Assistive Technology Assessment for Caring for Helpless Patients, Application for Funding Powered Wheelchair - Case Study Example

Surname: Presented to Institution Name, Location Date FUNDING АРРLIСАTIОN Ghadah ALAITHAN Date: 18/04/2014 Occupational Therapist Student Melbourne Community Health Centre 240 Malvern Road, Prahran, VIC 3181 SWEP Case Manager PO Box 1993, Bakery Hill, VIC 3354 Email: Swep@bhs.org.au To whom it may concern, Re Phyllis Jones: Application for funding powered wheelchair I am an Occupational Therapist working at Melbourne Community Health Centre [MCHC]. I am enquiring on behalf of one of my clients Ms Phyllis Jonesfor funding for a powered wheelchair. Six years ago, Phyllis was diagnosed with relapsing and remitting Multiple Sclerosis. Currently, Phyllis is developing a number of complications which include weakness in her upper and lower limbs, fatigue, balance deficit and proprioception problems within her lower limbs. She also has had several falls due to unsteadiness and fatigue. Therefore, seating assessment has been undertaken to determine the appropriate powered wheelchair for Phyllis. I have found the most compatible for her condition would be to purchase the Quantum 6000Z powered wheelchair with total cost of $15,949, supplied from Geelong Wheelchair Service. This powered wheelchair will benefit Phyllis to limit the impact of fatigue and increase independency when moving around the house and outside in the community.The required documentation of SWEP and the wheelchair prescription have been attached. I am grateful for your consideration on this application, in case you need any information or have any concerns, please let me know. Best regards Yours sincerely Ghadah ALAITHAN Occupational Therapist Student Contact details Phone: 03 9525 1300 Email: galaith@deakin.edu.au Occupational Therapist Report: Funding Application + Client: Ms Phyllis Jones Address: 72 Fitzroy Street, St Kilda VIC 3182 DOB: 7/3/1974 Gender: Female Presenting condition: Multiple Sclerosis Height: 169cm Weight: 61kg Client Background Information Phyllis Jones is a 39 year old woman who has been diagnosed with relapsing and remitting Multiple Sclerosis six years ago. As her health condition has deteriorated, she has been referred to an occupational therapist (OT) at Melbourne Community Health Centre [MCHC] by her neurologist to prescribe a wheelchair that suits Phyllis's needs. Phyllis lives alone in a small apartment on the first floor in St Kilda. Phyllis has no family support as she only has one brother who lives in Perth and her parents are old. Her mother had a mild stroke and her father has early signs of dementia. Phyllis is employed as a salesperson at one of the networking companies in her vicinity. However, she has been unable to return to her job for several weeks following her condition progression. Phyllis has difficulty with many activities she used to enjoy such as playing music and dancing. Phyllis is presently experiencing difficulty with driving because of her mobility issues and fatigue therefore she is not able to get out for shopping and visit her families and friends. Currently, Phyllis is experienced a serious exacerbation including weakness in upper and lower limbs, reduced fine motor movement, cognitive difficulties especially in the area of memory, planning and concentration as well as proprioception issues in her lower limbs. Fatigue is a major issue for Phyllis as she is not able to stand or walk for long periods, thus she is at risk of falls. She has council help for two hours per fortnight to assist with home cleaning. Phyllis has also developed some urinary urgency and therefore she has had several urinary accidents. Assistive Technology Description The OT has selected the most suitable powered wheelchair for Phyllis by using the seat/mobility assessment. The main purpose of the assessment and evaluation of the powered wheel chair is to make sure that it OT certainty that the prescribed AT is the most appropriate and will satisfy the needs of the user. Assistive technology assessment helps OT evaluate all features of the AT hence helping them know if it is the most appropriate. Powered wheelchair characteristics required for Jessica Quantum 6000Z Price Supplier details Base features Phyllis will require a small turning circle which allows her to move in small places. She also needs an easy access to a variety of terrains. 4 pole, mild-wheel 6 drive for maximum stability. Active Trac suspension with extra stability incorporates front OMNI Casters 2x15cm OMNI- casters on the front and back to prevent wheels hung-ups Electronic, regenerative disc brakes. Turning radius: 57cm Overall size: length: 91cm, width: 65.7cm 2x50Amp Off-board batteries and charger Maximum speed: up to 9.65km Weight capacity: 136kg $7383.00 Supplier details Geelong Wheelchair Services Address: 106 Bailey Street, Grovedale Vic 3216 Phone: 03 5244 0844 Email: info@geelongwheelchairs.com.au Seating system Phyllis will require postural support as well as tilt in space to reduce risk of pressure sores. She will also require a pressure cushion with continence cover which can be adjusted onto the seat. Phyllis will need an adjustable seat to assist with transfers. TRU-balance power positioning system which allows tilt in space and actuator. Standard solid curved backrest. Cobra headrest Quick height adjustable armrests. Back canes. Power elevating leg rests with angle adjustable footplates. Jay 3 backrest: $2671.00 $409.00 $650.00 $397.00 $228.00 $3,085.00 $850.00 Controls Phyllis will need a joystick control to enable gross motor control because of her