What is the wheelchair provision process?

Author: Sharon Jang | Reviewer: Emma M. Smith | Published: 25 March 2020 | Updated: ~

The process of selection is a complicated process that typically involves collaboration among people with spinal cord injury, their caregivers, device prescribers (Occupational Therapists or Physical Therapists), and vendors (sometimes referred to as DME Provider or Durable Medical Equipment Provider). The World Health Organization (WHO) identifies and breaks down this complicated process into 8 important steps. These include:

In the first step, you will be referred to a knowledgeable health provider. The referral process varies based on the services provided by each country. Some countries may have a self-referral process, while others may require a referral to a wheelchair/mobility device service.

In this step, you will be accurately assessed to determine the most appropriate wheelchair and wheelchair components for you. Factors that are evaluated during an assessment include: physical functioning, posture, lifestyle/the environment it will be used in, and the tasks that are to be performed using the wheelchair.

The prescription of a device that best matches the needs of the user then occurs. A vendor or therapist will work with you to choose the right wheelchair, cushion, and parts, and note down the many details and measurements of your wheelchair. In this step, you are encouraged to try various devices and seating set ups with a clinician or vendor to determine what is the most optimal set up for you.

Once a detailed prescription has been created, it is then possible to determine an accurate quote for the cost of the wheelchair. A request for funding to the appropriate source with a letter of justification is provided by the prescribing therapist and physician. Determining a source of funding should be in place prior to ordering the wheelchair. Once that has been processed and approved the vendor/DME provider can order the equipment.

When the equipment arrives, it will be set-up and put together for the initial fitting as prescribed by the clinician. In addition, the wheelchair is inspected to ensure that it is safe and ready for use. This step is typically completed by the vendor/DME provider.

Getting your wheelchair fitted is important to make sure your chair is suited to your needs. ¹⁰

The therapist and/or the vendor will make an appointment to check on the wheelchair to ensure that it has been properly assembled. During this time, they will also make final adjustments so that it fits properly. Some things that are checked during this step include:

• Making sure the wheelchair is the right size
• Ensuring that the wheelchair is properly adjusted to your needs so that secondary complications are prevented
• Confirming that any modifications made are fitting correctly.

In this step, you will receive instructions on how to care for your wheelchair and training on wheelchair skills. This step allows you to use your device to its greatest potential, and to receive the most benefits from the device. Some key areas that should be covered in training include:

• How to transfer in and out of your wheelchair
• How to handle the wheelchair
• Basic skills to use your wheelchair
• How to prevent and watch for pressure sores
• How to care for the wheelchair and seating components (e.g., cushion, backrest, etc.)
• What to do if there is a problem.

Follow-up is often required to fine tune the set up once the equipment has been used in a variety of environments. During follow-up sessions, the effectiveness of the wheelchair will be evaluated to maximize functioning, comfort, stability, and to make sure that the equipment has been properly maintained. There is no general guideline for how often a follow-up should occur; however, follow-ups and maintenance are beneficial and can contribute to the safe use of your device.

Read our article on Wheelchair Maintenance for more information.