Making Masks More Inclusive: Modifications Meet Patients’ Specific Needs and Protect from Illness

Wearing a mask has become part of everyday life. While they are critical for keeping ourselves and others safe, traditional masks that are widely available often do not meet everyone’s needs.

Therapists and administrators noticed that this was a challenge affecting patients at Shepherd Center. Adina Bradshaw, MS, CCC-SLP, ATP, a speech-language pathologist in the Assistive Technology Center (ATC) at Shepherd Center and Erin Radcliffe, BS, BME, a rehabilitation engineer and research coordinator in the ATC and Virginia C. Crawford Research Institute at Shepherd, took on the challenge to create a solution.

“We noticed that certain patient populations were losing their independence because of having to wear masks,” Bradshaw says. “I wanted to understand if there were other options for them to keep their independence while also staying safe.”

For example, people with high-level spinal cord injuries who do not have use of their hands use sip-and-puff technology by breathing into a tube that controls the chair’s movement to move their power wheelchairs. Patients move their chairs in any direction by following a code of breathing in (sipping) or blowing out (puffing). The sequence and intensity of the breathing directs the chair. Unfortunately, these individuals cannot wear a conventional mask and operate their wheelchairs at the same time, limiting their ability to move freely.

There are also patients at Shepherd Center who are nonverbal for various reasons and rely on reading lips or others reading their lips to communicate. Conventional masks cover the mouth and make it much more difficult for them to interact.

Bradshaw began researching commercially available masks that could meet their needs.

“There were very limited options,” Bradshaw says. “The options I did find were either sold out or included instructions that were difficult to follow.”

The senior management team at Shepherd Center gave Bradshaw and Radcliffe the green light to find a solution. Together, they turned ideas into a tangible product for patients to use.

With a little ingenuity, creativity and hard work, the idea went from proof of concept to execution in approximately three weeks. Today, Shepherd Center is releasing three quick and simple guides so mask users can modify their masks in 30 minutes or less:

1. Sip-and-Puff Straw Modified KN95 Mask Guide

This mask takes approximately five minutes to create using a pre-purchased KN95 mask. It explains how to create a hole in the mask to safely place a straw nozzle through, allowing users to access the sip-and-puff straw while wearing a KN95 or surgical mask. The guide outlines exactly what materials the user and/or maker needs, and all required materials can be purchased on amazon.com. Links to the specific products are included.

2. Sip-and-Puff Straw Modified Fabric Mask Guide

This mask takes approximately five minutes to create using a pre-made fabric mask. It explains how to create a hole in the mask to safely place a straw nozzle through, allowing users to access the sip-and-puff straw while wearing a fabric mask. The guide lists exactly what materials the user and/or maker needs, and all materials can be purchased on amazon.com. Links to the specific products are included. A link to instructions for making a fabric mask is also included.

3. Lip Visibility Adapted Mask Guide

This mask takes approximately 30 minutes to make and was adapted from a template by Sewing Seeds of Love. It explains how to insert a clear vinyl window into the mask, allowing for users’ lips to be visible while wearing it. This mask is washable and includes a feature to customize the ear loop for comfort and fit. The guide includes an adapted to-scale template for makers to print and use while creating the mask. Links to where to purchase the components on amazon.com are provided.

“It’s so important, during these unusual times of the coronavirus pandemic, for everyone to be able to use a mask to protect themselves and others,” says Michael Yochelson, M.D., MBA, chief medical officer at Shepherd Center. “The mask modifications our ATC team came up with could literally be lifesavers for someone if it keeps them from getting COVID-19. Whether you work for a healthcare system or just need these modifications for your day-to-day life, we encourage anyone to use and share these guides.”

The masks are being distributed to patients at Shepherd Center who need them this month. The Assistive Technology Center hopes that individuals beyond the walls of Shepherd can also benefit from these guides.

“We pursued this because we saw an immediate need,” Bradshaw says. “My goal is for anyone reading this to use these resources to help themselves, their family or their friends improve their quality of life.”

Written by Damjana Alverson