A patient’s guide for completing activities of daily living with one hand

Tips:

• To wash with a soap flannel/sponge: Place it across the knee and rub soap on it
• Most areas of the body can be reached by one hand. To wash your functional arm fully, place a flannel over the side of the bath or across your knee and rub your arm on it.
• Use a long handled back brush/sponge or loofah for your back, underarm and opposite side. Wrap the sponge head with a towel after bathing to help you reach the same areas to dry
• Sit and place a towel over your knee and rub your arm over it to dry
• Wear a towelling bath robe
• Put a loop on the end of a towel or use a back towel which has loops at either end. Attach the loop to a hook on the wall hold the other loop in your functional hand and rub your back against it.

Tips:

• Use a lightweight hair brush
• Have hair cut regularly and choose an easy care style

One handed hair tying techniques: HOW I PUT MY HAIR UP WITH ONE ARM - YouTube

Tips

• Use an electric razor for your face
• Use a hair removal cream for underneath your arms
• Consider getting waxed by a professional
• There are various permanent or semi-permanent hair reductions available from professional beauty therapists

Tips

• Put a piece of non-slip material on a surface or on your knee, place a nail file on top of it and then push your nails backwards and forwards
• Another way is to hold the nail file by sitting on it (i.e. between your thigh and the edge of a firm seat)

• Have your nails manicured at a local nail salon

Tips:

• Rest the toothbrush on the sink or side, or hold between your lips whilst applying toothpaste.
• Squeeze toothpaste directly in your mouth and then begin to brush your teeth.
• Floss your teeth with a disposable flossing tool which has a handle

To clean false teeth

1. Sit down with a flannel on your lap, place teeth in towel and grip between knees
2. Brush using a tooth brush.
3. Rotate the teeth till done all over.

Tips:

• To use a standard toilet holder: Pull the desired amount, put forefinger and thumb on either side of the paper by the perforation, use your thumb to pierce the perforation line and tear off paper
• Use moist toilet tissue that dispense single sheets
• Position toilet roll holder on the side of the functional arm, if because of the design of the bathroom this is not possible you could use a floor standing toilet roll holder, but make sure it is heavy enough to stand up whilst you are pulling off the paper

Feminine Hygiene

• It may be easier to use sanitary pads rather than tampons. Take the tape off using your teeth, put the pad onto a hard surface and press your pants onto it. Moist toilet wipes in the flat packets are easy to use to freshen up with.

General Tips

• When putting an item of clothing on, always start by dressing the affected arm first
• Clothes with some elasticity may make things easier e.g. Lycra, elastic, knitwear
• Garments with deep roomy armholes, or elastic waist lines, large neck or front/side openings are easier

Putting on a tie

1. Tuck the narrow end of the tie in the top of your trousers or between your knees. This secures the tie at that end.
2. Wrap the tie round in the normal manner to make the knot and pull down into position.
3. When undressing, leave the tie knot made up, loosen slightly and slip over your head. Sewing a material elastic band that is measured to the base of your neck can help keep this in position.
4. If all else fails, ties can be bought with ‘ready-made’ knots or as clip-on ties.

One handed tie technique: How to tie a tie with one hand - Half Windsor - YouTube

• Do hooks up in front, swivel bra round waist and then pull straps up (elastic straps are easier)
• A sports bra which has no fastenings can be pulled over your head
• Adapt bra by having D-ring fastenings with a Velcro loop

How to Button a shirt with one hand video: Easy Hack: Buttoning a Shirt Single-Handedly - YouTube

Tips:

• Sew the cuff button on with elastic thread so that it is possible to push hand  through the fastened cuff
• Use expanding cuff links
• Fasten the button first and put hand through the cuff
• Use Velcro with button sewn back over the button hole
• Use a loop of elastic instead of the buttonhole or put a piece of elastic between two buttonholes

• Wear trainers/shoes with Velcro fastenings
• Slip on shoes are easier
• To tie up a shoe lace the one- handed methods require you to use ring, index, and middle finger and thumb to tighten the bow. If you look on the website ‘YouTube’ and search for ‘Tying up a shoe lace with one hand’ there are videos which demonstrate the technique successfully.   

