be incorporated into a list of regularly scheduled household tasks.

Think about what is most important to you, and consider the amount of time it will take to accomplish each task.  Make a written list, and review the list with your housekeeper. The list should be reviewed periodically.

Why are housekeepers helpful to people with disabilities? 

Housekeeping creates a pleasant and clean environment for everyone.           

Cleanliness is particularly important for people with chronic illness who may be vulnerable to the impact of “germs”, viruses and bacteria, that are spread through the air, dirty dishes and dirty clothing. People with contagious illness can be a source of disease.

Housekeeping is important factor in creating a safe environment for people with disabilities. Mobility is a critical issue for people who have visual impairment and/or use wheelchairs, walkers, and other assistive devices. In emergencies, evacuation from a home may be very difficult for a person with disability. An organized environment will make evacuation much easier by removing clutter and creating clear, unobstructed paths to doors and windows. Minimal clutter also reduces injury from falls. More than half of all falls occur within the home. Regular housekeeping can also prevent injury through the early identification of risks. For example, electrical fires can be prevented through early identification of cords or outlets that need to be replaced. Finally, a safe, organized and attractive environment may serve as an antidote to feelings of anxiety and unhappiness, particularly for people with disabilities who spend a great deal of their time indoors.

Who is a plumber?

Plumbers install, maintain and repair pipes and other equipment that carry liquid and gas substances from one location to another.  These substances include sewage, acids, water, steam, and air.

Most plumbers complete 4-5 years of apprenticeship and technical education that is offered by unions and businesses.  A plumber studies:

• tool usage
• pipe systems
• pipelines
• plumbing techniques
• blueprint reading and design
• safety procedures and regulations
• welding
• computers
• government codes

After 2-5 years of experience as a journeyman plumber, a plumber is eligible for the exam that leads to licensure. Licenses are required in many states. Some states require an additional license if a plumber wants to work with gas.

 What does a plumber do?

Plumbers make and maintain connections between pipes and other equipment so that  buildings can be hospitable and safe environments for people. The pipes that plumbers install carry clean water throughout a building, and create a means for sewage to be removed from that building. Plumbing helps a building remain warm the winter and cool during the summer. In industrial settings, pipes can safely contain and remove the toxic materials that are  byproducts of production.  Plumbers also create power.  The steam that powers turbines, for example, is carried by steel pipes.

When should a plumber be hired?

Plumbers should be hired when you need access to water and gas, and when you want to remove waste materials. Plumbers maintain the sewage systems that remove waste material from tanks located underneath homes. A plumber also repairs clogged or leaking pipes.

Where do plumbers  work?

You will find plumber working in a wide variety of environments, including homes, offices, power plants and farms. Approximately half (57%) of all plumbers are employed by contractors.

Why are plumbers helpful to people with disabilities?

Plumbers who receive appropriate training can make the accommodations in plumbing fixtures that are frequently helpful to people with disabilities. Plumbers can work independently or with other skilled tradespeople, such as carpenters and architects, to create accessible bathrooms and kitchens that are safe and functional.

Who is a cook?

A cook buys and prepares food for cooking and serving to individuals and groups. The responsibilities of cooks vary with the nature and size of the setting in which they work.  Some cooks work in commercial or institutional settings, other cooks work in private homes.

Most cooks learn through informal, direct experience in restaurants.  In addition to cooking techniques, cooks learn about kitchen safety and safe procedures for food preparation, handling, and storage. While a great deal of training occurs informally, there are many opportunities for formal instruction. These programs usually last for periods that range from a few months to several years.  Through formal education and the guidance of experience chefs, cooks can progress from basic to advanced knowledge of international cuisine and complex cooking techniques More than 200 training programs for cooks are accredited by The American Culinary Federation. Training programs can be found in hotels, restaurants, vocational schools and community colleges. Apprenticeship programs are offered by culinary institutes, professional associations, trade unions, and the military.

What does a cook do?

A cook’s duties include knowledge of:

• Nutritional requirements
• Local and  seasonal ingredients
• Budget
• Cooking tools
• Recipe sources
• The ability to follow recipes and adjust their quantities and ingredients
• Cooking methods including broiling, steaming, baking, roasting, grilling and frying
• Garnish for food and platters
• Table service
• Safe food preparation and storage

The requirements for cooks in restaurants and other commercial activities are dictated by the wishes of the customers and, also, by the nature of the business, economic factors, health regulations, and issues of workplace safety. Similarly, cooks who are employed in private households are responsive to the wishes and budgets of their employer and recognize health and safety standards in their work. Cooks in private homes must be especially self-motivated and meticulous.  Kitchens in private homes do not receive government inspections. The safety and satisfaction of the private employer is literally in the hands of the cook!

 When should you hire a cook?

There are many sound reasons to hire a cook in a private home. These reasons vary from client to client, and the demands upon a cook can vary within one household. A dinner party or a holiday meal usually requires a different menu than Thursday dinner. Despite differences, one fundamental principle is associated with an emphasis upon meal preparation: good cooking facilitates good health and physical independence. The research of Giovanni Zuliani, M.D, Ph.D identifies poor nutrition as a specific cause of hospitalization in the elderly.

Cooking also facilitates social relationships. Food is a feature of social interaction in all cultures, and social relationships are a fundamental element in the maintenance of good health. Professional cooks can make socialization easier for people with disabilities who may not have the stamina and physical skills necessary to cook.

Professional cooks are trained to measure professionally, and to adjust their cooking styles and ingredients to the needs and wishes of their clients.  These qualities make cooks ideal for people who have particular nutritional requirements.  In addition, cooks know how to prepare and present their food in ways that are attractive to the eye as well as the palate.  Long- term compliance with diets will be enhanced if meals are not experienced as repetitive and boring.

Where do cooks work?

Most cooks work in restaurants, including those located in hotels, coffee shops and cafeterias. Full service restaurants employ almost half (41%) of all cooks, and 27% of cooks work in limited-service restaurants. Other cooks are employed by corporations and schools. 8% of cooks are employed by organizations that provide healthcare and social services. Cooks also work in private households. Some cooks cater or otherwise prepare food for a number of clients, while other cooks work exclusively for one household.

Why are cooks helpful to people with disabilities?

Nutrition plays a critical role in the physical and emotional health of people with disabilities. Nutrition is a predictor of disability status. Intake of fruits, vegetables and dairy products is reported to increase physical function in people with disabilities (Denise Houston, 2005, American Journal of Clinical Nutrition: Dairy, Fruit, and Vegetable Intakes and Functional Limitations and Disability in a Biracial Cohort: the Atherosclerosis Risk in Communities Study).

