Don't Lose Sight of Your Consumer's Goals!
- By Jay Doherty
- Sep 01, 2016
A mother who needs to care
for her children, a father who desires
to work and provide for his family,
a teenager looking to go out with
friends and participate in age-appropriate
events, or a child who wants
to play on the playground are valid
examples of “activity and participation.”
These are also just a few of the
goals any person may have, yet they
are rarely a top priority to a funding
source when considering the needs of
persons with a disability.
However, as clinicians and ATPs, we know that these goals
are likely far more important to the individual than grooming,
dressing, bathing, toileting and feeding. In fact, when we actively
participate in the evaluation and recommendation process,
assisting the individual in the accomplishment of these goals can
be much more rewarding for therapists and ATPs as well. The
consumer’s excitement when they achieve a goal that may have
been very challenging, or a goal they thought was impossible to
achieve, is what drives all of us.
The satisfaction derived from success can reinvigorate the team
members and bolster the confidence of the individual who is
So Much More Than “Official” MRADLs
This is not to say that the “mobility-related activities of daily
living” (MRADLs) a funding source is most concerned with are not
important, because they are. Not only do they allow the individual
to “get ready for their day,” they allow them to acquire the device
that will lead to and support their new-found independence.
My point is, we cannot lose sight of the other activities the
person wants or needs to participate in throughout the day, and we
want to be sure we can assist them in achieving those goals as well.
As clinicians, we have to evaluate our consumers for the
appropriate device to allow them to perform or participate in the
activities that encompass their basic needs, and document the
information that funding sources are looking for relative to this.
But we also know that activities of daily living (ADLs) have much
more to them than the five MRADLs of feeding, dressing, bathing,
grooming and toileting. As members of the evaluating team, we
can get so focused on these MRADLs or the “medical need” for the
mobility base and the options and accessories that are necessary
— and that the funding sources look at so closely — that we can
lose sight of all the other things that complex rehab technology
can bring to the table.
For example, “feeding” is far more than getting to the table and
eating a meal prepared by someone else, especially if the individual
has the capacity to shop for groceries, prepare the meal for
themselves and their family, and do the dishes afterwards.
Clearly, complex rehab provides the opportunity to do so
much more from an MRADL perspective for individuals who are
impacted by the disability they are living with daily. As clinicians,
we need to look beyond the home and consider all the other areas
in which that person may use their device. Think of the simple
activity of taking money out of the ATM or going to the doctor
and the impact that their technology can have on them in these
scenarios. Something as simple as driving their power wheelchair
on a city sidewalk and being able to see adequately and be seen
by elevating the seat to its highest elevated position and driving in
that position can be life changing. The functional aspect of what
this position provides places the wheelchair user in a safer position
to drive and control their power wheelchair through the crowded
sidewalks and participate in the “rest of the MRADLs,” like going to
the drug store to obtain a tube of toothpaste.
Beyond Reimbursement: The Client’s Goals
We often have our own focus during an evaluation because we
know what information is needed in order to get a piece of mobility
equipment justified. What we need to remind ourselves of is to
look closely at the goals of the individual, beyond the main five
MRADLs, which may not be entirely medical or even be one of the
MRADLs that their funding source pays for. However, we still need
to look at this individual as a person who is no different than we
are, find out what all of their goals are and help the person find a
way to achieve them.
Remember to look at the person’s entire everyday life. Don’t
be afraid to focus on the activities that they want to do, or
dream about doing in addition to what they have to do. These
are personal goals, and understanding them is a big part of
making a difference in someone’s life. I believe there is nothing
more rewarding than providing the equipment that will allow a
person to achieve a dream, or a goal. We too can be a big part of
someone’s life, and making a difference is truly why most of us
got into this field in the first place. So go back to your roots and
make a difference.
This article originally appeared in the September 2016 issue of Mobility Management.
Jay Doherty, OTR, ATP, is the clinical education manager for Pride Mobility Products Corp., Exeter, Pa. Jay can be reached via e-mail at firstname.lastname@example.org or by calling (800) 800-8586.