Polio

Jami CrostonKaren Dilfer

Jenny HaslerKristin Re

Gracie59 y/o femaleContracted polio at 7 y/oCannot move but has full

sensation from the waist downUE has full ROM and normal strengthUses manual wheelchairLives with husband, Frank, who is 64 y/oEnjoys cooking, spending time with

grandchild, entertaining, traveling, and swimming

Gracie’s Activities

Enjoys/Is satisfied doing Traveling w/ company Being a grandmother Swimming at the pool Independence

Difficulty/But does Pushing wheelchair Working with pain Home mobility Talking on phone Preparing meals Kitchen mobility Babysitting transfers

Gracie’s Activities

Can’t do now Reach cupboards Travel with ease Easily provide childcare

for grandson Push wheelchair

without shoulder pain

Could be more independent with new AT Babysitting Kitchen mobility Preparing meals

Gracie’s Current AT

Adapted van Pros

Chair lift No need to transfer W/c locks into place

Cons Expensive Not adapted to power

chair

Manual wheelchair Pros

Allows greater mobility Fits into van easily Independence Comfortable with chair Easy maintenance

Cons Shoulder pain Difficulty with transfers Difficulty propelling

chair

Gracie’s Current AT

Reacher Pros

Independence Inexpensive

Cons Weight limit Misplaces often

Swimming pool lift Pros

Helps her transfer to pool

Enables her to exercise Cons

Needs assistance moving w/c from lift

Modification of Existing AT

Power assist wheelchairReacher with magnetsTracking device in van if necessaryHeadset 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

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 shelfRole 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

Color Video Intercom

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)

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

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

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

Accessible Convertible Crib

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)

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

Magnetic Reacher

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.