Poor nutrition is associated with the development of additional medical problems. For example, nutrition is associated with muscle function and bone density and plays a role in the falls that result in injury. The secondary medical problems identified by The American Association on Health and Disability include:

• Asthma
• Cancer
• Chronic obstructive pulmonary disease
• Coronary artery disease
• Depression
• Diabetes
• Heart failure
• Hypertension
• Obesity
• Seizures
• Stroke
• Transient ischemic attacks

People with disabilities are more vulnerable to malnutrition than people in comparable socioeconomic groups who do not have disabilities. This vulnerability occurs for many reasons. For people with disabilities, food shopping and preparation can be very difficult. When compared to people without disabilities, people with disabilities tend to have less money to make food purchases, less physical capacity to shop for food and to prepare it, and less access to food by public and private transportation. People with disabilities are also reported to have more trouble in chewing, swallowing, and tasting. Appetite in people with disability tends to be impaired. Malnutrition and obesity are associated with disability, with both occurring at the same time in many people.

Good cooks are helpful to people with disability because they optimize the chances for good nutrition by knowledgeable food choices, skilled preparation, and attractive presentation. Good nutrition is associated with good health, and shared meals are an important factor in socialization.

Who is a health habit educator?

Health habit educators promote good health in individuals, organizations, and communities. Their goals can range from the early detection of cancer to educating community members about differences between symptoms of autism and willful, disruptive behavior. Health habit educators usually communicate information through personal interaction, educational programs, and written materials.

Health educators complete formal education programs in college and thereafter. These programs include internships that provide supervised clinical experience. Certification is available to health educators through the National Commission for Health Education Credentialing.  In order to be identified as a Certified Health Education Specialist (CHES), an individual must receive a B.S. degree and pass a competitive exam. Certification requires participation in formal programs of continuing education; 75 hours in 5 year intervals. Some health educators receive Master’s degrees from graduate schools. These graduate school programs are offered in the areas of:

• Community health education
• School health education
• Public health education
• Health promotion.

What does a health habit educator do?

The activities of health educators include:

• Education of individuals and families about medical diagnoses, treatments, and  procedures
• Implementation of programs through successful funding applications
• Development of educational programs, materials and events related to community health issues
• Design and distribution of educational materials such as pamphlets and posters to communicate information about health issues and health services
• Organization of health care screenings
• Supervision of staff who conduct health education programs
• Research
• Advocacy for health resources and public policies related to health
• Identification of supplemental resources for underserviced people and during states of public emergency
• Administration of public health campaigns
• Evidence based evaluation of success 

When should you see a health habit counselor?

Health habit education can be particularly helpful for people who have disabilities. Exercise, for example, can slow the progression of a disability and prevent the development of a secondary medical problem.

A health care educator should be consulted when you want to change behavior that impacts health.  The focus of change can include individual health, health issues within a community or organization, and the public policies of government.

Health care educators are helpful under a variety of circumstances. They provide information that can help in the assessment of a personal medical situation, promoting informed choices and the achievement of specific goals related to health.  Research supports the effectiveness, and  the positive perception, of health habit education. (Prev Med. 2001 Dec;33(6):595-9. Does health habit counseling affect patient satisfaction? Barzilai DA, Goodwin MA, Zyzanski SJ, Stange KC.)

During a personal or community crisis, health care educators can function as stabilizing forces through the provision of information that facilitates adaptive coping and identifies alternative resources.

Health care educators can also serve as resources within the political arena, offering information and perspective to officials who influence our public policies.

Where do health habit educators work?

Health educators work in private, public and non-profit settings. Some health habit educators work in individual or group private practices. Healthcare facilities and the government employ the majority of health care educators. Hospitals and other healthcare facilities employ approximately 37% of all health care educators.  Municipal, state and federal government, including the military, is the next largest employer.  The government employs approximately 21% of all healthcare educators.  Schools, private business, civic organizations, and non-profit organizations are other employers of health habit educators.

Why are health habit educators important to people with disabilities?

The Centers for Disease Control and Prevention (CDC) emphasizes good health as an achievable goal for people with and without disabilities. (CDChttp://www.cdc.gov/ncbddd/disabilityandhealth/index.html) Good health, however, does not mean perfect health. The symptoms of medical illnesses can be beyond voluntary control.  Nonetheless, each of us is able to work toward the optimal level of health that is realistically attainable. Some of the behaviors that health counselors recommend are:

• Balanced diets that include healthy amounts of alcohol
• Physical activity
• Medical check-ups
• Limited sun exposure
• Maintenance of social relationships

People with disabilities contend with life’s ordinary struggles and with the struggles superimposed by disability.  Disability can have a wide reach, extending beyond the technical boundaries of the disability itself. Sometimes the impact of disability upon health is significant yet imperceptible. Physical and visual disabilities, for example, can express themselves in limitations in exercise, food shopping, and meal preparation. Given these realities, it is not surprising that the rate of obesity is 58% higher in adults with disabilities than without disabilities. (Case Western Reserve University’s Department of Epidemiology and Biostatistics

Obesity is prevalent in people who have physical, sensorimotor and neuropsychiatric disabilities.

The process of health education incorporates principles of cognitive-behavior psychotherapy, an intervention that focuses upon the ability to set goals and to achieve these goals through conscious decisions. A strong relationship with another individual who provides information and encouragement is a cornerstone for behavioral interventions.  These interventions include the followings steps:

• Assessment of problems and progress
• Education about behavioral causes of problems and behavioral solutions
• Identification of goals
• Practice of problem solving behavior that continues outside of sessions.

Health education is particularly helpful to people with disabilities because, unless an individual has severe neuropsychiatric impairment, its goals can be achieved regardless of disability status.

Who is a dentist?

Dentists are doctors who offer preventive services, diagnose, and treat oral problems that involve teeth, gums and other parts of the mouth.

There are nine areas of specialization in dentistry.  These dentists are:

• dental public health specialists  who work within a community setting to address dental problems
• endodontists  who perform root-canal treatment
• oral and maxillofacial radiologists  who use imaging technologies to diagnoses head and neck disease
• oal and maxillofacial surgeons  who operate on the mouth, jaws, teeth, gums, neck, and head
• oral pathologists  who diagnose oral diseases such as oral cancer
• orthodontists  who use braces and other appliances to straighten teeth
• pediatric dentists  who provide dental treatment for children
• periodontists  who treat  gum and bone
• prosthodontists who  replace missing teeth with permanent or removable  fixtures,

All states require a dentist to be licensed.  Prior to licensure, a dentist must complete college and an accredited dental school. Education in dental school involves academic courses and clinical work under the supervision of a licensed dentist.  Following graduation, a dentist must pass a competitive exam that includes demonstration of academic knowledge and clinical expertise. Specialization in one of the nine fields of dentistry demands 1-2 additional years in a residency program, and requires a separate license. Dentists who plan upon a career in research can complete 2-5 years of training after their residency.

