Matching Persons with AT for Demo/Loan & Reuse Programs Lindsey Bean Kampwerth, OTD, OTR/L Clayton Guffey MSW, CRC, ATP ATIA 2010

Ripple Effect  The ripple effect is a term used to describe a situation where, like the ever expanding ripples across water when an object is dropped into it, an effect from an initial state can be followed outwards. - Wikipedia  Getting a piece of equipment has an effect on the person’s life- from the smallest ripple to the largest ripple

Where to Start?  Getting a piece of equipment is a very serious decision and can have positive or negative ripples.  Matching a person with the wrong piece of equipment can not help or person or even cause more problems.  Matching a person to the correct equipment can make their daily routine easier or make it possible to take a long awaited trip to Italy!

Who Does the Matching?  An occupational therapist will see all clients getting a mobility device Cane, crutch, walker, power or manual wheelchair, scooter, or cushion Cane, crutch, walker, power or manual wheelchair, scooter, or cushion Other trained staff will distribute raised toilet seats, commodes, shower chairs or benches, reachers Other trained staff will distribute raised toilet seats, commodes, shower chairs or benches, reachers

Gathering Information on the Client  AT Referral Form  Mobility Skills Course Score Sheet  Delivery and Instruction Form  Liability Release  Satisfaction Survey

AT Referral Form  Usually done over the phone but can be done in person  Client Information – name, date of birth, height, weight, diagnosis  Address Information – address and phone number  Equipment Interested in Purchasing

AT Referral Form  Do they currently have any insurance and have they tried to obtain equipment through this source (possibly refer to Washington University)  If using a mobility device now, what, and do they know the dimensions (i.e. Seat width and depth)  What will they be using the device for?

Appointment to see AT  Topics of discussion include: Home considerations Home considerations Transportation options Transportation options Special Considerations Special Considerations  Measurements  Pull options from warehouse

Consumer Data Fit to person/Clinical Evaluation Fit to person/Clinical Evaluation Current mobility deviceCurrent mobility device Device requested and planned useDevice requested and planned use weight, height and diagnosisweight, height and diagnosis seat width and depthseat width and depth

Appointment to see AT  Delivery/Instruction Form  Liability Release  Mobility Skills Course

Delivery and Instruction Form  Includes clients name, device number and date of delivery  Checklist to make sure the client has been instructed on how to use the device  Signed and dated by consumer or person picking up the device

Uses of Skills Course for Reutilized AT  Evaluation of Skills  Training of Skills  Modify/adjust equipment

Mobility Skills Course Score Sheet  Scoring is done on: Completion of the task Completion of the task Safety Safety Task Instruction Task Instruction  4 - completes task without assistance 3 – completes task with verbal assistance 2 – completes task with physical intervention 1 – unable to complete the task

Mobility Skills Course  Includes: Curb Cuts Curb Cuts Stairs Stairs Ramps Ramps Curbs Curbs Carpet Carpet Gravel Gravel

Layout

Ramp 1:20 Ramp 1:12 Potholes Stairs 3” curb

Turning Radius

Consumer Data Training Training Device usageDevice usage Device breakdown and transportationDevice breakdown and transportation Cleaning and maintenanceCleaning and maintenance SafetySafety

If there are any barriers… We have a 90 day warranty on all reuse equipment so if anything is not working we will fix it for free  Also if the client needs more training we will set up training appointments

AT Matching For Demo/Loans Main goal: Match an AT device and its features to a persons needs Foundation:  AT device/equipment selection takes time  What can ATP do to reduce the chance of device “abandonment”  Setting reasonable expectations for what AT can do

AT Matching For Demo/Loans Best Practice Considerations:  SETT Framework – Match person to AT  Consider low tech first then move to higher  Affordability – free vs. high cost  AT Matching as a “shared responsibility”  Start where the person is…

AT Matching For Demo/Loans Best Practice Considerations (cont):  Narrow it down to no more than 3 items to demo – best feature match  Determining if borrower will need support to use the device – rep or therapist  Determine when is it appropriate to have a consult meeting prior to making AT available (phone or in person)

AT Matching For Demo/Loans Challenges:  Not always having direct access to the person – i.e. a telephone contact – self report info  Not having benefit of medical or therapist records/reports or input  How to deal with “show me everything”  Very few come with a “specific device” request

AT Matching For Demo/Loans Challenges (cont):  Knowing detailed questions to ask – e.g. an EADL system  How do you not “muddy the pot” for a person/family – to many options  Home or facility based demo’s  Finding or identifying available support

AT Matching For Demo/Loans Info to Gather:  What tasks does AT need to complete or assist with?  Prior AT use/experience for task  How are they accomplishing task now – help or not at all  Present set up – i.e. computer, etc.  Dx/disability – Functional limitations, onset & progression

AT Matching For Demo/Loans Info to Gather (cont):  Overview of persons vision, hearing, sensation & cognitive status/issues (as appl)  What other AT do they presently have or use?  Who are their support persons? Will they need SLP, RT or OT support – do they have?

AT Matching For Demo/Loans Info to Gather (cont):  What are their expectations for a device/piece of equipment  What is their comfort with “technology” if looking at higher tech  What is the environment the AT will be used in  Can old skills be applied – i.e. typing

AT Matching For Demo/Loans Info to gather (cont):  Demographic, family and socioeconomic info  Funding – how will they get what they are interested in. 3 rd party? Plan?  Ask is there “anything else I should know” or “anything you did not tell me”  Set a plan for moving forward

AT Matching For Demo/Loans Discussion What do you ask or look for?

Contact Info  Paraquad Lindsey Bean : Bean : Carla Walker: Walker:  Arizona Technology Access Program (AzTAP) Clayton Guffey: Guffey: or x or x5