One Handed shoelace tying videos:

Shoe Tying - One Handed Technique - YouTube

Hannah's One-Handed Shoe Tying - YouTube

Dressing after Stroke | Tying Shoelaces with One Hand - YouTube

Accessible clothing lines:

The Able Label: The Able Label | Adaptive Clothing For Women & Men UK

Hilfiger Adaptive Line: Tommy Adaptive Clothing Collection | Tommy Hilfiger®

Tips:

• Use a surface height comfortable for you to prepare your food. For example, kitchen surface area, dining table or kitchen trolley.
• Consider using pre-prepared foods or readymade foods, if this is more convenient.
• Hot water dispensers with a push-button makes handling boiling water safer.

To wear an apron

• Use an apron with a pocket to hold utensils.
• Fasten or adjust the waist strap with Velcro grip or D-fastening (as seen in fastenings). 
• If the waist fastening is permanently fixed, put over your head first.

Chopping/ Peeling/Grating

• When peeling or chopping, secure items by using the spikes or vice on a food preparation board. Alternately you may find that placing the item on a damp tea towel or piece of non-slip mat, on a hard surface may assist.
• There are many compact choppers (electric and manual) available commercially that can be operated using one hand.
• When grating, use the vice on a food preparation board to hold the grater in place.
• A salad bowl cutter is a quick and efficient way in which you can prepare your salad

Cutting bread

• Use pre-sliced bread
• You can use the vice in a ‘kitchen workstation’ to cut a loaf of bread
• Use a cutting guide and board, sometimes known as a ‘Bread Slicing Guide’ this can also be used for other foods.

Buttering bread

• Place bread against something steady like a chopping board or a ‘Non-slip Mat’ on a work surface and spread butter towards you.
• Use a spreading board/ buttering board. This is ideal for buttering bread or toast with only one hand. This board hooks over the edge of a work surface or table. The bread is held in place within the angle of the raised edges.

• Purchase easy opening/gripping food storage containers
• Use clip-style bag sealers
• Arrange your most-regularly used items within easy reach in your cupboards.

Equipment:

• Many pre-prepared vegetables and rice can be brought from supermarkets, cooked in a bag and can be served immediately.
• Steam vegetables in the microwave with just a small amount of water.
• The ‘Buckingham Coolhand’ can be used to lift hot plates out of the microwave

• Cook food in individual portion dishes (avoid large, heavy dishes)
• Extension rails can be a good investment as they allow the shelf to fully extend from the oven and are available in many sizes. NEFF, Siemens and other kitchen brands offer telescopic/pull out oven rails. This means you can pull out the whole shelf to access food more easily which safer than having to reach into the hot oven.
• If you are concerned about this or would like to practise taking things out of the oven please talk to your occupational therapist. 

• A pan holder will secure a saucepan and stop it rotating when stirring. It also helps to keep the pan from accidentally turning and causing spills. Suction-cup feet secure the pan holder on the stove.

• To mix your food in the saucepan:

1. Place the saucepan towards the front two hobs.
2. Move the saucepan handle so it is directly in front of your torso.
3. Use your torso to steady the saucepan handle and stir towards your body either clock wise or anti clockwise.
4. Once the food is mixed, reposition the saucepan handle to the side to prevent it from being knocked.

• Use a very heavy pan e.g. copper, glass (heat proof) and flat cooking surface e.g. ceramic hob
• Use a wire mesh cooking basket to cook and strain vegetables, pasta or boil in the bag rice, this will eliminate the need to lift and drain a full pan of boiling water.

• Use an electric one handed tin opener or a ‘one touch’ can opener       
• Stabilise tin using knees, ‘Belliclamp’ or clamp on food preparation board and open with tin opener in one hand.
• Use ring pull tins, you may need to stabilise tin using above method. If this is difficult, a ‘Ring Pull Can Opener’ can make opening tins easier.

