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					     Polio
Jami Croston
 Karen Dilfer
Jenny Hasler
   Kristin Re
                 Gracie
59 y/o female
Contracted polio at 7 y/o
Cannot move but has full
 sensation from the waist down
UE has full ROM and normal strength
Uses manual wheelchair
Lives with husband, Frank, who is 64 y/o
Enjoys cooking, spending time with
 grandchild, entertaining, traveling, and
 swimming
               Gracie’s Activities

 Enjoys/Is satisfied doing  Difficulty/But does
  Traveling w/ company        Pushing wheelchair
  Being a grandmother         Working with pain
  Swimming at the pool        Home mobility
  Independence                Talking on phone
                               Preparing meals
                               Kitchen mobility
                               Babysitting
                               transfers
              Gracie’s Activities

 Can’t do now                 Could be more
  Reach cupboards              independent with new AT
  Travel with ease             Babysitting
  Easily provide childcare     Kitchen mobility
   for grandson                 Preparing meals
  Push wheelchair
   without shoulder pain
             Gracie’s Current AT

 Adapted van                  Manual wheelchair
  Pros                         Pros
      Chair lift                   Allows greater mobility
      No need to transfer          Fits into van easily
      W/c locks into place         Independence
  Cons                             Comfortable with chair
      Expensive                    Easy maintenance
      Not adapted to power     Cons
       chair                        Shoulder pain
                                    Difficulty with transfers
                                    Difficulty propelling
                                     chair
            Gracie’s Current AT

 Reacher                Swimming pool lift
  Pros                   Pros
     Independence            Helps her transfer to
                               pool
     Inexpensive
                              Enables her to exercise
  Cons
     Weight limit
                          Cons
                              Needs assistance
     Misplaces often
                               moving w/c from lift
      Modification of Existing AT


Power assist wheelchair
Reacher with magnets
Tracking device in van if necessary
Headset for phone
   E- Fix E20 Power Assist Wheelchair
 Occupational Performance
   Gracie is able to push using less force than her manual
    chair, enabling her to conserve her energy. The chair can
    easily convert the chair to a complete power wheelchair
    for longer distances.
 Family affected
   Gracie’s family will need to learn how to dismantle and
    attach the power features as well as maintenance.
 Efficiency
   Requires less energy than a manual wheelchair and
    weighs less and costs lees than a manual wheelchair.
 Effectiveness
   More energy will be conserved to enable for more
    activities completed by client
   E- Fix E20 Power Assist Wheelchair
 Delivery Timeframe
  Allow a few months for insurance approval and ordering
 Training needs
  Gracie and family will need to be trained on how to attach
   and dismantle the chair as well as maintenance and how to
   properly propel the chair and change it to a complete
   power chair.
 Cost
  About $7500-8000
 Repair
  24 month limited warranty and after the first 12 months
   repairs go on a case by case basis.
 Environmental Analysis
  Chair can not go up curbs and can only travel up to 10
   miles on the battery.
   E- Fix E20 Power Assist Wheelchair
 Obtaining chair
   First check the manual wheelchair compatibility list to
   make sure your chair will convert without difficulty. Fill
   out the order forms online or call the representative for
   the US.
 Role of OT
  The OT will be able to suggest the best power-assist
   chair for the client. OT can also measure client for a new
   chair if needed.
 Evaluation methods
  Evaluate patient based on need, ability to be able to still
   push the chair, and amount of activities engaged in.
 Outcome measures
  I would do a 6 month and year follow up to see how
   Gracie likes or dislikes the chair.
Extra Large Bright 5.6” LCD Color Video Intercom
               Color Video Intercom
 Client’s OP
    Will allow her to work around the house without worrying about
     missing the doorbell or answering the door to the wrong person
 Affect on family
    Has the potential to help the entire family
    Will also add security as her and her husband are aging so they
     are able to see who is at the door before answering it
    Does not have to be used at all times by all people – you can still
     answer/open the door manually
 Efficiency
    Allows Gracie to be more independent when she is at home
     alone
    Hands free so she will not have to worry about dropping the
     device as she has in the past
             Color Video Intercom
 Effectiveness
    Can be mounted anywhere that Gracie needs to see and talk
     to who is at the door
 Delivery timeframe
    Ships within 1-2 weeks from www.nokey.com
 Training
    Device comes with User’s Manual that addresses operation,
     troubleshooting, and maintenance
    Can be learned without in-depth training
 Safety
    Adds additional security when Gracie is home alone
    Allows more safety while Aging in Place
 Cost
    $329.00 for LCD Color Video Intercom
    $279.00 for one extra inside monitor
              Color Video Intercom
 Repair records
    Comes with one year warranty
    Product support included by phone, email, or website
    Can be repaired by general electrician
 Feasibility of purchase
    Fairly inexpensive
    Will last for a long time – can be taken to new home if needed
 Funding
    Device will have to funded by private pay unless insurance
     would fund because of safety issues
 Strategies for use
    Door bell rings, look at screen.
 Environment
    Inside monitor can be placed in as many room as needed (with
     additional monitors) and at personally desired locations
    Can be mounted on a desk or on the wall
    Outside monitor must be placed at exterior door
          Color Video Intercom
Process for obtaining AT
  Order off website, walk into Circuit City
   purchase off shelf
Role of OT
  Review user’s manual
  Discuss different model options
Evaluation Methods
  Ensure Gracie can operate key pad
  Role play with device
Outcome measures
  Ensure client satisfaction
RV
                Pimped Out RV
 Client’s OP
  Facilitates accessible travel around the country with
   family
  Will provide familiar and customized bedding, kitchen,
   and bathroom
 Affect on Family/Efficiency
  Gracie and her husband can travel the country as they
   have always wanted with the necessary adaptations
 Effectiveness
  Gracie will be able to travel more
  Will increase spontaneity
  Will be free of worry from hotel and airports being
   inaccessible
 Delivery Timeframe
  Adaptations range from 3-6 months)
                Pimped Out RV
 Training
  May want to take drivers course for driving RV (not
   mandatory
 Safety
  Always tie-down wheelchair before travel
  Comply with lift companies safety recommendations
 Cost
  Variable depending on RV style
  May have to pay more for RV than customary because
   of additional accessories
 Process for obtaining AT
  Purchase RV
  Send to vehicle adaptation company
                Pimped Out RV
 Role of OT
  Will be able to connect resources to Gracie and make
   adaptation recommendations
  Educate Gracie on the need to locate accessible RV
   parks
 Evaluation Methods
  May conduct driving evaluation
  Use ADAAG Checklist to access RV living space
 Outcome Measures
  Success/failure of RV adaptations will manifest in use or
   disuse of equipment and reason for disuse
  OT Follow-up for additional modifications
Headset for Phone
Accessible Convertible Crib
      Accessible Convertible Crib
 Client’s OP
  Enable Gracie to care for Grandchild while using her
   wheelchair
 Effect on Family
  Will allow Gracie to spend more time with her grandson
  Family will be more comfortable leaving Gracie with
   baby alone
 Efficiency
  Crib converts from a Baby Crib to a Toddler Crib to a
   Youth Bed and finally to a Junior Bed.
 Effectiveness
  One side of the gate opens, making the crib accessible
   from a wheelchair
 Purchase Info
  Call and order from Babe-Tenda Corp. (816) 231-2300
         Accessible Convertible Crib
 Safety
    Can adjust crib to provide appropriate level of safety for
     developmental stage of child
    Is more safe to have a place to change and dress baby instead
     of in wheelchair
 Cost
    Runs about $550
 Environmental Analysis
    Easily incorporated into house
    Can choose location of crib
 Role of OT
    Informs client of possible products
 Evaluation Methods and Outcome Measures
    Observe Gracie using crib with grandson
    Client satisfaction
    Make modifications as needed
   The Magic Bullet (as seen on T.V.)
Occupational Performance
  Gracie will be able to cook more at a faster rate.
   She will be able to make a variety of foods for her
   and her family.
Affect on family
  Family will be able to enjoy Gracie’s cooking
   while she conserves some energy.
Efficiency/Effectiveness
  Spend less time cooking, but still able to prepare
   meals for her family.
    The Magic Bullet (as seen on T.V.)
 Delivery Timeframe
  Next day shipping
 Training needs
  Will need to learn what blades to use with which meals and
   measurements for meals (refer to manual or cookbook)
 Cost
  $120-60 plus shipping and handling
 Repair
  1 year limited warranty
 Obtaining Magic Bullet
  Call or go on line to
 The Magic Bullet (as seen on T.V.)
Role of OT
  An OT can suggest the Magic Bullet for
   simpler meals and cooking strategies
Outcome Measures
  I would try the magic bullet out myself
   before I suggest it to my clients to make
   sure that it works as well as the
   advertisement shows.
Height Adjustable Cabinets
Reacher

