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3 Steps To The Right Ramp

Ramps – a wonderful invention that has made the inaccessible accessible in recent years throughout the world. But is a ramp always the best solution? To answer this question, let’s first  consider the following:
 
Step 1 – Does the person need a ramp to get over that step? Ramps are meant for wheels. For some, walking up a ramp is more difficult than taking a step. If you are using a wheelchair for long distances outside only, you might not need a ramp at the front door. 
 
Step 2 – Is there enough clearance at the doorway? The standard recommended gradient is 1:12. If an off the shelf ramp is going to infringe on your neighbours space you may need to think about bespoke options.
 
Step 3 – Will it affect other people in the home?

A Slippery Slope?

Ramps, grab bars and non slip flooring are the trio that comes to mind for most when thinking about how to make a home eldery/ disability friendly.

Ramps however, can require a bit more thought and here’s why:

Walking up a ramp: the muscle strength, flexibility and balance required to mobilise up a ramp is different from a step. 

Some people find it more difficult to use a ramp, for these people falls risk can be increased, rather than reduced.

People with memory difficulties may forget the ramp is there and when expecting a step down, become unbalanced at the unexpected terrain.

So do consider the above factors BEFORE installing a ramp, it’s not a one-size-fits-all solution.

Benefits of Ramps

Ramps are best for wheels, wheelchairs and mobility scooters.

Ramps improve access and could increase a person’s engagement with their community and social circles. 

If one family member needs a ramp, but another does not, an alternative may be required i.e. a portable ramp. Portable ramps can be cost effective and come in a variety of sizes. 

Case Study – The Problem Of “One Size Fits All” Solutions

A client with Parkinson’s and dementia had a ramp installed by his family because they had bought him a wheelchair to use when going on family outings. He was able to step into and out of the flat independently and was determined to maintain his ability to do this. He would only agree to sit in his wheelchair once outside the front door. The ramp remained in place and the client had three falls mobilising on the ramp due to difficulties balancing caused by his Parkinson’s. He then developed a fear of leaving his home and of falling, leading to refusal to leave the flat. This had a knock on effect to how he socialised with his family and attended appointments. Therapy was required to regain his confidence and ability to leave the house, but the first thing we did was remove the biggest risk to his independence and safety – the ramp!

This is a real case of a family with the very best of intentions at heart, but without full knowledge of the risks. Though a ramp may be seen as a solution for someone with mobility problems, without fully taking into consideration a person’s needs and motivations, there is a risk of creating more issues. 

If you are considering a ramp for yourself or your family member, we recommend first reviewing  these statements:

1 The ramp is for a wheelchair or mobility scooter only.

2 The person is motivated to use the ramp/wheelchair as appropriate. 

3 The person does not have a cognitive issue/memory problems that may cause them to use the ramp in an unsafe way.

4 The ramp will not be disruptive/create risks for other family members. 

Can you tick all the statements above? If not, this should be a red flag when it comes to installing a ramp. If you cannot tick any of the statements at all, the choice of a ramp is very likely the wrong one. 

If you have identified any red flags, we recommend having an Assessment by an occupational therapist. This Assessment can help you explore the risks/benefits of a ramp fully, and ensure you are selecting the best solution for cost, independence and safety.

Suggested Read: "Already Old" Does Not Mean Frailty!

Aging is inevitable but frailty doesn’t have to be. It’s important to ask, why do some people become weak as they age and others don’t? Sometimes people who have had an amputation or past health conditions are actually stronger than those with no medical issues and good nutritional health.

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