What do dentists do? 

Dentists create a clean office environment, using equipment and techniques that protect their patients and themselves from infection. They interact with patients in a calm manner, giving clear information. Dentists examine teeth, gums, and other areas of the mouth in order to assess dental health and identify disease. Dentists take x rays and interpret them. They treat the problems that are identified on the basis of examination and x-ray and, if a problem is found within an area of specialization, make referrals to dentists who have greater expertise. Dentists administer medications, including anesthetics that control pain and antibiotics that control infections. They make models for appliances such as bridges and dentures. Dentists provide instructions concerning the oral care that promotes good health, including flossing, fluoride and a healthy diet.

Where Do Dentists Work?

Most dentists work in independent practices, either independently or with a small group of other dentists. Dentists also work in public health clinics.  Some dentists are employed in hospitals and in dental schools. The federal government employs dentists in the military and in the Indian Health Service.

When should you see a dentist? 

Regular dental care is a protective factor in the development of oral disease, and early detection helps to achieve an optimal outcome in treatment. A dental appointment is commonly recommended every 6-12 months for routine exams and teeth cleanings. Risk factors for oral disease, such as smoking, diabetes, pregnancy and gum disease, may suggest the need for more frequent visits. Mouth symptoms can be signs of other, serious diseases including blood cell disorders, cardiovascular disease and HIV.  Early detection of these symptoms can favorably influence health through diagnosis and treatment of the underlying disease. Ask your dentist for advice about the time intervals between appointments that are best for you.

Why are dentists especially important to people with disabilities?

People with disabilities develop dental problems, including cavities and periodontal/ gum disease, more frequently than those who do not have a disability. Teeth grinding (bruxism) occurs more frequently in children with disabilities, and can result in bone loss, headache and facial pain. The disability itself can make preventative care, such as brushing and flossing, more difficult to perform.  People with disabilities are more likely to injure their teeth and mouths because they fall more frequently than people who do not have disabilities. The Centers For Disease Control (CDC) reports that people with disabilities, particularly women, are often physically injured because of abuse. 

Disability accompanies some chronic illnesses, and the medications used to treat these illnesses can contribute to the development of dental problems.  Dry mouth, a side effect of many medications, cause teeth to decay. Dry mouth is associated with some of the medications used in the treatment of disabilities including painkillers and Parkinsonism drugs. Transportation is another factor in poor dental health.  Private and public transportation are often inaccessible obstacles for people with disabilities who need dental care.

Grab bars are deceptively simple devices that perform a wide-variety of useful tasks. Properly installed grab bars function as safety devices that permit a person to maintain balance, lessen fatigue when standing up, hold up some of their weight while changing positions, and a solid support to grab to help prevent falls. Alternatively, a personal caretaker may take use of a grab bar by using it for support while working to transfer the patient.

Installation of grab bars takes much strategic thought. In order to support the weight of a full body grab bars can’t just be installed to the superficial sheetrock of a wall, but the wall must be mapped for more solid support beams. This will ensure that when the grab bar is in use it will not rip out of the wall. Another important aspect of grab bar installation is the placement. Areas of the home that are deemed high risk (such as the slippery environment of the bathroom) must be analyzed and the best position possible for a grab bar will be determined by a professional.

The ADA defines an important set of guidelines in their ADAAG (Accessibility Guidelines for Buildings and Facilities which are:
• The diameter of grab bars should be 1¼ to 1½ inch (30-40 mm) (or the shape shall provide an equivalent gripping surface)
• There shall be a 1½ inch (40 mm) clearance from the wall.
• Grab bars should not rotate in their fittings.
• The required mounting height is universally 33 to 36 inches (840-910 mm) from the centerline of the grab bar to the finish floor.
• ADA-style grab bars and their mounting devices should withstand more than 250 pounds (1112 N) of force.
• In public toilet stalls, side grab bars must be a minimum of 42 inches long and mounted 12 inches from the rear wall, and rear grab bars must be a minimum of 36 inches long and mounted a maximum of 6 inches from the side wall.
(Guidelines taken directly from the ADAAG produced by the ADA)
Working with our professional installers you can be confident that these guidelines will be met to ensure your safety.

Who is a roofer?

A roofer is a skilled worker who installs and repairs roofs.

What does a roofer do?

Roofers work with two basic types of roofs--flat and pitched (slanted). Rarely, new buildings have “green” roofs that include landscape roofing systems where soil is placed over layers of standard roofing material.  In building a green roof, roofers must be certain that the roof has sufficient structural support to withstand the weight and water needs of plants.

Flat roofs are covered with several layers of materials that begin with insulation. Next, a tar-like substance is spread over the insulation. Roofing felt is installed next,  and hot tar is spread over it. These steps are repeated, and the seams are sealed. Roofers usually glaze the top layer or embed it with gravel. Some flat roofs are covered with only a single layer of waterproof rubber or thermoplastic compounds. In these cases, roofers roll the sheets over the roof's insulation and seal the seams. They apply adhesives or mechanical fasteners to keep the sheets in place.

When building a pitched roof, nails are used to attach strips of roofing felt to overlapping rows of shingles. The roofing felt is fitted around vents, chimneys, and corners. Exposed nail heads are covered with roofing cement or caulking to prevent water leakage. When using materials such as tile, terra cotta, or slate, roofers use punches, hammers and mortar to place the shingles.

Where is a roofer trained?

Most roofers receive on- the- job training from more experienced roofers.  Some roofers complete a formal apprenticeship such as that sponsored by The United Union of Roofers, Waterproofers and Allied Workers. Apprentices learn their craft through supervised experience , and by studying technical subjects related to the roofing trade.  Once apprenticeship is completed, a roofer is recognized as a fully competent journeyman.

When should you hire a roofer?

The best time to hire a roofer is before you need one!

Good reasons to hire a roofer include certification, inspection, construction, and repair. Assessment of a roof may be a prerequisite for obtaining a mortgage or insurance. A roofer’s inspection can identify problems before they cause extensive and expensive damage. A poorly installed roof can result in water damage to a house’s structural support and to its interior belongings. If a roof is damaged, an inspection can determine if the roof should be repaired or replaced.  If you are building a new home, roofing consultation can helpfully guide your selection of  materials and style. Some of the more popular roofing materials include clay tiling, composite shingles, wood “shakes”, slate, concrete tiling, and metal roofing.

Why are roofers helpful to people with disabilities?

