Caitlin Miller, OTD, OTR/L, ATP, is a
Numotion ATP Ambassador Council
Member who has worked as a seating and
wheeled mobility clinician and now works
as an ATP supplier. She was asked why
compliance is such a challenge.
Wheelchair Provision Is a Process
“Unfortunately, I think this issue is more
common than we might like to believe,”
she said. “In reality, wheelchair fittings can
be busy and sometimes hectic, especially
if done in a clinic setting. This is why it’s
imperative to maintain an open line of
communication with your clients.”
Miller said she explains seating and
mobility assessment and fitting as a process.
“As cliché as it might sound, I typically like
to frame the new wheelchair experience as a
journey… I ensure my clients know this is not
a one-time-fitting-then-done type of thing.
It’s common for me to go back after delivery
to make small adjustments or re-educate.
If it’s a new injury or diagnosis, this process
can be overwhelming, and we can’t possibly
expect to accomplish everything in one
hour. The after-delivery follow-up is an area
that we need to capitalize on. This is where
relationships and trust are built and where
compliance and overall satisfaction can be
Miller was asked if non-compliance is
sometimes the result of consumers and
caregivers being too busy or feeling
overwhelmed. How often does life get in
the way of, for example, remembering to
check the inflation of air cells in a cushion?
“Hey, I get it,” Miller said. “I’m a mom
who works full time, has two kids, and
can’t seem to keep up with my car keys…let alone being a caregiver for a medically
complex individual or keeping up with my
own complex needs.
“I’ll start by saying the caregivers of
my clients are superheroes, right along
with the clients themselves. However,
again, I see an incredible opportunity for
education here. Of course, we know that
tilt/recline aren’t just fancy features we
put on a chair just because… but more
so because they have an actual medical
purpose. Providing education in this
manner might make caregivers and clients
more aware of the fact that tilt/recline/maintaining adequate air pressure can be
just as beneficial for their overall health
as is their daily medication. Also, I believe
in making things realistic and practical.
Setting practical expectations for pressure
relief as well as introducing technology
available on our equipment — pressure
relief reminders — are all ways we can
make things easier and increase overall
Given how busy wheelchair users and
their families can typically be — and
the overwhelming number of activities
required every day for someone with a
complex medical condition — what can
seating and mobility teams do to help
improve client compliance?
“I think the question actually answers
itself,” Miller said. “It’s in having a well-rounded
team of professionals that can
provide comprehensive care. The ATP/therapist/doctor relationship is invaluable!
When I worked as a therapist, I worked
with ATPs I knew I could count on. I knew
that if I referred to them, I could count on
their knowledgeable equipment recommendations,
I trusted they were ethical in
their paperwork completion, and I knew
that if/when my patients needed service,
they would be there… and ultimately, it’s
because of that trust that I would later go
on to work for Numotion.
“When we can form a comprehensive
team around a client,” Miller added,
“we essentially remove their burden.
When we make it easy to understand the
information, make ourselves available for
questions, and ensure a seamless process,
we can increase overall compliance and