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The next step: why wheelchair delivery is not a set and forget process 

By Briar Reid

As therapists when we are supporting people to achieve their goals it is essential to understand why and what success with that goal will look like. Often in the world of assistive technology, specifically wheelchairs we (therapist, supplier, participant and their supports) can get wrapped up in the what and forget about the why. This is due to the “what” (the wheelchair) being so much more tangible. When we understand the goal and what success of the goal would look like, we understand the need for training and why it really matters.  

Looking back at Hannah Long’s blog on reducing equipment abandonment we can also see that one of the key strategies to reduce the risk of equipment abandonment is education and training. Training for the person and their supports to embed the AT solution into their routines is key to long term use.  

In 2016, Smith and colleagues found that wheelchair knowledge accounted for over 90% of the direct effect of self-efficacy (being the user’s belief in their own ability to use a wheelchair in various situations) on life-space mobility.  To say it in simple terms a wheelchair user’s skills, have a significant impact on their confidence and therefore their belief that equipment is supporting them to do the things they want to do and go the places they want to go.

What is wheelchair training and education

RESNA (Rehabilitation Engineering Society of North America) discuss training as being one of the key steps in their Wheelchair Service Provision Guidelines. With “training” needing to include: 

  1. Instruction in power or manual wheelchair mobility skills to optimise function and safety. 
  1. Education regarding the set-up of the seating system including the specific postural support features and their impact on skin integrity, posture, function and overall health. 
  1. Education regarding wheelchair parts management (e.g. removal and attachment of components), and care (proper charging, applying and disconnecting wheel locks) to ensure maximum safety and positive long-term outcomes. 
  1. Education regarding maintenance, follow-up, repair, and available resources including the funding coverage. 

Education and training specific to the integration of the wheelchair into the user’s lifestyle. This may include techniques for travel in accordance with known standards for wheelchair transportation (charging, folding, etc.), instruction in securing the wheelchair, occupant safety restraints when being transported in a motor vehicle, and safety (wheel lock and anti-tipper application). 

Effective wheelchair planning for success

As therapists we need to ensure we plan and incorporate the need for these sessions into our delivery. Consider the following: 

  • Who needs to be involved to learn 
  • Who needs to be involved to “educate” 
  • What skills / knowledge need to be developed 
  • How long this is likely to take 

If we integrate these ideas in the planning, application and delivery of wheelchairs with the people we support, we go one step further in ensuring the device we recommend becomes embedded in day-to-day life and supports true goal attainment. 

References

1. Five Tips to Reduce Assistive Technology Abandonment, Hannah Long, KEO Care 

    2. Smith EM, Sakakibara BM, Miller WC. A review of factors influencing participation in social and community activities for wheelchair users. Disability Rehabilitation Assist Technol. 2016;11(5):361-74. doi: 10.3109/17483107.2014.989420. Epub 2014 Dec 4. PMID: 25472004; PMCID: PMC4581875. 

    3. RESNA Wheelchair Service Provision Guide, Rehabilitation Engineering & Assistive Technology Society of North America,  2011 

      About the author

      Briar Reid is a Team Leader and Clinical Lead at KEO. Briar has over 10 years of experience working as an OT in NZ, Australia and the UK, and specialises in assistive technology including complex wheelchair and seating.

      Briar provides a very hands-on approach to mentoring and supporting the KEO team and is passionate about sharing her knowledge to upskill and develop the KEO team to achieve great outcomes for the participants they support.