The National Roof Certification and Inspection Association  reports that less than half (46%) of the damage to a roof can be seen by a homeowner or an inspector on the ground. This fact suggests that direct inspection by an experienced roofer is necessary to assess the condition and safety of a roof. A home’s structural integrity is particularly important to people with disability, and roof defects are frequently reported.  Physical disability makes issues of personal safety a first priority.  Because of the burdens imposed by disability, problems must be anticipated or recognized before they become urgent and dangerous situations. Roof defects are the most common problem reported by during the course of formal home inspections. In addition, NRCIA reports damage from roof leaks and water penetration account for 30% of real estate inspection claims and 39% of homeowners insurance claims.

Who is a Painter?

A painter prepares surfaces, and the areas that surround these surfaces, for the application of paint and other substances. Painted surfaces can include the interior and exterior walls of a building, the infrastructure of new construction, structural surfaces such as bridges, ships and storage tanks, and a vast variety of materials such as wood, metal, and manufactured objects.

Painters do not have to fulfill basic educational requirements, although entrance into  apprenticeship programs requires a high school diploma or its equivalent.  High school courses in math, shop and reading blueprints are helpful. Most painters learn their trade as a result of direct experience under an experienced, journeyman painter. Technical schools work cooperatively with unions and contactor organizations to offer courses and apprenticeships. Courses that are taken as part of an apprenticeship may be applied toward an Associate’s degree.  Apprenticeships combine on-the-job-training with a minimum of 144 hours of classroom education. Apprenticeships are sponsored by unions and contractors organizations. Upon the completion of an apprenticeship, a painter is considered fully qualified to work independently.

The Department of Labor Bureau of Labor Statistics reports that the national median hourly wage of a painter is $16.48 and the median annual salary is $34,280.Approximately half (53%) of painters are self-employed.

What do painters do?

Painters serve aesthetic functions, creating attractive environments and appealing objects. They also protect materials from damage due to corrosion and other processes. When a painter selects materials, s/he is guided by issues of personal and environmental safety. Commonly used safety equipment includes glasses, safety shoes, gloves, hard hats and hearing protection. Maintenance painting may require the use of special safety equipment. Scaffolds, harnesses, Bosun chairs, swing stages, hydraulic lifts and aerial lifts are used to safely work from heights. Protective equipment, including high-grade masks and self-contained garments, can protect painters from toxic fumes in closed spaces.

 Where do painters work?

There are different kind of painters and they work under different conditions. Construction painters work on the exterior and interior surfaces of new or recently built sites. These are usually houses and commercial buildings. Artisan painters specialize in the application of decorative finishes, usually to interior walls.  Maintenance painters work on older surfaces. Some maintenance painters specialize in the use of materials that reduce corrosion on industrial structures such as brides and oil rigs. Painting and coating workers apply materials to manufactured products and transportation equipment including cars, trains, boats, buses, trucks and airplanes.

When should you hire a painter?

Painting contributes to a fresh and attractive home and office environment that is important to all of us. For those people with disabilities who spend a great deal of time inside, the aesthetic elements of an interior environment can be particularly important. The eye perceives approximately 7,000,000 colors! Painting also protects a variety of surfaces from destructive processes that occur naturally.

The need for a skilled painter is determined, in large part, by the balance between the requirements of your painting job and your level of skill, knowledge and available time.   Another approach to evaluating your need for a professional painter is to review some of the equipment that a painter uses:

• Hopper guns
• Pneumatic spray texture guns
• Spray texture guns
• Stucco patching guns
• Airless spray equipment
• High velocity low pressure HVLP spraying equipment
• Spray guns
• Striping machines
• Hydroblasters
• Pressure washers
• Steam cleaning equipment
• Wallpaper steamer
• Drywall taping knives
• Patching knives
• Spackling knives

If you aren’t experienced in the use of this equipment----you probably need a professional painter. If you don’t recognize the names and purpose of the equipment…you definitely need a professional painter!

Why are the colors used in painting helpful to people with disabilities?

Anecdotal reports, the observations of professional organizations, and research data document the role of color in mood and behavior.  Color has a subjective component and is experienced by individual people within a cultural context. These differences are associated with variations in the perception and interpretation of color.  Nonetheless, there is comprehensive support for the role of color as a factor that influences the function of human beings. Color communicates information, influences emotions, and impacts productivity in people with and without disabilities. A compelling example of the connection between color, mood and behavior was revealed in the results of research conducted by Dr. Alexander Schauss, director Washington’s American Institute for Biosocial Research . There was a short-term suppression of hostility in male prisoners when their cells were painted a particular shade of pink.

Color has a significant impact upon people with disabilities. Choice of color can influence:

• compliance with medication
• medication errors
• nutritional intake
• mood in medical settings.

Older people have more chronic illness and disability when compared as a group to those who are younger. Medicare recipients receive an average of 21 prescriptions annually. These older patients tend to be less compliant with their medication instructions than younger patients. Research reveals that patients respond more favorably to medication when it has a cheerful color, thus increasing the likelihood that a patient will take the medication. Older patients forget their medications, and confuse their medications, more frequently than younger patients. Again, research documents the significance of color in medication compliance. Research involving 2,021 subjects in 12 countries studied the interaction between 27 colors and 27 pharmaceutical brand attributes. The results of this research, and other research, suggest that patients identify medications more accurately when the color of the medication corresponds to the purpose of the medication. For example, a medication that is colored blue will be associated with relaxation and sleep.

Color plays a direct and indirect role in nutrition.  Blue, for example, tends to suppress appetite in people, regardless of their disability status, while the colors of red and yellow tend to stimulate appetite.

People with disabilities experience more difficulties with the process of eating than other people. Nutrition can serve as a risk factor or as a protective factor in people with disabilities. Malnutrition can create secondary medical problems, and these problems can contribute to the creation of further problems.  Good nutrition can prevent the development of such problems, or improve a secondary problem if it occurs. Research documents the vulnerability of people with developmental disabilities to a wide variety of medical disorders that are associated with poor nutrition.  These secondary problems include:

• underweight/overweight
• Bladder dysfunction
• fatigue
• bowel dysfunction
• depression
• conditioning problems
• dental problems
• sleep problems

When painting, the selection of color can be especially important for people with disabilities who tend to spend more time in interior settings. The interior design of health care facilities influences the health of  patients, and colors are critical elements in design. Bright yellow, for example, would be the wrong choice for a bedroom, hallway or sitting area for sighted people.  Bright colors are visually irritating because they reflect larger amounts of light than more muted colors. The white expanses of traditional health care settings also tend to be disorienting. The results of research in neuropsychology support the importance of color in helping patients maintain the sense of spatial orientation that is associated with lower stress levels.  Colors help patients with cognitive disabilities to remain oriented. The colors found in nature and reflected in artwork  tend to provide both helpful levels of stimulation and comfort, contributing to a sense of well-being.

PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT

Who is an occupational therapist?

