Thursday, December 20, 2012

Non-chew chicken recipe for a person w/ ALS

The Slick Chick

1 can cream of mushroom soup

1 can cream of chicken soup

½ cup milk

½ tsp. onion powder

4 cups rice, cooked

3 cups chicken, finely chopped in blender

1 cup cheddar cheese, grated

2 tablespoons pimento, finely chopped

Combine soups and milk in large saucepan,

mixing well, while heating and stirring

constantly. When heated add all

remaining ingredients and heat. Pour

into a lightly greased 2 quart casserole.

Bake at 375° for 30 minutes. Makes 6

servings.  Enjoy!             

Wednesday, December 19, 2012

Toilet Hygiene and the Use of Bidets for ppl w/ ALS/MND

ALS is a debilitating disease that can cause weakness throughout the body, impairing function with all day to day tasks.  In my seven years of working at the ALS clinic as an Occupational Therapist, most people with ALS (PALS) are more than willing to discuss difficulties they are having with dressing, walking, opening containers, opening doors, hand writing and a host of other daily activities. 

The activity of going to the bathroom is rarely discussed, as most of us were taught from a young age that this is a basic human function that should be kept private.  PALS rarely (unless prompted) discuss activities involved with going to the bathroom especially in terms of being able to manage their clothing and being able to perform toileting hygiene and cleaning.   In most cases this is probably an accurate and acceptable social norm; however what do you do if your hand and arm strength is greatly diminished?  An activity that was once a basic human function performed on a daily basis can turn into an extremely difficult task.  The consequences of this task not being performed effectively and correctly can lead to embarrassment and needlessly exaggerate functional deficits associated with ALS.  Even if a PALS has help with toileting hygiene, he or she may feel uncomfortable with this loss of independence. 

The bidet is a good solution for those PALS with loss of hand and arm function, who need assistance with toilet hygiene.  Bidets come in many different forms and at many different price points.  I have not heard any patient regret their decision to use a bidet at home to increase independence with toileting.    Some patients have been extremely happy with regaining a level of independence with such a private activity of daily living. 

Most bidets are sold as part of a toilet seat.  This bidet/toilet seat will be installed in place of your current toilet seat.  Bidets usually cannot be used in conjunction with a 3 in 1 commode or raised toilet seat.  If you are having difficulty standing up from the toilet, you may want to install a new ADA compliant toilet.  The ADA (Americans with Disability Act) height recommendation for toilets is 17 to 19 inches (floor to seat).  Depending on your ability to use your arms, you may also want to install a grab bar along one or both sides of the toilet at 33 to 36 inches high.  This can help most PALS with sit to stand toilet transfers and prolong independence with toileting.  Doing this can be helpful even if you need assistance from a caregiver with getting onto and up from a toilet. 


Most of the bidets I recommend do not come from a medical supply store and are not necessarily marketed exclusively to people who have disabilities.  For instance, the brand Toto is a Japanese manufacturer of toilets that are marketed as luxury items.  I believe that products made by these types of companies have a higher level of quality and are actually less expensive than products exclusively made for people with disabilities.

Bidets also have different functions that can be beneficial.    One of the major functions I would look for when purchasing a bidet is hands free use.  If you already have limited hand function, you don’t want to have to operate buttons or a remote control to use your bidet.  This defeats the purpose of hands free toilet hygiene.  There are many bidet options that come with sensors that activate the bidet system through shifting your weight on the toilet seat.  This ensures hands free hygiene and makes it so the bidet system cannot accidently be activated otherwise. 

Another function I would look for when purchasing a bidet is a drying mechanism that is also operated in a hands free function.  A bidet uses sprayed water to clean a person so you are going to need to be dried after using it.  Many bidets come with a blow dryer function to meet this need. 

There are other functions that you may or may not find helpful.  There are automatic toilet lid openers, self cleaning nozzles, heated seats, and massage functions.  Outside of the automatic seat, the other functions may or may not be needed. 

After reading this article, if you have any questions you can contact me at  I hope you found this article helpful.  I’ve attached some links to company websites that sell types of bidet systems discussed in this article.

Authors: Scott Rushanan, MS, OTR/L and Michelle Lewis, DPT, PT

New Video Depicts How Existing Technologies Can Facilitate Coordinated Care and Aging in Place


(Washington)—A new video from the LeadingAge Center for Aging Services Technologies (CAST) depicts how affordable technologies that are currently available can be integrated to allow seniors and people with disabilities to receive better-coordinated health care and to remain independent longer. The video will be premiered at the Institute of Medicine’s Assistive Technologies, Aging, and Disability workshop on December 19, 2012.


The story follows a character named Alma from home to hospital to rehabilitation and back home again. Throughout her experience of having and recovering from a stroke, Alma and her caregivers use a personal health tablet, medication dispenser, electronic health records, home monitoring, telehealth, engagement technologies and assistive technologies, in addition to a personal emergency response system with automatic fall detection, to plan her care, communicate with each other and allow her to remain safely at home with support.


“Our 2005 video painted a picture of what technology might do if created in service of aging, long-term care and post-acute care,” said LeadingAge president & CEO Larry Minnix. “This video portrays a vision we could implement today with the commitment of providers, payers and consumers.”


All of the technologies portrayed in the video are currently available for purchase and deployment. However, there are few communities or care networks that deploy these technologies in a coordinated way across care settings.


“Our goal with this video is to engage long-term care organizations in leading their communities to create integrated care networks that leverage technology to create efficiencies and improve quality of care and quality of life,” said Majd Alwan, PhD, LeadingAge senior vice president for technology and executive director of CAST. “We hope that hospitals, physicians, insurance companies, long-term post acute care organizations and consumers will see this vision and realize it is well within their ability to achieve it.”


CAST’s previous vision video about technology and aging, “Imagine – The Future of Aging” was sent to more than 60,000 health care providers and has been used by technology companies and long-term care organizations to catalyze technology development and pilot testing.


The new video is available through the following options:

·         The full version is available for viewing and embedding at:

·         A 2-minute condensed version of the video is available for viewing and embedding at:

·         When the embargo is lifted on December 19th, the video will be available for viewing, embedding and downloading at:

·         The video may be used without permission, but users should credit LeadingAge CAST and provide viewers with a link to the CAST website,  


The video was filmed on-location at Asbury Methodist Village in Gaithersburg, MD.


About CAST


The LeadingAge Center for Aging Services Technologies (CAST) is leading the charge to expedite the development, evaluation and adoption of emerging technologies that can improve the aging experience. CAST has become an international coalition of more than 400 technology companies, aging services organizations, research universities, and government representatives.



Emily Wilson | Communications Associate | LeadingAge | 2519 Connecticut Ave, NW, Washington, DC 20008 | P 202-508-9492 |