Wheelchair seating, mobility, and driving Flashcards
Certificate of medical necessity
A document that establishes why you need certain medical supplies; required for insurance reimbursement
Obtaining an certificate of medical necessity for power wheelchair
If a pt is able to propel self safely in home in standard wheelchair, and/or has caregiver to help propel them, insurance will not see it as a necessity
MAE
Mobility-assisted equipment
Medicare policies regarding MAE
Pt is eligible if they have a personal mobility deficit sufficient to impair their participation in mobility-related ADL’s (MRADLs), such as toileting, feeding, dressing, grooming, and bathing
-client (or caregiver) must be able use MAE consistently and safely at home
Requirements for specific mobility MAE’s (wheelchairs/scooters)
-Manual wheelchair: must have sufficient upper-extremity strength
-Scooter: must have sufficient strength and postural stability
Power wheelchair: must require specific features (joystick, lower seat height, etc.) that are not available on a scooter to complete MRADLs
What order should body be assessed when determining seating requirements?
- Pelvis and lower extremities
- Trunk
- Head and neck
- Upper extremities
Best approach to gather background info for fitness to drive
Contact DMV to verify driving history, do a chart review and gather collateral information
Comprehensive approach to help client be independent with community mobility
Select, test, adopt, and train client and family/support system in the use of the most appropriate transportation options
Older adult driving cessation (ending)
Several studies have indicated a link between driving cessation and social isolation, depression, and early nursing home admission
-Clients facing this will benefit from: community mobility alternatives, psychosocial support and travel training
Mobility management
Services that promote collaboration and cooperation among transportation providers and connect clients to those providers
Travel training
Short-term, direct, and intensive training to teach older adults and people with disabilities to use fixed-route public transportation safely and independently
Systems-level interventions
Addresses community mobility; includes consultation with transportation systems on issues such as design of travel environment for accessibility
-can be role for OTR
Paratransit services
Transportation alternatives operated by transit systems for clients who have functional impairments that limit their access to regular fixed-route services
On-road assessment/evaluation
Can be performed in either fixed or variable route depending on client needs; should progress from basic to complex maneuvers; should be performed in test vehicle
Area that should first be looked at with wheelchair propelling issues
Location of the axle in relation to the client’s center of gravity, seat-back height
-If the axle is behind the client’s center of gravity, the client may not be able to grasp enough of the pushrim during propulsion, making movement less efficient; if the seat back is too high, it can prevent the shoulder extension necessary to contact the pushrim.
