When a Standard Wheelchair is Not Enough
According to Merriam-Webster's online thesaurus, synonyms for the word "standard" include: average, run-of-the-mill, and standard-issue. When it comes to selecting a wheelchair for a client or loved-one, I would not consider any of those words as accurate descriptors for what I envision as the best piece of equipment to meet an end user's individual needs. However, depending on the situation a less complex and customizable seating system and wheelchair may be the most appropriate option.
By industry guidelines in the United States, a standard wheelchair is described as a wheelchair that is available in limited sizes (seat width and depth between 16 and 20 inches), non-adjustable sling upholstery, and typically weighs over 35 pounds. Due to the very limited adjustability and customizations offered on most standard wheelchairs, a standard wheelchair should only be utilized by individuals without postural deformities who will be seated in the wheelchair for short periods of time. While the larger drive wheels are designed to allow a user to self-propel a standard wheelchair, factors such as the limited sizes and weight mean that efficient self-propulsion is not likely to occur and the user will rely on assistance from a caregiver to push him/her in the wheelchair.
The summer before my senior year of college I completed an internship at a skilled nursing and long-term care facility in my hometown. Many of the residents utilized standard wheelchairs to move throughout the facility and/or during community outings. Each time I worked with a resident I did my best to position to him/her the best way possible so he could engage in the activities and be as comfortable as possible. Residents, family members, and staff came up with very creative uses for quilts, decorative pillows, bed pillows, etc. in an effort to position end users in the best and most comfortable positions. I cannot tell you how many times family members would ask what they could buy to help their loved one be more comfortable when he left his room, because the standard wheelchair was simply not cutting it.
So what happens when a standard wheelchair is just not enough, but a custom wheelchair is too much?
Let's take a look at three areas to ponder:
As mentioned above, when it comes to standard wheelchairs, sling upholstery is the most common option and adjustability is hard to come by. In order to ensure that the user will be comfortable and positioned appropriately, it is important to look into what seating options are included with the wheelchair.
For example, the wheelchairs in the Breezy Elegance line all come with cushions. In addition, the higher level models include height adjustable armrests and a tension adjustable back.
2. Features for Caregivers
Getting out into the community and being active is key for not only the end user's overall quality of life, but also for the caregivers. Be sure to look into how the wheelchair breaks down, folds, and the weight of the wheelchair.
Adjustable height push handles allows a caregiver the ability to position the handles at the height that is best for him. Appropriate push handle height is vital for ensuring that caregivers are taking care of their bodies too.
Pushing a wheelchair on various surfaces and over different terrains including up and down inclines can be difficult. A feature such as a locking brake lever provides the caregiver with more control of the speed of the wheelchair thus improving maneuverability and safety.
Third-party funding sources such as Medicare have a number of guidelines that must be followed in order for any type of durable medical equipment to be covered. One such guideline for Medicare is that the only equipment that will be funded are items that are intended to be utilized in the home. Unfortunately, equipment only intended to be used in an individual's home may not be what is needed for the end user to lead an active full life. In addition, securing funding for equipment designed for comfort with the caregiver in mind too may pose additional problems.
When funding problems arise some individuals and their families consider purchasing a piece of equipment out-of-pocket. The Breezy Elegance line of wheelchairs was specifically created to provide high quality, comfortable, and affordable wheelchairs to consumers requiring adjustability, accessories, and customizability beyond a standard wheelchair.
Please note when selecting any piece of seating and mobility equipment we strongly encourage a complete assessment including a mat evaluation of the client be conducted by an experienced clinician and complex rehabilitation technology supplier.
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Always remember at the end of the day, your client is your number one priority!
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Disclaimer: The contents of this blog are intended to be utilized as a general resource for clinicians and suppliers to then use clinical reasoning skills to determine optimal seating and mobility solutions for individual clients. Steve and Angie are unable to answer questions from members of the general public including caregivers and end users. Members of the general public should direct specific questions to their own clinicians, medical, suppliers, or other health care professionals.
Posted by: Date: 5/27/2015 12:00:00 AM
Filed under: Angie