Focus on Environment

When Wheelchairs Are Used in Facilities

• By Laurie Watanabe
• Dec 01, 2021

Environment is always a key factor in a seating and wheelchair evaluation. The rougher terrain of a rural home — or a kindergarten playground — could impact the wheelchair team’s decisions on wheelchair bases, seating and positioning, wheels, tires, and more.

But it can also be important to know when a wheelchair will be used in a group home, skilled nursing facility, assisted living center, or any other venue besides a private home.

Dave DeRoin, Vice President of Sales at Broda, explained why.

Managing Wheelchairs with Multiple Caregivers

Mobility Management: If a wheelchair user lives in a facility, do we need to assume that there will be multiple caregivers handling that wheelchair, and that those caregivers might turn over frequently, so they may not have a great deal of familiarity with the wheelchair?

Dave DeRoin: Yes, I think that’s a consideration. Turnover in a facility can be quite high, so a lot of manufacturer’s reps go in and spin our wheels in educational in-services to show the different shifts of caregivers how to properly use the chair. We certainly do that. But turnover is always an issue.

With the many people handling the wheelchair, one of the things that we like to do is build the chair not only for the patient — which is the primary importance — but also build it for the caregiver. Absolutely, ease of use is extremely important. In fact, some feedback that we got caused us to label the cylinder assemblies on our chairs that create the function for tilt and recline. So we label those with a numbering system now, and we can tell people, “This is the [function] you do first, this is the one you do second, this is the one you do third.” Doing that has cut down on some of that educational in-servicing we’ve needed to do.

MM: So if the person qualifies for a tilt system, it’s a medically necessary system. But if it’s difficult for the caregiver to use, then they end up reclining before tilting, for example. I assume that as the manufacturer, you’re thinking, “The easier we can make it for somebody to use our tilt mechanism, the more likely they are to use it as clinically intended.”

Dave DeRoin: That’s exactly right, and that’s really why we created that kind of numbering system. Because we noticed that the easier cylinder to activate was the recline, and so what most people would do is they would activate that and never even activate the tilt — which, as you can imagine, causes a whole other set of problems. That’s why we created these numbering systems with a bright sticker on the back to say, “Do this first, then do this.”

We’re not the only manufacturer [with wheelchairs] inside the facility. And so we would be crazy to think that all of these caregivers can memorize everything there is to know about every type of chair that’s in their facility. We always look for ways to make it easier.

MM: Because not all systems work in the same way or in the same order. So you’re doing what you can to make yours easy with the hope that it will be used properly and according to what the clinician suggests?

Dave DeRoin: Yes. From the therapist to the doctor to the ATP, they’re prescribing that chair for a specific reason, and we just want to make sure we’re doing our best to help keep their patients compliant.

Supporting the Facility’s Disinfection Protocols

MM: Infection controls and cleaning are always important in facilities and in healthcare, but during the pandemic, everybody became much more aware of them. I presume another factor important to you is that your chairs are easy to clean and are durable? That they can stand up to a lot of cleaning?

Dave DeRoin: With these cleaning protocols, it was probably time for a reset. Not that the pandemic’s been great, but there are things that we’re all putting into practice now that should have always been in practice. I think we’re all just really cognizant of washing our hands, which we should have been doing, but this kind of gave us a reset. And the same goes with chairs.

I think we paid more attention in the last two years to making sure people understand the types of cleaners that work on our chairs, how to clean them, what parts remove from the chair to make it easy to get in those hard-to-reach spaces. Our chair’s a little unique in that our seating system is built into the frame itself. So we’ve developed some ways to cover our seating with a medical-grade vinyl. That’s just an option, but it allows them to use whatever cleaner is approved in their facility on that medical-grade vinyl.

MM: Because you don’t have control over what kinds of cleansers are used?

Dave DeRoin: Right. We suggest, and we have it in all of our operations manuals, that the type of vinyl that we use is open to many cleaners. We tell people, “Just make sure that it’s not an irritant to the skin of the patient you’re working with… and that cleaner would be fine.”

The types of cleaners that [facilities] are using now are a higher grade than I’m sure they’ve ever used. So I think our patients are probably benefiting from that more than they ever have.

Building in Real-World Durability

MM: Are there any other factors that you would recommend examining if an ATP supplier or clinician told you, “I’m working with a client who’s in a facility: What else do I have to consider besides ease of use and ease of cleaning?”

Dave DeRoin: Probably ease of use and longevity. One of the things we certainly take into consideration is the durability of our chair. We have chairs that have been out there for 15 or 20 years [in the field] that are still working great. It’s a popular feature for us, and we recently updated to a 10-year warranty on the frame. The 16-gauge steel that we use is extremely durable.

Whether it be a group home or a long-term care facility, they’re not always the best caretakers of the chair. We know that. We know it gets used, it gets abused, and to have that type of a warranty is definitely a popular feature.

But for any ATP, I would tell them it begins and ends with the patient, a hundred percent. We want to make sure that the patient is getting exactly what they need — and we feel that in long-term care, we have both covered. We have not only the right seating system for many of those patients, but we also have the durability and the ease of use that a facility is looking for.

This article originally appeared in the Nov/Dec 2021 issue of Mobility Management.