Those of us in the business of home health care have an amazing and intimate view into the lives of so many. We are the places people come to for the stuff their doctors and physical therapists tell them they need. We are also the places people come to for solutions, for ideas, for all the things the health care system doesn't mention or can't provide.

So, while many HME dealers have made a living providing the big important tools for mobility and independence—power chairs, scooters, lift chairs, and the like—those of us on the inside have had many satisfying moments introducing folks to the little things—the small, everyday tools ("aids for daily living")—that often make such a difference for an individual facing life's challenges.

I am struck by the panoply of gadgets designed to help humans do things. In fact, most products on the market could qualify, I suppose. It is often not until someone has difficulty doing something, though, that the "ah-ha" delight of discovery is appreciated. I see this look every day. And it is the reason to be in this business in the first place. I started keeping notes on the "little things." What follows are some of the stories that go with them.

THE GAS-CAP CONUNDRUM

It was a late fall evening when a woman came into our store, clearly on a mission. With a diagnosis of ALS barely 6 months old, Judy (as she introduced herself) had begun to feel the disease's swift effects move through her body. While her legs still felt strong, her hands weakened by the day. She had all kinds of tools for eating, opening jars, and holding things.

The challenge facing her now was her gas cap. She lived and traveled alone for the most part, having resettled her life away from family a few years previously. Like many of us, she associated driving with independence. So, it was extremely upsetting to her that she was having increasing difficulty removing the gas cap from the tank. And with self-service gas stations the norm, her worry was real and growing.

She had tried wrenches, nonslip gripping mats and tools, and some homemade concoctions. While each tool had worked initially, it could not offer her continued support as her condition worsened. We spent more than an hour looking at gadgets, trying them out, poring over catalogs. "I'll find something," I said as I took her name and number. She picked up a few things, but left unsatisfied.

I could not get Judy out of my mind, even after my initial searches seemed to result in the usual array of gripping tools. I wondered how else she might solve the problem—inviting friends perhaps to drive with her? However, the whole point for Judy was to drive as far and as long as she could without assistance. She had begun her journey to a new place where she would have to rely on other people eventually, and she did not want to advance the trip if she could avoid it.

Then, a few days later, I found it—the gas cap wrench! I could not believe my eyes. I had not been in the business long at that point, so I could (and still do) thrill at such discoveries. With what seemed to be its universal design, and a stout enough four-point handle, I was certain this tool could help Judy. When it came in, I called her immediately. She drove over that evening. We opened it and went promptly to her car. It worked!

She tried it over and over again. I even tightened the cap a little harder to see if the tool could help her remove it. Yes! We hugged and did a bit of a Snoopy dance in the parking lot. It cost her about $20 that night, and it gave her a few more months of independence. It gave me that full feeling when you know you're part of someone's life for more than a minute.

The story of Judy and the gas cap underscores the importance of the little things when facing and addressing the complexities of illness, injury, and the many curveballs life throws at us. While I was always a fan of ADLs, that experience convinced me to expand what was already a strong array of such products in our store, and to focus even more seriously with our staff on being sure we always considered these small, everyday tools as we listen to our customers.

SOCK YOUR CUSTOMERS

For newcomers to illness or injury, the discovery of a sock aid is like finding gold. I see it all the time as we show folks the fairly simple way that the basic sock aid gets someone back in the swing of putting on socks again. And I enjoy finding the many incarnations of sock aids that exist.

The one with the three fabric "fingers," for example, is easy to bend and manipulate. The handles are long enough for most users to grab onto and pull up the leg. I am always interested, though, to find just how many people cannot use this type. They prefer the hard plastic molded half-circle. There is more room for the foot once the sock is on. And the handles, often coated with foam, do provide a great grip for the user.

Kathryn Arbour

Donning socks gets much trickier, though, once we are in the realm of compression stockings and socks. Some of the donners are scary looking at first, and not all that intuitive to use. With a metal or plastic frame, these tools are tall, designed for the stocking to fit snugly around the opening for the foot. The key is to get the sock on there properly for the donner to work well.

I've seen customers work up a sweat as we teach them to use it. Helping them not get discouraged by demonstrating these tools with ease is essential. Folks see that with practice they will be successful, and they are often more willing to give something new a try.

I am most impressed, however, by a donner that resembles a type of open-ended legging shape. This donner is made of a durable synthetic material, and the sock slips onto it easily. It comes with a nonslip pad for the floor so the individual can slip the foot in and work the sock onto the foot with an alternating toe/heel action. It takes some practice and some work, but the stocking goes on surely nearly every time.

The problem seems to be that the handles are not long enough for most. So, the sock gets so far and then the individual must either bend over too far, or lift the leg to grab the handles. We have suggested lengthening those handles to make this tool even more effective.

So, while in my opinion, the perfect sock aid has not yet been created, the success stories persist. "My husband always helped me with my socks every morning, but now he's gone," said one 80-year-old customer with severe arthritis, who resisted the first couple of times she came in. Each time we showed her sock aids, and each time she warmed up. Finally, she tried them, spending a couple of hours in the store. She called us a few weeks later just to say thanks. "I have the hang of it now," she said. We did a high five! It's the little things, for sure.

REACHING FOR SUCCESS

The latest chapter in my notebook has been on the topic of reachers. Now these tools are well known and fairly ubiquitous. Many of the big-box stores even carry these handy tools. But whenever you study something, you sometimes find aspects previously unappreciated or unrecognized.

To find more articles on cash/retail sales, visit the free archives section. You'll find a knowledge database including articles such as: December 2007 Why Retail, Why Now? By Ty Bello Merchandising, product selection, and anchor properties are just three of the many variables that can help HME providers maximize cash sales in the Baby Boom era. November 2007 Life After Winning, By Wes Hopper If you believe in your role as patient educator, there's no need to be squeamish about "pushing" retail cash sales.

One of the best aspects of the modern reacher is that it now comes in different lengths—dramatically different lengths. We have a pediatric one that barely measures a foot long! We experiment quite a bit with different types of reachers, checking out what our customers are attracted to, which ones they turn up their noses at. Of great appeal are the models with pivot heads and grippers that lock. These features make so much sense. Instead of having to twist the arm and grab onto a thing for dear life, the ability to pivot the grabber arms and lock them gives so much more latitude for use.

There is a very long reacher, about 48 inches, and this one sells more slowly than the other sizes. It is a bit awkward to use, especially for those who are shorter. On the other hand, there was a 6-foot 7-inch guy about to have a hip replacement who cooed with glee when he found this thing. He was getting himself ready for the days of recovery after the surgery. A reacher is a staple for those undergoing hip replacement surgery. He had already picked up one of the standard ones, but while practicing, he realized its limitations. Despite his long reach, the standard device simply did not have the reach upward that he needed to get some of his favorite stuff. This one, along with its pivoting and locking head, gave him the perfect gadget. Inspired, he roamed around the store and found nearly a dozen more "cool" things to take home. "If I have to have this hip replaced," he laughed, "I can at least have some new toys to play with."

The best part for us is that as he progressed from his surgery, he came in a number of times, looking for the little things that would get him through the next stage of recovery. He told us how skeptical he was initially when someone told him to check out these "aids for daily living." He found the reacher and some of the other tools to make him more comfortable. "I'm a believer now!" he said. He laughed his big laugh and said he'd be back soon.

Kathryn Arbour co-owns Capabilities in Westminster (a suburb of Denver), Colo, with Pam Pressel. Opened in 2005, Capabilities offers products for health, comfort, and independence. Arbour can be reached via her Web site: www.capabilities.com.