Home is Where You Make it

By: Joseph “J.B.” Radabaugh, CTRS, ATP/SMS, Clinical Education Manager

The home assessment is an integral part of the complex rehabilitation equipment recommendation and assessment process. It can give you more information about where the client it planning to use the equipment and how they want to use it. Sometimes, I feel that how clients use the equipment becomes more of an afterthought during the home assessment process.

The word “wheelchair” is a noun. If you remember your schooling, then you know that a noun is a person, place or thing. Many times, we put the wheelchair in the category of a “thing.” The way that we should look at a piece of mobility equipment is that we assess a person for a thing that is used in several places. So, what are the places and the intended ADLs that need or want to be completed while using the device?

It is imperative that we meet the medical and mobility goals that are related to the recommendation of the specific piece of equipment. We should not, however, stop there. We must ensure to the best of our skills that we calculate the physical home environment and the shape of space available, as well as the activities that can be completed independently from the seated position.

Most of the home assessments conducted by suppliers in the field contain the bare bones information needed for insurance coverage. They don’t take into account the different roles that the end user may utilize with their equipment. How can we get a better understanding of the anticipated use of the equipment in the environments in which they plan to use the equipment? The answer: the home assessment. When completing a home assessment, I find that the best way to check for accessibility in the home is to use trial equipment that is as close as possible to the recommended equipment. You can find potential issues or limitations in the home environment and see if there are any components that can be changed to increase access for our clients. Gone are the days of making your environment fit the mobility device. There are so many options available from numerous manufacturers that can decrease the length and width of the wheelchair. This allows our clients to reach environments that they could not reach previously. Do yourself and your clients a favor and take some time in the home assessment. As we know, it’s the little things that make all the difference in the world.