• Stabilise jar by using the vice on a food preparation board or placing between your knees, feet or against body with upper arm. Use a non-slip mat on a work top to help grip the jar or bottle.
• Use a non-slip jar opener; these are inverted cones of different sizes that will help to grip almost any size bottle/jar. See picture below.
• Use a ‘spill not’ jar opener which has three different size holders to secure your jars or bottles                                                     
• Electric powered wine bottle openers are available online. Important features to look for include a non-slip material and easy to press buttons. A clear base is also helpful.
• To open bottle tops, ‘Gropener’ is a useful gadget to use!
• A wall-mounted bottle opener is another trendy alternative.

• Single handed non-slip tray
• Put a non-slip mat on a tray to stabilise items
• Use a Kitchen trolley, steering with one hand in the front rather than on the handle

Use a dishwasher

To hand wash dishes:

1. Use a hand pump or sensor soap dispenser. This can be fitted to your kitchen sink so that it does not move when you are using it.
2. Use a washing up brush with suction cups
3. Use suction pads to stabilise item and wash one at a time.  

Dampen a sponge, pour washing up liquid over it and squeeze it to create suds. Wipe your cutlery over the sponge to wash then rinse under water

To dry the dishes:

1. Place item on a tea towel on work surface, place a second tea towel on top (or fold first tea towel over the item) and dry with hand
2. Place items on a tea towel between your knees and dry with hand
3. Use plate rack and leave to dry, and then pack items away.

Tips:

Consider adapted cutlery, such as a splayed fork, ‘nelson knife’ or ‘Knork’ cutlery. These utensils can be used for one handed eating by combining cutlery functions, for example the splayed fork is a pronged fork with edges designed for cutting food and a deep rounded body, which functions like a spoon.

• Cut food up first with a rocking knife and then use a fork to eat one handed.
• Use a non-slip mat to hold the plate still while you are eating.
• Use lipped plates or a plate guard to act as a wall to help pick up food.
• Suction egg cups; this enables an individual to eat an egg without the need to hold it steady.

Hanging out the washing

• Lower the wash line, throw item over wash line and then attach pegs. Alternatively, you can use a clothes drier.
• Put clothes straight onto a hanger, shake out and then hang on line/airer.
• You can also place wet clothes halfway over the line – particularly larger, heavier items. This is easier than trying to peg the hems.

Hanging up clothes

• Lay item of clothing on your bed, put hanger into clothing and lift by handle onto rail.

To fold laundry

• Lay out a t-shirt, towel, sheet or other item of laundry on your bed. Fold item over your bed with about half, maybe a little less, draped over the side of the bed, with the other half-lying flat. Reach and bring each corner up into the position you want to fold it in. It may take several steps to fold one item.

Changing duvet cover

• To put a duvet cover on, first lay the cover out on the bed. Put the duvet into one corner (inside) and secure on the outside with a peg or two. Put the duvet into the other corner (inside) and secure with a peg or two. Secure the duvet along the top of the cover with pegs. Shake the cover down and do up. Or climb inside and feed top corners in first.

Changing bed sheets

• Spread the loose sheet out over the bed and then tuck in the corners/sides as you walk around the bed.
• With a fitted sheet, tuck in sheet on one corner of the mattress first and then sit on the sheet whilst stretching it over to the other corner of the bed. Repeat for all corners.

Equipment:

Reaching/picking up items

• A ‘Helping Hand’ or ‘EasiReacher’ can ease reaching

• It is possible to type one handed on a standard keyboard and lots of online sites can show you how to do this.
• Sticky Keys function (press Shift x3) allows you to press multiple keys simultaneously in order to execute a command e.g. ctrl + Alt + Delete.
• There are also many options to buy keyboards designed specifically for those with the use of one hand (designed to decrease stress and strain on your functional hand).
• SwiftKey Keyboard: use SwiftKey Flow to draw from letter to letter to use on all devices compatible with Android/iOS.

Equipment:

• Typing for long periods can be tiring with one hand. Why not use your voice?

