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Invention Provides Self-Reliance, Dignity for the Wheelchair User

On a silver-skied Thursday morning, Glenice Johnson takes dainty bites of a cinnamon roll and sips a morning coffee in her Sioux Falls home, ensconced in her kitchen with photographs of children and grandchildren and a lifetime's collection of crockery and decorative plates.

Two years ago, this simple scene seemed impossible.

Glenice, 74, has multiple sclerosis. Only a few years after building this home with her husband, Dave Johnson, in 1989, she was forced to use a wheelchair. As the disease progressed, it challenged her again.

"She was not able to transfer from the wheelchair to the toilet and back," says her son Greg Johnson, a pastor at Trinity Lutheran Church in Tea. "Naturally, it began to involve my dad. He's an athletic 75-year-old, but with the lifting, it became dangerous."

"It was not possible for me to do this anymore," said Dave, who is also a pastor, part time, at First Lutheran Church.

"At some point, someone had to build something new or my mom was going to the nursing home," Greg said.

So he did.

"It has been for us, maybe 'lifesaver' is too strong of word, but it has meant that she could remain here at home," Dave said.

And what does staying at home mean to Glenice?

"Everything," she said.

Glenice now spends her day in a wheelchair that her son developed, and Greg has turned over the wheelchair to a group of South Dakotans who work to find others who could benefit the way his mom has.

The chair, called the Dignity200, is the first wheelchair on the market that allows what the makers call "self-toileting."

The user pushes a lever that drops a center panel from the seat. The person backs the chair over the commode, readjusts clothing and urinates or allows for a bowel movement as if sitting on a toilet seat. Once clean, and after adjusting clothing, the user moves the chair away from the commode and the panel is returned to place.

"If I'm here by myself, I can take care of what I need to," Glenice said. "Mentally and emotionally, it is a tremendous plus. It makes all the difference in me being at home."

It has changed Dave's life, too.

"It has taken a lot of pressure off," he said. "It extends the time that I can be away from the home, and it has meant it is easier to provide care."

Saving On Cost Of Care

While the primary concern is with the emotional benefits from Glenice living at home, there is a cost benefit as well.

"If it weren't for this chair, she'd be in the nursing home," Dave said. "The cost of that, you're spending big bucks to be in a nursing home."

The adjustable, custom-built chair, available at Kreisers medical supply store in Sioux Falls and a growing number of similar stores, costs $2,950.

It is an expensive chair, Greg admits. But chair effectively pays for itself every three weeks, considering that a month's stay in a long-term care facility can run at least $5,000.

But the greatest benefit might be a wheelchair-bound person staying home as long as possible.

"I think they feel like less of a burden," Greg said. "They are so aware of the burden they put on the caregivers oftentimes. Dignity is returned. You can go to the bathroom on your own."

Drawn Up In The Dust

The design wasn't easy.

Greg said he was able to figure out how to remove the understructure from beneath the wheelchair but couldn't work out the drop-down panel.

He called up a rancher friend with a background in engineering to pick his brain, who happened to be out planting corn.

"About two hours later, he called back and said, 'I got it!' " Greg said. "He designed it in the dust on the glass of his cab."

Together, they began to work on prototypes. The hardest part, Greg said, was "making sure the seat cushion would be of a quality that allows her to stay in the seat all day. If that didn't work, it wouldn't be possible."

Dignity Medical Devices uses local manufacturing, with parts made in Watertown and Wentworth and assembly in Minneapolis.

The Dignity200 now is approved by the Federal Drug Administration and is in testing for applications outside the home.

The heartiest response Johnson has received about his chair, aside from his delighted mother, is from those who control risk.

According to the Centers for Disease Control and Prevention, health care workers who routinely lift and move patients have a higher risk of injuries than workers in most other occupations, and the number of those injuries are increasing.

In September, the chair became part of a risk prevention study overseen by the University of South Dakota medical school in partnership with the Good Samaritan Society.

"The lifting and transferring from chair to commode and so forth for residents whose conditions tend to be frail, that's a significant issue and a significant source of injury to residents and staff," said Bill Kubat, vice president for resident community and quality service at the Good Samaritan Society.

A trial of the chairs at a Good Samaritan facility helped the chair get where it is now. Stories emerged, including staff who felt the chair made their work safer and a woman who had not used the bathroom on her own for four years and cried when the chair had to be returned at the end of the trial.

But the longest test case has been Greg's mom, who has been in the chair for two years.

"For my mom, she can feel like she's on her own a little more again," Greg said. "And my dad doesn't have to be home. He's got a lot more freedom and he's doing a lot less lifting. It has changed their life."