medical problems causing difficulty handling CPAP gear

[humanfactors]

I am new to cpaptalk.com. I joined because I am a healthcare provider who works mostly with older adults and have noticed that some of my patients who have trouble with their fingers and arms have trouble using their CPAP equipment. Manipulating the straps and the masks is a challenge, as is working with the machine buttons. I thought I would post something here to see if my observations are isolated to people I interact with.

Specifically, do you (or someone you care for) have hand or shoulder pain or stiffness, hand numbness, paralyzed arm (or any other medical conditions), blindness, or any other condition that makes it difficult for you to put on your mask, adjust your straps, push the buttons on your machines, and/or clean your equipment? Have you come up with any ways to make it easier to get through these daily tasks?

I appreciate in advance your replies. If I find that my clinical hunch is correct, I am going to try to put together a project to see if I can raise some awareness about this issue.

[Julie]

What a good note! See if you can work together with someone in Occupational Therapy (who have all kinds of tricks and gadgets we'd normally never think of) to come up with fixes and let us know how it goes.

[49er]

Human Factors,

Oh my gosh, your post is very timely.

Due to a condition, I have visual perceptual and manual dexterity problems that make various parts of cpap treatment very challenging. For example, even though there is an excellent video on freeadvicecapap.com about how to take part the Quatro full face mask, I still have not been able to do it due to my inability to visualize how to take it apart. I don't see the big picture.

I tried to no avail to explain this to the sleep center employee I dealt with last week and was very frustrated that he didn't understand. My alternative solution was to simply clean the mask as a whole. But I fear that is not adequate as I continue to have problems with leaks.

Hopefully, a new nasal pillow mask that should arrive this week will be easier to maintain.

Anyway, thank you so much for being concerned about these issues. I would love to hear more about your project.

Feel free to pm me if you want more information about my situation.

49er

[DoriC]

My husband has problems with his finger dexterity and would know how to adjust his mask if it leaks during the night but he can't find or feel the ends of the velcro straps to pull open and readjust. If the ends had some kind of loops he could feel for he'd be able to do it himself. As it is, when the leaking starts it wakes me up I have to get up and readust for him which disturbs both him and me. Great post!

[mebeingme]

the auto-start/auto-on feature helps alot. The nasal pillow masks help also. I've also used beads of hot glue at the ends of the straps.

[Janknitz]

As a retired occupational therapist, I've often thought about the challenges some of the masks and machines could present, but nothing a good OT can't come up with ideas for. Hopefully one who knows something about CPAP and how it works!

For example, the auto off/on setting suggested above obviates the need to deal with the buttons on the machine. I don't know how other machines work, but the big main button of the Philips Respironics S1's could just as easily be pressed with the side of the hand, an arm, an elbow. Whether an OT not familliar with the machine will realize there is an auto on/off feature is another question. I used to read manuals, and watch how other people operated equipment to be able to adapt things for my patients. Hopefully there are still good OT's out there with the creative skills to come up with things.

Nasal pillow masks like the Swift FX can be simply pulled on without adjusting or clipping anything for someone who has poor manual dexterity. Some strategic loops sewn into mask headgear would help pull it into place. A hose hanger can help make it easier to manage the hose, etc. Cleaning, or taking apart a mask with a lot of little pieces could be a challenge, or snapping a cushion back into place so it seals well, if someone lacks fine motor coordination. There are ways to solve almost everything with a little time and ingenuity.

[humanfactors]

These are great responses. I haven't started a project yet, but I'm thinking about trying to compile a list of problems and solutions (like "if you have this concern ____, try using this product ____. Or if you have this concern ____, try adjusting the equipment like this ____.) That way, someone who has trouble with equipment doesn't have to start from scratch when trying to find a solution.

From the responses to my post, it sounds like asking OTs would be a great starting point. Should I also be asking people who work at durable medical equipment companies who set up CPAP?

[chunkyfrog]

--Maybe even providers at nursing homes.
Patients who participate in their own care are not only less work, but their outlook is brighter.

[Julie]

You might ask DME's, but knowing whether you were getting correct information from individuals could be very tricky, especially if they sound reasonably confident and knowledgable, but aren't, never mind that they could have a vested interest in certain items... cynical maybe, but the horror stories that I've heard here about them would make me very leery of who says what.

[chunkyfrog]

I wonder if there are any accessibility specialists nearby, who work with the disabled doing everyday tasks.

[humanfactors]

I'm not familiar with the term, accessibility specialists. Is this a special type of OT? Do you have any suggestions on how I might find someone with this type of training?