Wheelchair Positioning

During my time on my professional rotation, I was anticipating I would get the chance to participate in more opportunities to assist with wheelchair positioning, but have had just a few opportunities. I definitely got the chance to adjust many a leg rest (lengthening or shortening, per patient’s needs) and even had to use a wrench on a couple different occasions (I know… I’m impressed with me, too). Other than this, I got the chance to observe my mentor as she adjusted wheelchairs for a couple of long term residents whose head rests had been inadvertently moved by caretakers and were no longer providing proper support (in addition to other modifications to various wheelchairs’ arm rests, back supports, etc). This past week, I had the opportunity to sit in on an assessment for a custom wheelchair. One of my sweet patients discharged from therapy this past week, but prior to leaving us, she needed a custom wheelchair paid for by Medicare. A durable medical equipment (DME) vendor came out to the nursing home and discussed options with my patient, her daughter, my mentor and myself and took measurements. If I’m being completely honest here, the assessment was probably not the vendor’s best (maybe he was having an off day), but my mentor took almost all of the measurements and had even taken some ahead of time to have an idea of a seat depth and width that would work best for my patient. The vendor spoke about my patient almost as if she wasn’t there at times and referred to her Attends as diapers. I was not super impressed. The thought that kept recurring in my mind was, “wow, OT has such a BIG role in wheelchair positioning and ensuring that patients are fitted correctly in order to promote individuals to be at their best function.”

OTs role in wheelchair positioning has most certainly been established in places like skilled nursing facilities where many of the patients spend most of their days in wheelchairs. OTs understand how proper positioning can improve an individual’s ability to participate in such daily tasks as self-feeding and grooming, and can even influence individuals’ abilities to socialize and effectively interact with others. OTs have the expertise needed to assess a person’s position in their wheelchair, make modifications as necessary and make recommendations for seating systems that make for the best fit. Occupational therapists can go to Continuing Ed. courses with a focus on wheelchair positioning and can also refer to online resources on the topic. The rehab company I am currently with actually has a manual they provide their therapists with that assists with the wheelchair positioning process. One of the neatest parts about it is that one of my mentors actually helped to develop the manual! As my rotation continues these next six weeks, I hope I have the opportunity to learn more about wheelchair positioning from my mentor, the resident expert, in order to use my skills to help my future patients to have the most appropriate and comfortable seating possible.


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