   magnets


             Reacher clinging
              to wheelchair
                Magnetic Reacher
 Client’s OP
   Magnets will keep reacher on w/c preventing
      misplacement and increase independence.
 Effect on Family
   Husband is usually needed to obtain hard to reach
      items and this will free his time as the reacher will be
      on hand.
 Efficiency/Effectiveness
    Will keep reacher in a consistent location
    Decrease search time. Easy to make: glue magnets to reacher
     and adhere to w/c. (May have to glue magnets to w/c if made of
     titanium)
                 Magnetic Reacher
 Cost
   Cheap: price of magnets and glue
 Strategies for Use
   Will use reacher for more things because always with
     Gracie
 Process for Obtaining AT
   Already has reacher
   Buy magnets and glue at craft store
 Role of OT
    OT will adapt reacher and fit magnets
 Outcome Measures
    OT will assess if reacher use is increased and if a greater sense
     of independence is obtained by Gracie
Pull Down Cabinet
Pull Down Cabinets
 Ct’s occupational performance will increase
  during meal prep. Gracie will be independent
  and not need set-up.
 Husband (who currently does set-up) will be
  relieved of his set-up duties as Gracie is able to
  pull down the shelves and use reacher for still
  hard to grab items.
 Cabinet installation will be expensive, will be a
  remodeling project for the kitchen, could be
  installed in the bathroom too.
                                    Efficacy article
   Levy, C. et al. Variable-Ratio Pushrim-Activated Power Assist Wheelchair Eases Wheeling over a variety of terrains for Elders. Arch
    Physical Medical Rehabilitation. Vol. 85 January 2004.



 Tested Elderly manual wheelchair users with their own chair and a
  power assist prototype chair.
 Tested on a level surface, carpet and an incline.
 Measured the electromyography activity of upper limb and torso,
  Heart rate, number of pushes, category ratios scale perceived
  exertion, and consumer assessment of power assist wheelchair.
 The study found that the prototype reduced all of the measures
  when compared to a manual wheelchair except for the amount of
  pushes did not change.
 10 of the 11 subjects found the power assist chair to be easier and
  consider buying one.

				
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posted:10/7/2012
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