Occupational therapists help people achieve a greater range of function when they  have disabilities.  These disabilities can be temporary or permanent, resulting from traumatic injury, developmental disorders, medical illness and other problems. Occupational therapy can be helpful to people who have disorders within the autism spectrum, facilitating verbal communication and appropriate social skills.

Occupational therapists use the ordinary activities of daily life (“occupations”) as treatment modalities. Toys, for example, can be used in a sensory enriched therapeutic environment to help children who have motor and communication problems, and other symptoms of developmental disabilities and brain disorders. Recreational activities, including games and sports, can serve as therapeutic interventions for young people. Board games, card games and computer games can be used to help senior citizens with memory problems.

Occupational therapists work with people throughout the life cycle. They work with infants when there is a concern about developmental delay, with middle aged adults who have impairments in functioning, and with elderly people who are struggling with the impact of age, neurological impairment and general medical illness.

Specialized equipment, such as eating, bathing and dressing aids, are used by occupational therapists in order to help patients accomplish the tasks necessary for independent function. These tasks include cognitive, emotional and social functions as well as motor function.

Physical therapy is often incorporated into the treatment programs of occupational therapy. However, physical therapy is a separate discipline that focuses upon developing the physical strength and endurance used in motor function.  Occupational therapy focuses upon the skills used in the management of everyday life.

Qualifications:

Following college, most occupational therapists complete a two year master’s degree program.  A small number of occupational therapists continue their education and receive a doctoral degree. Programs are offered by some schools that allow a student to receive a college degree and a master’s degree in five years. All programs of training require students to have supervised experience with patients.

Licensure is a requirement for occupational therapists in all states. Standards for licensure vary from state to state. However, all states require that licensed occupational therapists receive certification, and take continuing education courses, after passing the National Board for Certification of Occupational Therapists (NBCOT).   A certified occupational therapist uses the title of Occupational Therapist Registered (OTR).

What do occupational therapists do?                                                      

Occupational therapists work with individuals and groups to help people become more effective in the activities necessary for daily living.   Treatment helps patients to better function in those areas that satisfy personal needs, interests and goals. These goals can range from the basic skills of self-maintenance to the achievement of major leadership positions.

Prior to developing a treatment program, occupational therapists interact with patients and review their medical records in order to assess their medical status and their levels of function. Following assessment, treatment plans are developed that associate goals for functioning with the specific therapeutic activities that can help the patient to achieve these goals.

The goals of occupational therapy are often believed to be limited to tasks involving gross motor function, such as dressing and eating.  Occupational therapy, however, has a much broader range of effectiveness.  Occupational therapy is also a helpful intervention for problems with mental and emotional functioning, including communication, sensory processing, attention, and reasoning. Role playing is incorporated into occupational therapy to  simulate  “real life” situations in work, school, and social interaction.

Equipment is  used in occupational therapy. Walkers, canes, braces and wheelchairs are used when the patient has a physical disability. Occupational therapists also use specialized, adaptive equipment.  This equipment is designed to create greater independence in activities such as bathing, dressing, grooming, meal preparation, reaching and movement. Occupational therapists can help a  patient select equipment that is appropriate for the patient’s current status and goals.

Occupational therapists are trained to assess a patient’s environment in order to minimize risks and optimize adaptive behavior.  Occupational therapists usually provide consultations at home, but can also consult in offices and elsewhere.

The American Occupational Therapy Association describes the orientation of occupational therapy as holistic. Treatment adapts the environment to the needs of the individual, and the  individual learns to adapt to the demands of the environment. In keeping with this orientation, the patient is considered a member of the treatment team.  Efforts are made, when appropriate, to include family and other significant people in the communication process that concerns treatment.

Occupational therapists keep careful records of their interventions as the patient progresses toward goals. Treatment is periodically evaluated to assess its effectiveness.  Results are discussed with the patient and other members of the treatment team.

 When should you consult with an occupational therapist?                 

Occupational therapy can be a helpful treatment, or a component of a treatment program, for people with disabilities or developmental delays who want to improve their ability to function in daily life. Occupational therapy can be considered when adults and children encounter difficulty in:

• Motor function
• Communication
• Attention
• Socialization
• Self-care
• Daily routines
• Emotional regulation
• Sensory regulation
• Judgment
• Basic information
• School
• Work
• Recreation
• Self-regulation
• Sensorimotor function

The comprehensive nature of the list above reflects the comprehensive impact of occupational therapy.  Age imposes no absolute limit upon the usefulness of occupational therapy.  A large body of research indicates that the brain is “plastic”, i.e. adaptable and capable of change. The brain’s “plasticity” diminishes with age but, in the absence of severe injury, plasticity endures. Change may occur more slowly with age, but change remains possible.

Where do occupational therapists work?

Occupational therapists work in a wide variety of professional settings that reflect their commitment to people throughout the life cycle. 9% of occupational therapists are employed in nursing homes, working largely with the elderly.  At the other end of the age continuum, occupational therapists treat infants and toddlers who have developmental delays and are enrolled in early intervention programs. Occupational therapists also work in academic settings from pre-school to high school graduation. 27% of occupational therapists work in state, community and private hospitals. 7% are employed by health care services. Rehabilitation facilities depend upon the skills of occupational therapists for the treatment of traumatic brain injuries and other brain disorders. Occupational therapists are part of the treatment teams in psychiatric hospitals.  They are effective in teaching people with serious and chronic mental illness how to perform basic, vital tasks such as shopping and housekeeping, and how to manage resources such as time and money. Many occupational therapists provide services within the homes of people with disabilities. 3% are employed by individual and family services.

Why is occupational therapy helpful to people with disabilities?

Occupational therapy is about doing the best that you can with the circumstances that you confront. The significance of the environment for people with disabilities is emphasized by Susan Bachner, an occupational therapist with a Specialty Certification in Environmental Modifications (SCEM)amongst other certifications: “Occupational therapists understand how an environment can make things easier or harder on people, especially if they are elderly or have a disability. I take a good look at the physical setting and the physical, cognitive, and emotional challenges of the people in it to understand what constitutes a good fit between them,”… Above all, how is the person going to function in the physical environment while engaging in the routines and daily activities that make life meaningful for that individual?”

Occupational therapists understand that disability interacts with other aspects of an individual’s life to create vulnerabilities and opportunities; disability impacts an individual’s environment, and an individual’s environment impacts his or her disability. Occupational therapists are trained to facilitate the environmental changes that enhance safety, productivity and satisfaction. These changes can be important without being expensive or exhausting.  Removal of scatter rugs and clutter, for example, diminishes the falls at home that are the greatest source of injury and accidental death in people who are over the age of 65. Occupational therapists offer guidance concerning places of work as well as home. Serving as advocates for people with disability, and as educational resources for their family, friends, co-workers and employers, occupational therapists can facilitate realistic and cooperative attitudes that are reflected in progress.

