Making the Functional Beautiful: Cutlery for Arthritis Hands

Patient Expert

Adapting to living with rheumatoid arthritis involves many challenges. One of these challenges is starting to use adaptive products. For many, it can be very difficult. This often has a lot to do with the way adaptive products look: institutional, medical, clunky. Ugly. But what if adaptive products were beautiful, as well as functional?

This was the challenge Isabel Heubl, now 26 years old, chose for her third year final product. Originally from Germany, she was studying 3D Design at Falmouth University in England. Remembering the decision process that went into her creating the Integral cutlery, she said “everyone else said ‘I want to do the next new, amazing chair,’ and the next this and the next new that. No one thought about products that are seemingly not ‘sexy’ enough, but are needed.” Isabel decided to go to hospitals and nursing homes in her quest to find a product that was truly needed.

The problems with adaptive cutlery

After speaking to people who were aging, or lived with arthritis, Parkinson’s disease, and other conditions and disabilities, she discovered that cutlery for people with grip difficulties was neither functional, nor aesthetically pleasing. Adaptations in cutlery consisted of a piece of foam or plastic stuck on the fork, knife and spoon, which had a number of problems. Both materials didn’t feel nice to hold and broke apart easily, and the foam quickly became a repository for bacteria.

In addition, there was a very emotional aspect to using these types of adaptive cutlery. “The people got very upset having to use something with a piece of foam. It made them say ‘I don’t want to be eating with that, I’d rather be fed,’” Isabel told me. “Eating is a very personal thing. If you spend your whole life with silver or cutlery, you don’t want to be eating with a piece of foam when you get older. All of them had tears in their eyes, some threw it. They got so very emotional.”

Designing the cutlery

“My way of designing is very user-centered. Look at the end user and their actual need and design with them rather than for them,” Isabel explained. She was supported in her work by the NHS innovation team, which granted her access to different facilities and workshops to develop prototypes. Isabel’s design process included visiting a number of hospitals and nursing homes to “find out what people needed and what they wanted from an aesthetic point of view.”

She describes an extremely collaborative experience, saying “they were very kind, telling me about their difficulties and what they liked and didn’t like.” It was important for her not to be biased about what people needed, so she would bring clay for them to form the shapes that would be helpful. She returned again and again with prototypes, fine-tuning the design. In total, 48 prototypes were tested before she had the final design.


A number of factors were included in the design. Each piece of the stainless steel cutlery has a ball at the end which fits into the hand of the user in a number of different ways. The ball is hollow, but the piece does have some weight. Isabel explained that this prevents it from falling out of the user’s hand. As well, the fork is somewhat flat, allowing the user to scrape food onto the fork. Isabel mentioned that this was used more often in eating than a stabbing motion.

From design to market

After finishing her degree, Isabel returned to Germany. There, she went to an industry fair where she talked to two manufacturers about her cutlery. One of them, Amefa, was interested in producing the cutlery. “We went to elderly [sic] homes to test the cutlery,” Isabel said and the cutlery passed with flying colours. It was released with the name Integral in five European countries, including Germany and Austria, in late 2014. An American distributor has indicated interest in making it available on the North American market. We will bring you more information about this as it becomes available. Update January, 2016: You can now purchase Integrale on eBay.

I asked Isabel how it felt to see her design on the market. “It felt great, but it felt even better when I saw people using it!” she replied. The Integral cutlery is used in nursing homes and many of her friends have bought it for their grandparents.

Since returning to Germany, Isabel has been very busy. She has designed a lamp, works freelance for a number of companies, and works for a medical consultancy firm assessing the function of products used in hospitals.

My opinion

I have lived with RA for well over 40 years and over that time, I have seen little to no change in the adaptation of cutlery. When I was a child, the solution for a more comfortable fork was — you guessed it — to stick a piece of foam on the handle. Certain forms of plastic handles have become somewhat less ugly, but are still very obviously an adapted tool and hardly aesthetic. When I first saw a photo of Isabel’s cutlery, I was stunned at the beauty and elegance of it. It is top-level design, something that anyone would buy. The blend of form and function is exactly what great design is about. Knowing that there are people out there who are committed to creating beautiful adaptive products makes me very happy. Isabel has a great future in front of her and I look forward to seeing her next products.

See More Helpful Articles:

10 Things That Make Life with Rheumatoid Arthritis Easier

Health Resources to Cope with RA

10 Easy RA Cleaning Tips

How Can You Get Back into the Hobbies You Love?

Lene writes the award-winning blog The Seated View. She’s the author ofYour Life with Rheumatoid Arthritis: Tools for Managing Treatment, Side Effects and Pain and 7 Facets: A Meditation on Pain.