Materials

Choosing what materials to put in your home is a factor in infection control. Broadly, this breaks down into three main categories of surface:

  • Bactericidal
  • Inhospitable (hard, non porous)
  • Sanitisable

Inhospitable

Broadly speaking, hard, smooth 1 surfaces are less hospitable than porous or ridged surfaces. (And easier to clean.) So tiles are better than carpet, obviously. But also big tiles are better than small tiles because they have fewer crevices. Dolphin boards are better than any tiles. If you do choose tiles, get smooth glazed ones over crackled or unglazed ones. Choose bactericidal grout. (Be aware that enzyme cleaners and fatty acids (like from cooking oil) can combine to break down epoxy grout…) Choose window film over net curtains. Choose…. well, look, I don’t need to specify exactly what things to get; just grasp the principle and use it to make your own choices.

There are always other complicating factors to balance. It’s depressing to live in a place with no warmth or texture, and that matters: pain is weird. If you are driving a heavy power chair indoors, you will crack laminate so you gotta go for tiles. If you are self propelling and self-transferring then you probably don’t want carpet (unless you are working out!) but you might want a cushioned lino in case of transfer tumbles. So figure out what you need and what you can live with. But equally: don’t assume that the functions of institutional decor are inalienable from the aesthetic.

You don’t have to lay pus-green lino in your house or sit on vinyl horrors and gaze at fake teak veneer to get the infection control benefits of those materials. Read the NHS Health Building Notes and figure out what is the METHOD and what is the GOAL (I know I never shut up about this haha sorry).

Resisting the creeping, dead embrace of the institution is crucially important. I mean this quite seriously. It’s not about denying disability - it’s about resisting all the “shoulds and oughts” that get tacked onto it. It’s about having a different idea about how your life can go. About untangling things. When you are institutionalised (at home or in a unit) you are re-formed by other people’s priorities, expectations and assumptions; you import a lot of unhelpful, disabling shit into your brain and your life that’s really completely unnecessary and nothing to do with you. Don’t let the institution stage a tragedy in your living room. It’s the only play it knows. You know at least one more.

Anyway, back to infection control. :P

1. There is an interesting new surface called sharklet, which has a micropattern based on sharkskin that repels bacteria, but I am talking about the things you can buy at Topps Tiles and Carpet Remnant World, you know? And interestingly, highly textured or fibrous surfaces like paper can actually somewhat trap the bacteria within itself and therefore transfer fewer bacteria to your hand when you grasp it. So like with everything, it’s not so simple and I’m no expert, but we do what we can.

Bactericidal

The antimicrobial properties of copper are well established, so get handles and taps etc made with copper. Copper is obviously crazy expensive but brass is cheap and still kills bacteria, just a bit slower. It’s super expensive to buy things made out of unlacquered brass because it’s fashionable at the time of writing (June 2017), but you can just buy sad, unfashionable, lacquered brass and take the lacquer off with nail varnish remover. I bought this in industrial quantities from Amazon in the hairdresser suppplies dept. It’s no more than ten pounds; look for acetone. Check out this make for a step by step.

The downside of unlacquered brass is that it tarnishes and looks dirty. It isn’t dirty! You can spruce it up with half a lemon, if you feel so moved. I cannot be buggered, personally.

Antibacterial materials

I’m not, you know, advocating this strongly because it’s not clear to me that the literature supports this strongly, but we used antibacterial paint and antibacterial plug sockets and so on. They are not massively more expensive and you might be able to get funding for them. We did because the NHS uses these materials in clinical settings and Stuart has some specific vulnerabilities to infection**. But equally they use antibacterial hand soap (as do we - it’s hard to find anything else) and their own studies say those are no better than ordinary soap an water in normal usage. I figure there’s no harm.

Note: On the possible harms of antibacterial materials.

I am quite interested in this idea of bacterial population. I don’t pretend to understand it, I’m just flagging it up to you as something to consider and read about yourself. This is basically the idea that bacteria occupies an environment and if you kill off harmless bacteria (most is neutral or beneficial and some critical) then you create an opportunity for harmful bacteria to multiply (as it is no longer competing with all the other stuff). This is a related idea to re’s a lot of talk about this in gut health, obviously, and it’s hard for a non-scientist to sort through the woo on this topic to figure out what might be useful. One thing I do know about a bit is the importance of bacteria in skin health and also wound healing and I wonder if there’s a connection.

I can’t link you much because all the sites are locked (and god forbid disabled people and carers have access to anything they need like medical education or scientific evidence, right? No, we have to cobble together primary care from 99 page Google Books previews, wikipedia, and random blogs of microbiologists) but if you can get hold of the article “Wound cleansing: ritualistic or research-based practice?” and follow the cites out you will find some interesting discussions in nursing about ritualistic cleaning vs actual evidence based and effective practice. You can get a free peek at some of that on the nursing times archive.

So I sort of expect for thinking on this to move soon. In a few years I might be writing on here to put a an open trough of soil in your bedroom or something, but all I can tell is the best practices I know of right now? And those are all about reducing, removing, and eliminating bacteria.

Sanitisable, AKA: Can I Boil It?

Basically this is just considering how you will clean things. Everything should be dishwasher safe, or boil-washable, or steam-cleanable. That’s still a lot of stuff, you know? You won’t run out of stuff to buy even keeping to these rules.

This ties back into the dolphin boards and tiled floors I talked about at the beginning. Other easy rules: buy all white bedding and towels in 100% cotton. I buy high thread count plain white cotton percale bedding from soakandsleep in the sale. Colours and patterns fade on boiling and can’t be bleached clean so don’t buy them. Polyester goes grey on boil washes so avoid it. Cashmere and wool is out. Forget about it. I have a velvet armchair and this is obviously ridiculous, and eh… sometimes I am ridiculous.