reduced fine motor control and cognition issues Mounts for controls to be positioned left or right. $276.00 Total Cost $15,949 Clinical Reasoning for Recommended Wheelchair for Phyllis The Quantum 6000Z is recommended for Phyllis for different reasons. One of them is that Quantum 6000Z has mid wheel drive which allows the user to navigate all places even those that are tilt and take short corners. The Quantum 6000Z has higher speed and a battery which can last for long period of time. This will help Phyllis outside in the community if she wants to travel for long distances. Thirdly, the Quantum has an adjustable angle footplate which makes it easy for Phyllis to transfer on/off the chair especially when she is fatigued. The tilt in space system in the Quantum 6000Z will help Phyllis with pressure relief and increased pressure support. It also allows her to confidently stay in the wheelchair for a longer time as she can change her position. Lastly, the Jay 3 Cushion with continence cover will overcome Phyllis urinary urgency. The Human Activity Assistive Technology Model (HAAT). The occupational therapist has used the HAAT model when prescribing the Quantum 6000z for Phyllis. For the Occupational Therapy, HAAT model provide a lot of assistance by providing an effective framework in evaluation of the assistive technology in helping those who are using them The activity According HAAT model, activity is the process in which a task is carried out due to the performance of an individuals. Performing activities are a critical part of human existence; they are carried out as way of lives of people. Quantum 600Z powered wheel chair is used in helping individuals who are having problems with movement like Phyllis (Pierce, 2008). The powered wheelchair will help Phyllis to by providing her with support since she is suffering from very serious exacerbations that include weakness within the lower and upper limbs. With the powered wheel chair Phyllis will be able to get back to her job, visit her friends and enjoy moving around the community. Other problems such as inability to walk or sand for long will be solved by availability of the powered wheelchair. This allows the user like Phyllis to perform the activities such as arranging of clothes, making her bed, and taking a shower within her apartment with a lot of ease. (Novak & Watson 2005). The human There are three main components that are known to be according to HAAT model and they include the cognitive, physical and affective aspects of the abilities of human beings. Quantum 600Z powered wheelchair is one of the most effective assistive technologies it only requires a little confidence from the user which is taught by OT. Although Phyllis has cognitive issues in areas of memory, planning and concentration these maybe a challenge but the wheelchair is fitted with fine motor controls which helps and all she needs is to be confident and avoid being frustrated. Although learning how to use the powered wheel is a challenge due to her cognitive conditions, OT will make continuous follow ups and teaching to make sure that she is working well with the wheelchair. (Scope, 2005). The context Within the HAAT model the context refers to the environmental factors that are involved in the use of assistive technology and the challenges that reduce the effective usage of the of the assistive technology. Some of the factors that are seen as stumbling blocks for usage of the assistive technology are either physical, cultural, social, or institutional contexts(Pierce, 2008).The social context is surrounded by the acceptance of the AT by the people who are around Phyllis although this can be challenges Phyllis will be taught how to accept the fact that not everyone will accept her condition. The wheel chair will definitely be of great assistance for Phyllis as she will be able to learn how to overcome challenges that comes her way (Scope, 2005). The assistive technology Assistive technology is any equipment, technical system or an instrument that is used by the disabled or the elderly to either compensate prevent or relieve the deficiency they have. AT assessment comprises of several components which include the interaction between the user and the AT. The powered wheel chair has many features that will help Phyllis achieve aspiration but this will depend on how she will interact with the AT. The input that Phyllis will put on the AT will greatly influence the output that AT will bring. This can be seen by the base features that the powered wheelchair has including 6 wheels, 4 poles that guarantees stability this will only be maximised by the confidence that Phyllis will have on the wheelchair. To overcome the challenges brought about by cognitive issues the technology of using a joystick will allow her to be able to control the wheelchair more conveniently. All the features put together will allow Phyllis to manage her conditions with ease she will be able to move from place to place without much strain on the body as it provides more comfort than without it. Other challenges are learning how to control the wheelchair, postural support systems, and the wheelchair is fitted with cushions that will help in shaping the posture of the usher. Phyllis has to learn how to sit in the posture that the wheelchair has. Goal setting After doing seating and mobility analysis OT has chosen Quantum 600Z basing on the goals that Phyllis want to achieve in her day to day life. These goals include; Being able to work and move around the house without any risk of falling, she intends to do this by learning how to use the powered wheel chair within a