Who is an optometrist?

Optometrists examine eyes and provide therapeutic interventions such as corrective lenses and rehabilitation exercises. Unlike ophthalmologist, optometrists are not physicians and do not perform surgery.

Optometrists complete formal training programs that combine academic learning and clinical experience. The Doctor of Optometry (O.D.) degree is usually received after the completion of four years of education. Some optometrists complete an additional year of residency in one of the following areas of specialization:

• Family practice
• Primary eye care
• Pediatric optometry
• Geriatric optometry
• Vision therapy and rehabilitation
• Cornea and contact lenses
• Refractive and ocular surgery
• Low vision rehabilitation
• Ocular disease
• Community health optometry

All states require licensure for an optometrist. Licensure involves the award of an O.D. degree from an accredited school and a passing grade on the National Boards in Optometry. Continuing education and license renewal is required in some states.

What does an optometrist do?

Optometrists provide a number of diagnostic and therapeutic services that include:

• Testing vision
• Assessing symptoms of eye disease such as glaucoma, cataract, corneal ulcer, dry eye,  and  astigmatism
• Detecting  visual symptoms of medical illnesses such as diabetes
• Rehabilitation exercises
• Counseling patients on preventive and corrective care for their eyes

Corrective, therapeutic and prism lenses are frequently prescribed by optometrists. Optometrists who engage in vision therapy and rehabilitation often use some of the following equipment:

• Eye patches
• Electronic targets with timing mechanisms;
  • Computer software
  • Balance boards (a vestibular device)
  • Visual-motor-sensory integration training devices

Therapeutic vision exercises are repetitive procedures that are intended to develop or improve visual skills by changing the way in which visual stimuli are processed and interpreted.

Where do optometrists work?

Approximately half of all optometrists work in independent offices of optometry, and about 22% of these optometrists are self-employed. 13% of American optometrists are employed by physicians. Optometrists also work in retail stores, outpatient clinics, and hospitals.

When should an optometrist be seen?

The time to see an optometrist is before a problem develops. Routine, annual eye examinations are often recommended. Some treatable eye conditions, such as corneal ulcer, dry eye, glaucoma and astigmatism, can result in permanent visual disability if not detected.

People with medical conditions that are associated with visual impairment, such as diabetes, should request clear instructions concerning the type of health care professional who should be consulted, the nature of recommended interventions, and the recommended time intervals between appointments.

Below is a list of symptoms that should alert you to the possibility of an eye problem, and the need for evaluation:

• Watering eyes
• Blurred vision
• Head and eye injury
• Floating spots and flashes
• Eye pain
• Diabetes

Why are optometrists helpful to people with disabilities?  

Professional attention to the eye can prevent visual impairment, reverse or slow the progression of eye disease, teach adaptive techniques when disability is permanent, and restore vision through medication and surgery.

Visual problems in children can influence other areas of development, particularly academic performance. Socialization can be hampered when children find it difficult to participate in  sports and games that require visual acuity and coordinated motor movements.

Some of the common visual disorders that present in childhood include:

• Myopia: objects aren’t clearly seen at a distance
• Hyperopia: objects aren’t clearly seen when they are close
• Presbyopia: a physical problem of the lenses impairs perception of close objects
• Astigmatism: an irregularly shaped cornea causes blurry vision
• Amblyopia: impaired central vision in one eye
• Strabismus: eyes do not work together and appear “crossed”

Older people tend to develop increasing disability, and these disabilities include vision.  Some cause of visual disability are:

• Cataracts: a cloudy spot covering the lens that helps the eye to focus
• Glaucoma: increased pressure in the eye that can result in blindness
• Macular degeneration: deterioration in the portion of the eye, the macula, that causes a loss of central vision
• Diabetic retinopathy: damage, that can lead to blindness, to blood vessels that supply the eye with oxygen and nutrients
• Retinal detachment: detachment of the retina from tissues that support it, resulting in blindness

Medications, surgery and laser treatment can be effective methods for reversing some forms of visual impairment and correcting others. Surgery is an effective intervention for cataracts, macular degeneration, diabetic retinopathy and retinal detachment. Early detection and treatment is the critical issue in eye care.

PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT

Who is a hairstylist/barber?

A hairstylist is also known as a hairdresser or cosmetologist. These terms are all derived from the Greek word “kosmetikos” which is translated as “skilled in adornement”.  Hairstylists shampoo, cut , style, color, and permanent wave natural hair and wigs. Hairstylists shape eyebrows using wax, string or tweezers. Hairstylists are also trained as aestheticians who provide skin care services that include facials, electrolysis and cosmetics. Hairstylists are trained to perform manicures and pedicures. Manicures and pedicures can only be performed by a licensed hairstylist or nail technician.

A barber and a hairstylist share many functions. Both hair stylists and barbers are licensed to color, bleach, permanent-wave, and highlight natural hair and wigs. Barbers perform facials. These tasks are usually performed for male customers. Unlike hairstylists, barbers also shave facial hair and shape bears. Interestingly, the English word for barber comes from the Latin word “barba” which means beard. A barber is the only professional who is licensed to shave with a straight-razor.

What are the requirements for becoming a hairstylist?

All hairstylists (cosmetologists) and barbers must be licensed. Requirements for licensure vary between states, although some states provide some reciprocity in licensing. The selection of licensing requirements that follow reflect New York State law, but are generally representative.

Licensing Requirements For  A Cosmetologist:

• 1,000 hour state-approved course of study or documentation of the equivalent education from another state or country
• passing grade on the state written examination
• passing grade on the state practical examination
• a physical examination by a physician or a physician’s assistant

An individual who has been trained in cosmetology in another state may qualify for a cosmetologist’s license if  s/he can document 5 years of  academic and practical experience in a field equivalent to cosmetology.

Licensing Requirements For A Barber:

• completion of a formal course of study determined by a state licensed school
• 2 years of apprenticeship with ongoing supervision by a licensed barber
• 1 year course of study concerning transmission of contagious diseases and sanitation/sterilization  procedures in a barber shop
• a physical examination by a physician or physician’s assistant

Hairstylists and barbers are expected to continue their educations through workshops that are offered at their salons and  at other sites. Hairstylists must receive a separate state license to open a business.

What does a hairstylist/barber do?

The basic tasks of hairdressers and barbers include:

• assessing hair, scalp and face to recommend hairstyle and grooming options to clients
• discussing options with clients within the context of the client’s wishes, social activities, and occupation
• washing and conditioning hair
• cutting, styling and drying hair
• advising clients about hair and grooming products
• advising clients about techniques for  maintenance of hair at home
• maintaining  a sanitary workspace and sanitary equipment

Where do hairstylists/barbers  work?

