OT 620 Fabrication of ADL Adaptation Write-Up -Assistive Gas Cap Opener Student: Estee Woods, OTS Human: My grandmother,

Cheryl Lester, was diagnosed with osteoarthritis in 2004, mainly affecting her knees and fingers in both hands. Cheryl had a total knee replacement in 2006 on her right knee and plans to have the other replaced in 2014. She experiences pain, stiffness and limited range of motion, which leads to weakness in her lower extremities, hands and wrist. She was recently diagnosed with diabetes (regulated by medication) and has been taking medication for thyroid disease, anxiety, high blood pressure and cholesterol. She also has sleep apnea, which is controlled by a CPAP machine. She admits that she doesnt wear it as much as she should. She is independent in all areas of occupation. However, she fatigues easily when walking or gross motor is demanded. She complains of tiredness throughout the day, which could be attributed to lack of sleep. Cheryl states that it takes her 2-3 hours to get to sleep and will wake up throughout the night. This could be caused by the decreased use of her CPAP machine. She also has a hard time focusing on and completing tasks. She often jokes that she has ADHD. Her short attention span affects her leisure pursuits. When asked what she enjoys, she lists shopping, watching television, going out to eat, spending time with grandchildren and taking care of her husband. When presented with new ideas for leisure pursuits she is quick to reply with a reason it is not enjoyable to her. Cheryls sleep and leisure routines are severely affected. Before retirement, Cheryl worked as an LPN for 40 years in the small town of Cass City, MI. She has one daughter, two sons, three stepsons and one stepdaughter, as well as 22 grandchildren. In her younger years she enjoyed dancing, meeting new people and entertaining.

Activity: Due to my grandfathers condition, my grandparents are on the road to attend doctors appointments often in Saginaw, Detroit and Ann Arbor. This causes more frequent stops for gas to fill up the car. The effects of the arthritis in my grandmothers hands make taking off the gas cap a difficult task. The twisting of the wrist and gripping hand position required to remove the cap cause pain and discomfort to the small joins in her hand. She has occasionally been forced to ask other patrons to help her, putting her safety at risk. She needs a device that will allow her to remove her gas cap without stressing the small joints of her hands. Description of the Assistive Technology Device: The adaptive device that I have designed will allow my grandmother to rely more on her gross motor strength and less on the small joints of her hand. The device is made out wood, some screws and spray paint for aesthetic purposes. It is intended to be stored within the trunk of the car or backseat and retrieved when needed. The device fits over the existing gas cap, with a slat for the handle to fit into. It also has a long handle attached to provide leverage and more of a gross motor grip. Materials: 1. 5/8 X 2 X 2 of Birch Plywood- $6.92. This can be found at your local home improvement store. Scrap wood from around the home could also be used. 2. Jigsaw-$49.98. There are some that are less expensive and others that are more expensive. I was lucky enough to barrow one from the neighbor for this project. 3. Pencil and Ruler 4. 1 Sheet of 150 Grit Sandpaper- $1.99. Price includes 4 sheets of sandpaper. This I also had on hand. 5. Drinking Glass for circle template.

6. (6) 1 Drywall Screws- $1.59. I bought these in a package of ten at a local home improvement store. 7. Drill- $29.98 and up. I used a drill that I already had with a 3/32 drill bit to drill pilot holes. 8. Screwdriver- $2.98. I used a #2 Phillips that was in my toolbox but any universal screwdriver will work. 9. Spray paint (any color)-$2.98. I used Rust-Oleum All-Purpose spray paint in Silver 10. Cardboard or drop cloth for paint barrier. 11. Drawer liner- $2.98. I used this to wrap the handle of the device for comfort and protection from scratching the vehicle. You can find the rubber non-skid drawer liner in any big box store (i.e. Wal-Mart, K-Mart, Meijers, Bed Bath and Beyond, Menards), in the miscellaneous kitchen gadget isle. 12. Spray Adhesive-$2.99. I used Elmers All-Purpose Spray Adhesive. This can be found at any hardware, home improvement or craft store. Assuming that you have access to a screwdriver, jigsaw, pencil, ruler, and drill this device would only cost $19.45. This device also has the potential to be no cost if you have scrap wood and other items laying around the home already. Construction: 1. Place plywood on an open area, free of clutter. Flip over a drinking glass, place it on the piece of wood and trace the rim with a pencil to form a circle. Use a ruler to draw a 12 x 2 rectangle for the handle and a 3x 3 square. 2. Cut out all three pieces with the jigsaw. Sand all sides of each piece with sandpaper.

3. Use a jigsaw to round the corners of the 3x 3 square and cut down the middle to create 2 bracing points for the gas cap handle to go between. Make sure that your gap is wide enough for the handle to fit but not too wide that the device slips. 4. Drill 2 pilot holes in both pieces from the 3x 3 square piece. (see picture). 5. Screw those two pieces (using two screws for each side) to the circle. 6. Turn the circle over and place the rectangular handle on the back. Drill 2 pilot holes into one end of the handle about 1 apart. Drill the handle into the back of the circle using 2 more screws. 7. Place device on cardboard or barrier and spray paint. Let dry. Apply second coat if needed. 8. Measure the circumference and length of the handle. Cut those dimensions out of your drawer liner. Spray Adhesive onto the total circumference of the handle. Quickly, apply the drawer liner onto the handle to provide comfort and scratch protection. Potential or Possible Precautions: It is possible that fingers and other body parts can become wedged between the device and vehicle it is being used on. Make sure the device is sanded to prevent the possibility of splinters. Also, be mindful of the position of the device, as not to scratch the paint on your vehicle. Device Introduction and Training: To implement proper training I will review the following steps with Grandma as a preparatory method, and to increase comprehension. We will then drive to the gas station, where I will demonstrate the proper way to use the device from beginning to end, without actually pumping gas. I will then answer any of her questions or concerns, and offer another demonstration if needed. When she is comfortable, I will ask her to show me how to use

the device. We will practice as many times as she needs, to increase the likelihood of use. I will also include a copy of the following should a question arise in the future: Directions for Easy Use Pull up to the gas pump, turn off the car, locate and grab the device out of the preferred spot in the vehicle. Open the door to the gas tank manually or with the release button located inside the vehicle (depending on vehicle specifications). See car manual for more information. Hold and position the device so that the handle on the gas cap fits into the slat on the device. Use the palm of your hand, elbow or forearm to force the arm of the handle clockwise until the gas cap releases. Set device aside. Remove the gas cap. Set the gas cap aside. Pump the gas. Return the nozzle to the pump. Locate and place the gas cap back into the hole to the tank. Locate and place the device on the gas cap. Use the palm of your hand, elbow or forearm to force the arm of the handle clockwise until the gas tightens and clicks tightly into position. Close the door to gas tank and store device in a desired, easy to access and remember spot within your vehicle.

Evaluation of Effectiveness: Effectiveness will be measured by the following: Cheryl is able to demonstrate the proper steps involved without any verbal cues on or before her third demonstration. Cheryl will remember to use the device each time she pulls up to the pump. Cheryl reports a decrease in pain and demonstrates an increase in independence when using the device.