period of three months of continuous self training in the house. She endeavors to move around and do other things without feeling fatigue, through continuous self training and exercise she has a goal of reduce her feeling of fatigue within a month of acquiring the wheelchair Phyllis has plans to get back to her job within a month after receiving the wheelchair she plans to practice using the wheel chair for long distances every day to enable her get used to using it and get her to her job without any problems Phyllis plans to access the public means of transportation without help from other people. She plans to learn accessing the facilities by practicing on how to use the powered wheelchair on daily basis and within two weeks she will have succeeded. She plans to travel to other places outside her community confidently within one month. Through attending social events that will help her learn how to socialize with people she will be able to achieve her goal with the help of the wheel chair OT intervention The occupational therapy has assessed and evaluated the level of function of Phyllis with her daily work. It was very important for OT to asses Phyllis before prescribing her a wheelchair in order to determine the most appropriate one for her(Pierce, 2008).. From the assessment it was obvious that Phyllis needs a powered wheelchair to enhance her ability to perform daily tasks with more independence and safety. Due to her cognitive issues concerning her memory and concentration makes her vulnerable and needs wheelchair, this is backed up by her weakness and fatigue that has made her unable to either stand or walk for long distance Phyllis was taken through full home assessment which included modification of home’s toilet and bathroom was done by OT. This will enable Phyllis to be able to use the powered wheelchair within the house without any problems. The modification that has put in place within the house will make Phyllis achieve her goals of moving within the house without much of a help. OT has made sure that the modification fit exactly the model size and specification of the wheelchair making it even more convenient for her (Novak & Watson 2005). A trailed period of one full day has been given by Geelong powered wheelchair in order for OT to evaluate if the wheelchair that was recommended to Phyllis actually fits her needs. During this time OT was tasked with teaching Phyllis on how to use the powered wheel chair as well as giving a demonstration on the same. OT will show Phyllis all the features of the wheel chair and teach her how they work one after another this ways she will be able to understand how it works. AT evaluation Creation of the Quantum 600Z powered wheelchair is the most distinct technology that has helped many. Many people with motion problems like Phyllis have benefitted a lot from the technology. According to the consumers, the equipment is totally excellent in performance. Its efficiency is totally indisputable as it gives total confidence to those using them making them enjoy the product as they go about their activities usually. This is proved by the quality of features of the equipment. Phyllis did very with the chosen powered wheel chair during she was able to understand the basic of how to use the powered wheel chair. Although she had challenges due to her cognitive conditions she is doing batter. OT has realised that it will take time for Phyllis to clearly understand how to use the AT, OT will help her with it. They noticed that all the features that the AT has gave a positive advantage towards her improvements. Most of the consumers are totally satisfied with their Quantum 6000z powered wheelchair. It was evident that it gives the power to overcome most of the obstacles that could have limited them from doing what they wanted to do, like movement which is totally satisfied by the AT. Summary This report is an essential document for OT since it helps them in prescribing the AT for the disabled including Phyllis. OT through this report has shown clearly the importance and the need to help the disabled like Phyllis access AT as they can make their lives batter by enabling them achieves their perceived goals. The report also shows how important it is for OT to evaluate the AT before any prescription to make sure the AT will optimally benefit the user. The user also will be more confident in using AT that is more friendly hence OT is tasked that. Bibliography Cooper, R.A. (1998). Wheelchair selection and configuration. New York, NY: Demos Finucane, C. (2006). Equipment. Choosing a suitable powered wheelchair: a guide. International Journal of Therapy & Rehabilitation, 13(2), 87-90. Karp, G. (1998). Choosing a wheelchair: A guide for optimal independence. Cambridge: O’Reilly. McDonald, R. (2010). Wheelchairs: Posture and mobility. In McCurtain, M.Molineux, & J. Supyk-Mellson, Occupational therapy and physical dysfunction: Enabling occupation (6th Ed.) (pp.469-488). Edinburgh: Churchill Livingstone Elsevier Novak, I., & Watson, E. (2005). Seating and positioning: A practical guide to assessment and prescription. Allambie Heights, NSW: Cerebral Palsy Institute. Pierce, S. (2008). Restoring mobility. In M.V. Radomski& C.A. TromblyLatham,C.A, Occupational therapy for physical dysfunction (6th ed) (pp.817- 853) Philadelphia: Lippincott, Williams & Wilkins. Scope (Vic) Ltd. The wheelchair prescription kit: Resource information and assessment tools for use in the prescription of wheelchairs. Glenroy, Vic: Scope (Vic) Ltd. Scope (Vic) Ltd. (2005). Seating and Positioning Prescription Manual. Glenroy, Vic.: Scope (Vic) Ltd. Read More