Emmanuella and I had a wonderful time at the Edmonton Seating Clinic today. We got to observe an elderly, nonverbal client be transitioned from her old and ill-fitting wheelchair to a new more supportive and compact wheelchair. This was a very informative experience because it revealed how much art there is to seating an individual.
The way an assessment occurs depends on the client and the starting wheelchair. However, it follows a general process:
There is a whole team of people in the room including: the client, two occupational therapists, the vendor/wheelchair tech, the prescribing therapist, and the caregiver.
It is a very small meeting room with all those people in there as well as a desk, adjustable plinth, and the wheelchairs
One of the occupational therapists guides the assessment and takes notes, while the other occupational therapist takes measurements.
There is a lot of emphasis on observation, conversation, and feel involved in collecting these measurements. While this is going on there is constant back-and-forth to determine the client goals, what is working with the current wheelchair, what is not working, and what is possible to change.
After a path forward is decided, the tech goes and looks at what what supplies they have and the client is moved from the chair to the plinth. The examination continues on the plinth with the patient seated and laying supine to confirm certain measurements.
The new wheelchair is then assembled with the back rest, cushion, straps, and foot rests. Finally, the patient is moved to the new chair and all final adjustments are made.
Insights:
The most interesting part was the amount of compromise that went into the seating.
There is not a defined set of outcomes for the client; the results of the session depend on many variables.
The seating clinic typically only sees the patient once. Follow-up is done by the prescribing therapist.
It also brought attention to the diversity of wheelchair patients that we are likely to see in rural and remote settings. There is not really a one-sized-fits-all assessment and seating session.
Even if we develop certain technologies, they may not be applicable for every case.
It is not easy to make modifications to the wheelchair (i.e. use the wrench). How could those changes be made and if we only have one person?
Soon, we will be able to complete the first in-house trial for the wheelchair module! Then we will be able to see how our technology changes or enhances the seating.
-Courtenay
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