Seating Assessment and Management in a Nursing Home Population

Krasilovsky, Gary

doi:10.1080/j148v11n02_03

Cited by 12 publications

(3 citation statements)

References 5 publications

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“…The need for wheelchair seating assessment is substantial, as the prevalence across LTC facilities within the Vancouver health region was nearly 6 in 10 residents. This finding is consistent with smaller studies reporting prevalence of wheelchair seating issues between 46 and 80% [4,7,8] and comparable to the 63 and 67% prevalence rates found by Miller et al [12,13] . This is the first study a Number of occupational therapists per 100 residents.…”

Section: Discussionsupporting

confidence: 91%

“…This finding is consistent with smaller studies reporting prevalence of wheelchair seating issues between 46 and 80% [4,7,8] and comparable to the 63 and 67% prevalence rates found by Miller et al [12,13] . This is the first study to consider the type of wheelchair seating issue identified by the SIT tool.…”

Section: Discussionsupporting

confidence: 82%

“…Several studies conducted in the United States, most over 15 years old, found high levels of wheelchair-related problems. Shaw and Taylor [6] found over 80% of LTC residents in their study identified at least one wheelchair-fit issue; Krasilovsky [7] similarly found 80% of residents referred for assessment required substantial seating intervention. Fuchs and Gromack [4] found at least one therapist goal for wheelchair use was unmet in 50% of cases.…”

Section: Prevalence and Predictors Of Need For Wheelchair Assessment mentioning

confidence: 99%

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Prevalence and Facility Level Correlates of Need for Wheelchair Seating Assessment among Long-Term Care Residents

2012

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Background: Wheelchairs are frequently prescribed for residents with mobility impairments in long-term care. Many residents receive poorly fitting wheelchairs, compromising functional independence and mobility, and contributing to subsequent health issues such as pressure ulcers. The extent of this problem and the factors that predict poor fit are poorly understood; such evidence would contribute greatly to effective and efficient clinical practice in long-term care. Objective: To identify the prevalence of need for wheelchair seating intervention among residents in long-term care facilities in Vancouver and explore the relationship between the need for seating intervention and facility level factors. Methods: Logistic regression analysis using secondary data from a cross-sectional study exploring predictors of resident mobility. A total of 263 residents (183 females and 80 males) were randomly selected from 11 long-term care facilities in the Vancouver health region (mean age 84.2 ± 8.6 years). The Seating Identification Tool was used to establish subject need for wheelchair seating intervention. Individual item frequency was calculated. Six contextual variables were measured at each facility including occupational therapy staffing, funding source, policies regarding wheelchair-related equipment, and decision-making philosophy. Results: The overall prevalence rate of inappropriate seating was 58.6% (95% CI 52.6–64.5), ranging from 30.4 to 81.8% among the individual facilities. Discomfort, poor positioning and mobility, and skin integrity were the most common issues. Two facility level variables were significant predictors of need for seating assessment: ratio of occupational therapists per 100 residents [OR 0.11 (CI 0.04, 0.31)] and expectation that residents purchase wheelchair equipment beyond the basic level [OR 2.78 (1.11, 6.97)]. A negative association between facility prevalence rate and ratio of occupational therapists (r_p = –0.684, CI –0.143 to –0.910) was found. Conclusion: Prevalence of need for seating assessment in long-term care is high overall but it varies considerably between facilities. Increasing access to occupational therapy services appears to mediate this need.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 82%

Section: Prevalence and Predictors Of Need For Wheelchair Assessment mentioning

confidence: 99%

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Prevalence and Facility Level Correlates of Need for Wheelchair Seating Assessment among Long-Term Care Residents

2012

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Occupational Therapy Intervention for Residents in a Skilled Nursing Facility: A Focus on Atypical Patients

Elliott¹

1997

Occupational Therapy In Health Care

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The 1990 implementation of the Omnibus Budget Reconciliation Act (OBRA) has expanded opportunities for occupational therapists to treat individuals with non-traditional illnesses. Therapists working in skilled nursing and long term care can benefit from gaining an understanding of the OBRA guidelines and patient's rights, especially regarding restraint reduction. Occupational therapists possess the necessary skills to assess and treat these individuals to help maximize their functioning as well as improve their quality of life (Moon-Sperling & Pinson, 1991). The premise of this article is to inform therapists about various types of ethical and legal intervention with atypical patients in skilled nursing facilities and to introduce therapists to the laws supporting provision of these services. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-342-9678. E-mail address: getinfo@haworth.com].

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Wheelchair Use by Residents of Nursing Homes: Effectiveness in Meeting Positioning and Mobility Needs

Fuchs

Gromak

2003

Assistive Technology

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The purpose of this study was to assess the effectiveness of wheelchairs purchased by Nebraska Medicaid for residents of nursing homes. Effectiveness was defined as (a) meeting therapist goals, (b) matching the request form wheelchair specifications, (c) conforming to accepted physical or occupational therapy practices for positioning and mobility, and (d) degree of user satisfaction. The authors completed a 16-item evaluation form for each of 42 subjects. Competent subjects completed a satisfaction questionnaire. Changing postural alignment (67% of subjects), mobility (43%), risk for pressure ulcers (38%), and comfort status (31%) were most frequently included in therapist goals. For 21 subjects, one or more therapist goals for wheelchair use were not met. The most frequently unmet goal was independent propulsion for a specified distance or destination within the facility (15 out of 18 subjects having that goal). Ninety-three instances of inadequate wheelchair equipment were discovered. Twenty subjects were at increased risk for pressure ulcers. Frame or seating dimensions did not match those of 19 subjects in one or more ways. Seat frames (27 subjects), seat cushions (24), and trunk supports (22) were most frequently inadequate. For 67% of the subjects, all wheelchair frames and components were of the same type or style as those specified on request forms, and when they were not, the deviations from request specifications were minor. Twenty-six percent of the subjects owned wheelchair components purchased by Medicaid that were not in use, but in only one instance was this an actual wheelchair frame. Eighty-six percent of the subjects who completed the questionnaire were mostly satisfied with their wheelchairs. Overall, the wheelchairs were meeting many subject needs and therapist goals. Lack of adequate follow-up and follow-along services may have contributed to the frequency of problems discovered.

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Seating Assessment and Management in a Nursing Home Population

Cited by 12 publications

References 5 publications

Prevalence and Facility Level Correlates of Need for Wheelchair Seating Assessment among Long-Term Care Residents

Prevalence and Facility Level Correlates of Need for Wheelchair Seating Assessment among Long-Term Care Residents

Occupational Therapy Intervention for Residents in a Skilled Nursing Facility: A Focus on Atypical Patients

Wheelchair Use by Residents of Nursing Homes: Effectiveness in Meeting Positioning and Mobility Needs

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