Discharge Planning Flashcards
When does discharge planning start?
Immediately, as soon as you preform the initial chart eval before even seeing the patient
What is the best way to give a patient an HEP, how can you be sure they understand it?
Have them record a video of your instructions and demonstrations
periodically ask the patient to preform their HEP for you so you can check their understanding
What is the easiest way to gain a couple inches in a doorway so a wheelchair can fit through?
Remove the innermost molding or remove the door itself and replace with curtain
What is the rule for constructing wheelchair ramps?
1 foot of length for each inch of height
What can you give a patient if they’re too weak to stop their wheelchair from rolling backwards on the ramp
“grade-aids” that stop wheelchairs from rolling backwards
How will someone who pushes their wheelchair with their feet need to go up a wheelchair ramp?
backwards
All wheelchair prescriptions require what?
A face to face visit with an MD/DO
diagnoses
reason they need the WC related to mobility during ADLs
How long does a person need to sit in a wheelchair at home everyday in order to qualify?
4 hours WITHIN home
Wheelchair decision making
Can they push a standard WC ->
Can they push a lightweight wheelchair ->
Can they propel a power operated vehicle (Scooter) ->
Can they use a motorized WC
If a patient can walk to their bathroom no problem but has trouble walking to their kitchen do they still qualify for a wheelchair?
Yes because it can be said getting to the kitchen is necessary for ADL, even if they can walk short distances fine
Scooter wheelbase tends to be ____________ compared to a wheelchair and therefore less stable _________
narrower but longer wheel base
less stable side to side
Patients need more _____________ control for a scooter
Trunk and upperbody control
How can you tell a scooter from a wheelchair
Scooter- seat is held on by one big pole, you cannot drive a car from a scooter, only a motorized wheelchair
T or F: Scooters can have armrests and seatbelts
T
What is a power assist device?
can be added onto many manual wheelchair to assist user
advantage: More portable, can be taken off chair so chair can be folded and put in vehicle
Are recliner seats with lifts covered by insurance?
no
Pt has trouble transferring in and out of bed due to high surface, what can you recommend them
automatic hi-lo
Tilt in space vs Reclining wheelchair
Tilt in space: Hip angle stays the same,
will not fold
Reclining- Can fold, but still heavy to load into car, harder for patients to re-adjust skin when adjusting back of the chair which can cause skin and tone issues
What is the advantage of cambered wheelchair wheels?
Easier to turn quickly for sports
Why would a patient need a wheelchair with an adjustable base?
Make the base longer = more stable
make the base shorter = easier for wheelies to hop curb
Advantage of low mount brakes on a wheelchair
They wont hit it with their hands when propelling wheelchair
better for higher functioning patients who can reach them
Pneumatic vs solid tires on wheelchair
Pneumatic- more shock absorption
solid tires- less maintainence
Seat width of wheelchair should be less than _____________ wider than a persons hips and thighs at __________
Less than 1.25 inches wider
at the widest point
Seat depth for a wheelchair should be _________________ than the posterior buttocks to the popliteal fossa
1-2 inches less
What is the standard height of a wheelchair?
Standard hemi height?
19-19.5
17-17.5
How should the backrest of a wheelchair align with a patient’s scapulae
should be below scapula or above inferior angle, but not at it
how much will medicare pay for DME under part B?
80%
that leaves a 20% co-pay for patients
secondary insurance will only pay the co-pay for covered medicare expenses
What would you need to document in order to qualify a patient for a lightweight wheelchair
arm weakness, breathing/cardiac problems and inability to push a standard weight wheelchair
What qualifies a patient for a motorized device
A need for the motorized device in order to preform mobility related ADLs in routine or normal parts of home
Will medicare pay for any bathroom equipment?
no, no benches, no grab bars, no elevated toilet seats
except for a 3-1 that can function as a bedside commode, shower chair, and elevated toilet seat
Will medicare pay for a fully electric bed for any diagnosis?
What will they pay for?
no
they will however pay for semi-electric (head and foot of bed can be adjusted electrically and the overall height is adjusted with a manual crank)
When should you order a hospital bed for a patient?
if the pt requires a lot of help to transfer and needs to transfer from higher surfaces
or caregiver needs a higher surface to help pt with hyigene
note: some couples will not want to order a hospital bed and its our job to just inform them of the benefits
how are home evals most commonly done?
give the patient/family a worksheet to complete and draw a simple floorplan.
A ramp requires atleast a _____________ landing space at the top and bottom, or to separate two levels to the ramp
4 square foot
For safety there should be a ________ on each side of the ramp
2-3 inch curb
T or F: If a patients care giver cannot lift a regular manual wheelchair into the vehicle they qualify for insurance to way for a lightweight one
F
Most insurance companies require no more than _______ between the time of eval by a physician and the date the patient is getting a chair
no more than 30 days