More than half of all hairstylists (52%) are self-employed as freelance stylists and barbers, or offer personal care services as employees in private barbershops and hair salons. Other sources of employment include:

• department stores
• health and personal care stores
• nursing care facilities
• cosmetology schools
• general merchandise stores
• motion picture and video industry
• physicians
• death care services
• amusement and recreation industries
• spas
• hotels
• resorts
• rehabilitation centers
• assisted living facilities

 When should you hire a hair stylist or barber?

Unless you have the skill to do a lot more with a pair of scissors than cut off a tag, you may need a professional hairstylist or barber. The interval between hairstyling appointments is quite short if you want to maintain the style---and color!--- that you had when you left the shop. Here are some suggested intervals:

Haircuts

• short hair: 4-5 weeks
• medium hair:  4-6 weeks
• long hair: 6-8 weeks

Coloring

• 4-8 weeks

Deep Conditioning

• 1-2 weeks

Why is hairstyling important for people with physical disabilities?

Physical appearance plays the same role in the life of a person with disabilities as it plays in other lives.  Our society places a disproportionate emphasis upon physical appearance. People with disabilities, like all other people, can choose to conform to these values or to discard them. Nonetheless, unless you like very long hair, ultimately you may want your hair cut. In the past, this required a visit to a hair salon.  Recently, however, there is a trend toward mobile hairdressing.  This service brings a licensed hairstylist to your home with appropriate, sanitary equipment.

The significance of hairstyling to people with physical disabilities has not been the direct focus of controlled research.  However, the practical value of a professional haircut can be considered within the context of:

1. documentation of discrimination in employment on the basis of disability
2. documentation of disproportionately high rates of unemployment amongst people with disabilities
3. documentation of discrimination in employment on the basis of physical characteristics other than disability

In 2011, the U.S. Department of Labor’s Bureau of Labor Statistics documented a 15% prevalence of unemployment amongst people with disabilities compared to 8.7% of people without disabilities. Both groups were actively seeking employment.  The disproportionate incidence of unemployment amongst motivated job seekers with disability was constant across all education levels, including the highest.  9.1% of people with disabilities who completed college were unemployed compared to 4.1% of people who completed college but did not have disabilities.

Data strongly supports the importance of physical appearance in employment opportunities. One study is of particular interest because it provides information about hairstyle as a factor in employment decisions.  The Employment Law Alliance (ELA), a network for employment and labor law firms, hired a market research firm to investigate the impact of physical appearance upon hiring decisions. The results of this poll indicate that physical appearance, including hairstyle, may influence employment decisions. In ELA’s poll, 14% of a sample of workers believed that their hairstyle was a factor in employment based

PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT

PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT

Who uses home health monitoring equipment? 

People who use health monitoring equipment at home represent a large and growing group whose diverse members range from seriously ill patients to professional athletes, and include:

1. people with chronic illness and/or disability
2. senior citizens who want to live at home
3. people who want to take a proactive role in maintaining good health

Home health care monitoring equipment is also used by family members of health care recipients, professional caretakers, physicians, and other medical professionals.

Health monitoring equipment is one facet of an escalating trend toward home medical care in the United States. The National Association for Home Care and Hospice (2008) estimates that approximately 7.6 million people receive home health care. The intersection of sophisticated technology and increased health costs has propelled home care by making it more comfortable and portable as well as cost effective. Home health monitoring equipments can help an individual to avoid stressful and expensive hospitalizations, visits to the emergency room and trips to the doctor’s office. Conversely, the equipment can identify health problems at their earlier stages when they are most treatable.

The use of home health monitoring devices  reflects a greater awareness of the preventable nature of some serious diseases.  In examining the causes of deaths globally, the World Health Organization (2003) estimated that 2 million deaths are the result of inactivity.

Home monitoring equipment also represents a growing awareness of the risks associated with living at home.  For example, more than half of all falls experienced by senior citizens occur at home. One out of four senior citizens who live independently experiences an annual fall at home. 50% of people who fall are unable to rise independently. Unassisted people have a mortality rate of 12% at one hour. There is a mortality rate of 67% for those who remain unassisted for 72 hours. 38% of those who survive the fall never return to independent living.

Home health care equipment is being examined by government and private organizations for potential applications to healthcare, including issues of public health.

What is home health care monitoring equipment?

Home health care monitoring devices are battery and/or electrically powered mechanisms that are used by people who want direct, real time information about their health status or the health status of someone in whom they have an interest. Health monitoring equipment is a tool that can help an individual, caretakers, and doctors to assess a medical situation and to make informed choices about management . The information that home health care devices provide is particularly important to people with medical illness, disabilities, and to people who are vulnerable to the development of serious medical illness.  These groups include more than 10 million Americans over the age of 65 who live alone in their homes.

Some of the advantages of home monitoring equipment includes:

• reduction in risks
• earlier help
• faster medical intervention
• decrease in the need for caretaker presence
• decrease in the use of physical constraints and restraints

Feedback from health monitoring equipment provides information about current physiological function. This equipment can also track health data over time. A user or caretaker can discern physiological patterns, and changes in these patterns. Information from home health equipment can alert a caretaker to the needs of an individual with disability if the individual cannot anticipate or communicate these needs. Alarms can summon immediate help from a caretaker in the vicinity. Data can be manually or automatically transmitted to remote locations, alerting or reassuring family, friends and professional caretakers.  Physicians can receive data for interpretation and intervention.The transmission of data from home health care devices has become easier and more efficient as the result of developments in computer technology and mobile phone technology. Health data can be transmitted from a device to a home computer or cell phone, and then transmitted through these systems to a doctor or caretaker. Computerized data management systems can automatically monitor medical data and, in the event of a sudden change, alert the user, doctor and designated caretaker.

Home health monitoring equipment is much more than a sophisticated device.  The device is part of an interactive system whose effectiveness is determined by the coordination of the system’s vital components: technology, support services, environmental resources, and the individual characteristics of users, caretakers, and professional service providers.

Home health care equipment includes:

•         alarms (manual, automatic)
•         blood pressure cuffs
•         glucose monitors
•         GPS systems
•          fall detectors
•          flood detectors
•          glucose meters
•          infusion pumps
•          moisture sensors
•          monitored medication dispensers
•          motion detectors
•          scales
•          spirometers
•          wandering alarms

·         Blood Pressure Cuffs

Blood pressure cuffs are the familiar name for sphygmomanometers.  These cuffs are wrapped around a limb, usually an arm, and then inflated. As the inflated cuff places pressure on the arm, a device produces measurements for both systolic blood pressure (heart contraction) and diastolic blood pressure (heart relaxation).

