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THE HANDICAPPED - FEEDING, TOILETTING AND WASHING
Introduction
Any disablement slows down activity, not the least of limitations being caused by the
length of time it takes a handicapped person to perform the simplest tasks. The family will
often step in and act for him in order to save their time thus denying him the satisfaction of
personal accomplishment. The handicapped are often in rebellion against the fate which
prevents them from doing everything for themselves and as they want it done, and the families
often resent the tie they are upon their time and energies. Rebellion and resentment are not
always on the surface but manifest themselves in overprotection or rejection, in dissatisfaction
or acquiescence.
Feeding
It will be seen, therefore, that a disabled person in the house will slow the tempo of
living for the family if they are to include him in their activities. At meal times, for example,
a blind person has to be told where the various foods are - nine o'clock potatoes; six o'clock
meat; three o'clock carrots; and if he has not learned to cut up his own food this has to be
done for him. A one-handed person, perhaps having suffered a stroke, will take longer to get
the food into his mouth because of the difficulties in getting it on to his fork.
There are several causes for difficulty in feeding oneself normally, such as loss of
control of steady hand movements, fingers which will not grip, loss of feeling (touch), loss of
sensation of position, inability to bring the hand towards the mouth, inability to bend the
elbow or move the shoulder joint, loss of mobility in thecervical spine. Feeding utensils can
be of the "standing" type which do not have to be lifted, i.e. a polythene tube in a cup or
beaker, or the raised tilting container held in a swivel bracket on side supports which tilts as
the lips press on it and which regains its upright position when the lips no longer touch it.
The feeding cup with its spout, the Doidy cup which is fashioned to slope towards the mouth,
the perforated lid on a cup which prevents spilling and the two handed cup (soup bowl) are
aids to drinking which have to be held and which help to overcome the difficulties which those
with weak hands experience in using ordinary drinking receptacles.
Where only one hand can be used, cutting the food on the plate presents the feeder
with some embarrassment unless an aid can be obtained to meet the particular need. The
curved pronged type of cheese knife known as the "Nelson" knife will break through the
fibres with pressure on the curved part of the blade, and by turning the handle round in the
hand the "prongs" spear the food which can then be carried to the mouth. As the prongs
and the sharp curve are on opposite sides of the blade it is impossible for the feeder to cut
himself. The scissor-knife has prongs at which would normally be the pointed ends of the
scissors. Meat and other foods are cut with the scissors and then conveyed to the mouth on
the prongs. Counter-balanced spoon-bowls and weights on handles at right angles to the bowl
enable liquids to be lifted without spilling. Long handles, fat handles, bent handles, are
some of the many modifications which have to be made to feeding utensils. Plate bunkers to
clip on to the rim of a plate and stand up at right angles to the plate, are available in plastic
or stainless steel and prevent food being pushed off the plate on to the table. Double suckers
fixed under the bottom of the plate will prevent it sliding across the table as a one-handed
attempt is made to grapple with recalcitrant food which will not go on to the fork or in to the
spoon.
There are many more aids available to help with feeding but the process is slower than
if two able hands and arms were available. Eating is a personal activity and it is extremely
frustrating to be forced to depend upon another's help.
Toiletting
About a thousand times a year one needs to use the toilet and a handicapped person
who has not become independent needs to ask this number of times for help in lifting and
lowering on to and off the chair and the toilet pan. How embarrassing and undignified for him.
\ raised toilet seat attached to the pan and rails either side will give many handicapped
persons the independence they require in this particular function. A fall-bar covered in foam
rubber and fixed to the walls will give confidence and support to someone whose balance is
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