Page 24 - Mobility Management, August/September 2020

ATP Series
The Technique of the Transfer
the same way for 15 or 20 years. So you don’t take any of that away or change it.”
Sweeney said evaluating transfer routines is ongoing, ideally. “A lot of people think wheelchair prescription is one and done,
or two visits and done,” she said. “It’s so complicated that if you’re doing it well,
it’s at least four visits, especially in home health. I encourage [the seating team] to make it a long conversation, not necessarily to increase utilization, but to make sure [client] needs are met. Every person who uses a wheelchair, whether you’re seeing them for the wheelchair or not, is a [situa- tion] that you should be thinking about the wheelchair. If it’s a person with a stroke, and you’re working on therapeutic gait, and they use a wheelchair, look at the wheelchair setup, look at their education about their arms or about their bodies and their posture in the chair. It is complicated. Shoulder health over time is part of what we should be looking at with every new intervention.”
And she also wants clients to view their seating team as an ongoing resource. “I don’t think most folks, especially those coming in with a progressive diagnosis who finally need their first chair, realize the role of the team. I need to have [the client] on my radar and I need to be on their radar on a semi-regular basis, whether it’s once
a year or once every five years, depending on what crops up. Just imparting that: This is what we do, and this is what we are here for, to make sure you are mobile and inde- pendent and your posture is supported and you’re comfortable and you’re functional. So come back if there are issues.”
Peterson extends that education to the caregiver. “It’s educating the consumer, but it’s also educating their caregivers,”
he said. “I worked in a state hospital in Massachusetts and in different places, and every caregiver is different. With a lot of caregivers, if [a component] doesn’t swing away, they’re going to make it swing away,
whether that means breaking it or not. So in designs, in education, make sure they know how to swing it away, how to put it back on, how to store it. Do you want some- thing that’s removable, like an armrest? Because that’s how things disappear. Or do you want something that flips back?”
Clients and caregivers change, Peterson pointed out. “Transfers should be reas- sessed, because it’s going to take a toll on the caregiver. We see it with kids: As our young friends with cerebral palsy and muscular dystrophy get older, they get bigger. Our function changes, our shape changes. We’re not static beings.”
Peterson recalled creating a power flip- down transfer arm, an armrest that flips down to serve as a transfer board and bridge the gap between the chair and another surface. “It’s every day,” he said of the need for creative transfer solutions. “All the providers and therapists have to do is ask. What do you want to do? We can do that.” m
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