Wheelchair Service Follow Up

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Introduction

Follow up happens after the wheelchair user has received their wheelchair and has been using it for a while. Follow up appointments are an opportunity to;

• gather information from the wheelchair user;
• check that the wheelchair is in good working order;
• check the fitting of the wheelchair.

All wheelchair users will benefit from a follow up visit. However, follow up is most important for:

• Children;
• Wheelchair users at risk of developing a pressure sore;
• Wheelchair users who have a progressive condition;
• Wheelchair users who have had difficulty with any of the training or instruction given to them.

There is no rule about when follow up should happen though one follow up session within six weeks of the date of delivery is often found to be useful. it will depend on the needs of the user. However, for children, it is ideal if follow up occurs on a regular basis at least every six months, as their needs can change quickly as they grow.

Follow up can be carried out either;

• in the wheelchair user’s home;
• at the wheelchair service centre;
• at any other location that suits the wheelchair user and the wheelchair service personnel.

This depends on whether the wheelchair user is able to travel to the centre, and whether wheelchair service personnel are able to travel to the user’s home.

Common Actions

Common actions during the follow up process include:

Providing more Advice or Training

• For example if a wheelchair user is not using their wheelchair as expected, it may be because they is not confident about how he/she can get in and out of the wheelchair when he/she is alone. More training in transfers can help to solve this problem.

Check the Wheelchair is in good working order and re-adjust the wheelchair

Carrying out minor repairs.

• Always encourage wheelchair users and their family members/caregivers to maintain the wheelchair by carrying for a wheelchair at home. Wheelchair service personnel can also help the wheelchair user to arrange for major repairs if it is not possible to fix any broken parts immediately.

• Referring the wheelchair user to another service for support or assistance.

The following form can be used to guide follow up. Personnel should make a note of any action that is needed after the follow up visit.

Management of Follow Up Appointments

• Give wheelchair users a follow up appointment when they receive their wheelchair.
• Visit wheelchair users at home for follow up, where possible.
• Make follow up visits part of routine visits to communities by community-based rehabilitation (cBR) personnel who have been trained to carry out follow up.
• Arrange a follow up phone call if transport is difficult and the wheelchair user has access to a phone.

Case Study

Follow up visit to Thusitha

Thusitha is seven years old and lives at home with his parents and older sister. He has muscular dystrophy and received a wheelchair through the wheelchair service a year ago. At that time he could walk short distances. He was able to do a standing transfer in and out of the wheelchair on his own. He said he wanted a wheelchair because he is finding it hard to get to school.

At the follow up visit, Thusitha said that he is now finding it hard to get in and out of his wheelchair himself. He feels tired and uncomfortable by the afternoon at school. This makes it hard to concentrate. His wheelchair is the correct size and has a medium slung backrest with a simple comfort cushion.

During the follow up the wheelchair service personnel:

• Found out how Thusitha was getting in and out of his wheelchair. Thusitha was finding it hard to lift himself off the wheelchair. The wheelchair service personnel taught Thusitha how to transfer with a sliding board, which he found much easier.

• Reviewed Thusitha’s additional postural support. It was decided that Thusitha would be better supported with a higher backrest and a cushion with posture control and pressure relief. The wheelchair service personnel took the measurements needed to be able to prepare this for fitting.

• An appointment was made for Thusitha to visit the wheelchair service centre for a fitting for his new backrest and cushion.

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References