Philippa is unable to tolerate pressure in the palms of her hands, making it difficult to hold or grip cutlery. Off-the-shelf equipment does not offer a suitable solution. The OT had made a cutlery holder that fits around the back of the hand, using thermoplastic splinting material, and the client’s special melamine-handled fork and spoon were being fixed temporarily to this with Velcro. This was not satisfactory because the fixing was loose, the Velcro was not washable, and the thermoplastic was impossible to wash in warm water because of its low softening temperature. Philippa was therefore continuing to be fed by a Personal Assistant.
The Remap engineer made two new cutlery holders, using the OT’s design but with a different thermoplastic material, derived from standard black gutter down-pipe, which could be softened and formed with a hot-air gun but was stable and rigid at washing-up temperatures. The cutlery holder goes over the back of the client’s hand, hooks under the thumb, and hooks just round the edge of the hand on the opposite side, not touching the palm at all. Two were made, one for the left hand, and one for the right. The melamine handles of the client’s cutlery were filed to fit the shape, and they were glued together permanently. The right-hand one is the spoon, with the bowl facing upwards, and the left-hand one is the fork, with the prongs facing downwards.
These have proved satisfactory in daily use, and can be hand-washed like normal cutlery.
Philippa has regained the convenience and satisfaction of feeding herself, for the first time in some years, which improves her quality of life considerably, and reduces the workload of her personal assistants.