‘Dragon Voice Recognition’ is an example of software you can use with your smartphone or with your laptop/computer. 

• There are also a number of ‘hands-free’ devices available to use. When answering calls at home you can opt to use the speakerphone option to conserve your energy.

• There are a number of one-handed controllers available for various consoles  

• If your dominant hand has been affected, the non-dominant hand needs to be trained to compensate and practice is needed to improve speed and legibility. Ask your occupational therapist if you want more advice on this.

• Start with patterns across the page and progress to letters. NB: joined up writing is easier. An example is shown below.

• To steady the page while writing:

1. Use a non-slip mat e.g. Dycem to put paper on
2. Use paperweights
3. Use blue tack
4. Use a vice/desk clamp

Writing aids and grips can help to improve comfort and control when holding a pen/pencil – this can be useful when learning to write with a weaker or non-dominant hand

• When reading, use 1 or 2 pillows on your lap to keep the book near eye-level.
• Use rubber bands around each ½ of the book to keep pages open. As you read, slide the next page under the rubber band.
• An E-Reader, tablet or computerised book can be easier to read as they are lighter and easier to change pages.

One handed knitting/crochet tips and tutorials: One-handed knitting – Elisabeth Ward (elisabethward04.com)

For guidance on one handed gardening tips including: digging, weeding, mowing/lawn maintenance, pruning/trimming, weeding, watering, sowing seeds/planting and garden design you can visit: Gardening when you use one hand, Thrive’s one handed gardening, garden with weak or arthritic hands (carryongardening.org.uk)

For certain health conditions and disabilities or following injury you must inform the DVLA as these may affect your ability to drive. To check if your condition needs to be reported you can refer to the A-Z list here: Check if a health condition affects your driving: Find your condition on the A to Z list - GOV.UK (www.gov.uk)

You may be eligible for the Motability Scheme which enables disabled people and their families to lease a new car, wheelchair accessible vehicle, scooter or powered wheelchair, using their disability benefit. For more information visit: Getting a Motability car - Citizens Advice or How it works | Motability Scheme

If you have had a brachial plexus injury the Traumatic Brachial Plexus Injury group have provided some useful information on driving assessment and adaptations here:

Driving Adaptations Resources – Driving and Adaptions – Traumatic Brachial Plexus Injuries support and information (tbpi-group.org)

Driving Assessment Resources – Driving Assessment – Traumatic Brachial Plexus Injuries support and information (tbpi-group.org)

For more information on:

•       Fitness to Drive

•       Driving Adaptations

•       Theory Test Support

•       Learner Drivers with physical or hidden disabilities

•       Hubs Mobility Advice Service

•       Powered Wheelchair & Mobility Scooter

•       Transfers

•       Equipment Stowage

•       Child Car Seats

Please visit https://www.drivingmobility.org.uk/

Parenting with one hand:

One-Handed Baby Care: Looking After Your Baby With One Arm | Snugglebundl – Snugglebundl

One-handed parenting: A practical guide for new parents - Disability, Pregnancy & Parenthood - Google Books (Your OT can provide you will the full booklet on request).

www.babydan.com  sells foot pedal operated child safety gates

www.ontheotherhand.org a self-help website that is written by an OT with a partial hand including information on raising a child with an upper limb difference

https://www.reach.org.uk - association for children with hand or arm deficiency

Sites that relate to limb deficiency/amputation/prosthetics/nerve injury

https://www.amputee-coalition.org/ - a self-help and information site

www.mtb-amputee.com - Mountain biking with a high level amputation

https://limbless-association.org/  - Leading UK charity for the limb-loss community

https://www.erbspalsygroup.org.uk/  - UK based organisation offering advice, information and support to families affected by Erb’s Palsy

https://tbpi-group.org/ - Website that supplies information and support to adults living with a Traumatic Brachial Plexus Injury

Other:

http://www.toysrbob.com/onearm - practical tips for managing everyday tasks with one hand from someone with lived experience

One Hand Can | Living one-handed in a two-handed world – One handed cooking tips and video demonstrations