·         Glucose Monitors

Blood glucose monitors are small digital devices used to measure the amount of glucose in blood. The skin is pierced, usually at the fingertip, to produce a small sample of blood.  The blood sample is applied to a specialized test strip which contains reactants. Glucose monitoring can be critical to healthcare, particularly in diabetics.

·         GPS Systems

Personal GPS systems are small devices that are designed to provide  family and authorities with the location of people who have dementia and wander. These devices are comfortably attached to the patient after being incorporated into a pendant or a wrist/ankle bracelet.

·         Flood Detectors

Flood detectors are small sensors that detect water when placed on a floor. Using wireless technologies, the detector provides an early alert.  If water is present on the floor, sensors transmit information  to a receiver that is integrated into a home alarm system.

·        Infusion Pumps

An infusion pump delivers medications, fluids, or nutrients directly into a patient’s circulatory system. Infusion pumps provide exact quantities of medication over a predetermined time interval without the ongoing presence of a health care provider. Manual administration would increase both cost and errors.

·         Monitored Medication Dispensers

Monitored medication dispensers are programmed to the proper dose of medication at predetermined time intervals. A monitored medication dispenser at home with treatment..

·         Motion Detectors

Sensors reduce falls and also reduce the need for a constant caretaker presence and for restraint. Magnetic sensors in a pad sense a change in movement.  The pad is connected to a cord and a phone-jack, and set off an alarm when an individual begins to stand.

A motion detector is a device used for the detection of movement within a given area. Motion detectors can be integrated into such things as: security alarms, automatic flood lights, or camera. There exist four types of motion sensors:

• Passive Infrared Sensors: Sense heat given off by a body.
• Ultrasonic: Emits bursts of ultrasonic waves and measures reflection off an object to determine if it is moving
• Microwave: Sends out microwave waves and measures the reflection off a moving object functioning similarly to the ultrasonic sensor.\
• Tomographic Detector: Senses  abnormalities in radio waves as they travel through a space surrounded by mesh network of nodes. Has the ability to detect through walls and obstructions.

·        Scales

Scales estimate body weight and body fat. Body weight and height are measurements used to calculate Body Mass Index (BMI). There are many types of scales. Balance scales are usually found in medical settings. They uses body weight as a counter weight to level a beam resting on a fulcrum.

·        Spirometer

Spirometers  measure the volume of air inspired (inhaled) and expired (exhaled) over a predetermined period of time.

·        Wandering Alarms

Wander alarms are used to protect patients with dementia who cannot safely leave a predefined area. Alarm triggers can be placed on doorways, windows, room and property perimeters. Sensors in wrist bands or pendants trigger silent or audible alarms if a patient crosses a boundary.

The Federal Drug Administration (FDA) is reviewing new technology. These devices are designed to be implanted inside of the body, and to transmit medical data to physicians at remote locations. Some of the devices under review include implants that measure cardiac pressure, blood glucose and tumor progression after biopsy. The FDA has recently created a website that provides information about home use equipment.

When is home health care monitoring equipment used?

Home health care equipment is used under a variety of circumstances. In choosing home health care equipment, consideration should be given to its purpose and, also, to the user’s physical, cognitive and environmental resources. If monitoring devices are appropriately selected and used, the equipment can serve several simultaneous functions.  It can:

• monitor wellness
• assess sudden changes in physical states
• assess changes in physiological patterns
• assess changes in patterns of behavior associated with medical risks
• detect behaviors associated with safety risks
• communicate information to caretakers and medical personnel nearby or in remote locations

 Home health care monitoring equipment is used when an individual or caretakers want to assume more direct responsibility for the management of health issues. For patients with disabilities, this equipment can be a critical factor in maintaining independence outside of a residential facility. Health care monitoring equipment is often incorporated into a home setting when someone with a stable pattern of health becomes medically unstable.  This can occur in acute illness, following discharge from a hospital, and in the deterioration associated with a chronic, progressive illness.

Where is health care monitoring equipment used?

Health care monitoring equipment is used in a variety of circumstances that include individual homes and:

• designated healthcare service companies
• hospitals
• nursing homes
• out-patient medical offices
• pharmaceutical companies
• rehabilitation facilities

Why is home health care equipment helpful to people with disabilities?

Home is the preferred residence for the vast majority of Americans, including those with disabilities. Health monitoring devices facilitate successful adaptation within a home environment for people with disabilities as well as for people who don’t have disabilities. For a person with disabilities, this equipment can be a critical factor in living at home rather than in an institutional setting.

Home health care equipment can also be used to improve general health for people with and without disabilities.  Many health care devices are programmed to provide  feedback that facilitates good health habits. Data received from health care monitoring devices, such as scales and pedometers, can be uploaded to computer software programs. The user can view his daily achievements, track progress, and send information to a doctor or fitness trainer Exercise and weight control are helpful for all. 

Health care equipment is particularly helpful for people with disabilities as they also contend with the standard problems of advanced years. More than 10 million Americans over the age of 65 who live alone in their homes.  Disability and chronic illness increase with age, and problems in mobility are a primary cause of age related disability. The U.S. Census Bureau has documented an inexorable trend toward longer life in the United States. Between 2008 and 2050, it estimates that the number of Americans over the age of 85 will more than triple. While life is a blessing, old age frequently brings illness, disability, social isolation and economic concerns. Home health care equipment is a cost effective approach to better health and function.  In the process of using these devices, relationships with can be created with health care providers.  Burdens upon caretakers are reduced by health care equipment, and this factor can be a protective factor in relationships with family members and friends who serve as caretakers.

Home health care equipment  decreases risk through interventions that facilitate effective management. Medication, for example, is prescribed to be helpful.  However, medication can be harmful or deadly if it is misused. The Centers For Disease Control report 700,000 emergency room visits annually, resulting in 120,000 hospitalizations. An automated, monitored medication dispensing system has been developed to ensure that medication is taken at the right times in the right amounts.  In addition, devices have been developed that communicate auditory and visual reminders.

As our population ages, Americans experience higher medical costs associated with chronic illness and disability.  Home health care devices have been documented to be part of a cost-effective system of medical management. For example, the use of home health care devices can decrease the need for long-term paid caretakers and can also decrease the demands upon family caretakers. In 2009, the National Alliance for Caregiving estimated that approximately one-third of all American households included an unpaid caretaker. The National Association of Home Care and Hospice (2008) compared hospital and home care under three medical conditions and found the following differences:

Home health care equipment empowers people with disabilities, acting as tools that help users to control their circumstances and their decisions.

PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT

PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT

PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT

PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT

PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT

PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT

PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT

PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT

PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT

PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT

PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT

PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT

PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT

PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT PLACEHOLDER TEXT