We did the impromptu occupational therapy assessment thing last night, with the aid of the Streetmachine, some pillows, turbo trainer, and a partially-unfolded BSO.
Rumours of barakta's compatibility with bar-end shifters appear to have been exaggerated. They're just a bit too stiff, even for her right hand - she can get them to work, but not in a way that's particularly compatible with emergency downshifts or long-term avoidance of wrist pain. Obviously extending the arm to get a bit more mechanical advantage would be an option.
Twist-grip appears to be the better option for the primary shifter, then. Preferably a nice long grippy one, or one where there's a thick end, preferably at the thumb-end of the bar (which I think means mounting it upside-down - likely to be ugly cable wise, but not impossible). Certain triangular grip-shift controlled gearing becomes an increasingly attractive option to everyone but my wallet, which is weeping in the corner.
Trigger shifters are still firmly in the "haha no" category: she can work them fine, but only in one direction. Adding leverage to the thumb side of a trigger shifter seems silly, as it completely wrecks the ergonomics. Stick to bar-ends for that.
I assume electronic shifting is the sort of unobtanium that makes expensive German hub gears seem sensible? Unless I want to get fettly with some beefy R/C servos and a microcontroller, I suppose. Anyone ever tried that? Did it work?
Things look better in the brake lever department. No problems with my bog standard 4-finger Tektro levers, given a bit of twiddling of the reach adjustment screw. She can even sort-of work them with her left hand, though the issue there is that her fingers are permanently bent, so there's a fiddly shoulder-based unhook-from-bar-and-hook-round-the-lever motion that isn't compatible with braking in a hurry. Might be viable for a rear brake used drag-brake style, though.
In other news, I got a garish email from Kevin including directions, which I diligently followed on Google streetview with a view to creating a waypoint on my trusty Garmin. Of course, what I'd overlooked is that OpenStreetMap is frequently contributed to by the sort of people who have beards and a penchant for unconventional means of transportation...