Rita Henn & Partners Rehab

Paediatric Rehabilitation

Talita Hamers — Fri, 26 Oct 2018 11:27:54 +0000

Paediatric Rehabilitation

Introduction to Paediatric Rehabilitation

Welcome to the start of your child’s rehabilitation journey. You will receive a lot of information in the coming days. Caregivers, well-meaning friends, the internet, support groups and other families are all good sources of information, but it’s a lot to take in. Don’t try to learn everything at once. Rely on your professional team to guide you through the steps, day by day.

Because recovery is unpredictable, it can be very frustrating. Answers may seem hard to come by right now and all the medical facts can be very confusing. We will do our best to support you and your child through this phase of the rehabilitation process.

You will be attended to by a full rehabilitation team which consists of:

A Doctor
Nursing staff
Physiotherapists
Occupational Therapists
Speech Therapists
Social Workers
Psychologists
A Dietician
A Rehabilitation Programme Manager (RPM)

Please note that depending on your child’s condition and the need for certain types of therapy, your child may not be seen by all the members of the rehab team.

Condition

Therapy Units

What you should bring to rehabilitation for your child?

Suitable clothing is needed for therapy. Your child is advised to wear comfortable, loose clothing such as trousers or tracksuit pants, takkies/trainers and socks. Pyjamas, boxer shorts and slippers are not suitable or safe for exercising. Please ensure your child has enough clean clothing at all times, including underwear/nappies.
With regards to shoes/ takkies/ trainers, it is often helpful to provide shoes that are one size larger than your child normally wears, to make it easy for him/her to put them on and take them off. If walking is a rehab goal, the shoes should have rubber soles to prevent slipping.
Toiletry items such as a toothbrush, toothpaste, comb, brush, shampoo, soap, deodorant and face cloths.
Bottles, teats and dummies/pacifiers
Familiar items such as photos of parents, siblings, family and friends.
Comfort items, such as a favourite pillow, blanket, toys or music with headphones (but please be cautious of bringing valuable items to hospital).

Key principles of paediatric rehabilitation

Rehabilitation is a complex process. The two major therapeutic approaches being used for children is Neuro Development Therapy and Sensory Integration Therapy. Much of the process is based on the principles of normal child development, learning to move again and acquiring a new or developmentally expected skill. The building blocks to success include:

Integrating your child’s senses in order for them to better understand the external world around them
Actively attempting to perform a variety of tasks/exercises
Using play and playfulness as a way to actively engage your child in therapy
Being motivated to persevere with training

Learning is enhanced by a lot of repetition and practise. Therapists and nurses provide the knowledge and the skills to enable your child to do particular tasks, which then need to be practised repeatedly. You will need to practise the skills learnt with your child as much as possible in your own time as well. Independent practise allows for increased social stimulation and interaction throughout the day, rather than just in your prescribed therapy sessions. Planning to practise every day is essential. Please ask the staff and therapists to assist you in fitting your own independent practise times into your daily routine.

Therapy assessment

During your child’s first three days of rehabilitation, the therapists will evaluate what your child can and cannot do by him/herself and how they engage in play. For babies and infants, this may include aspects like their ability to calm and their sleep / wake cycles. Therapy may take place in a variety of settings, including the ward, the gyms and outdoors. All of these environments are used to optimally prepare your child for the challenges ahead. The assessment is an important part of therapy and helps the team to determine how to assist your child, and you as parents in returning to your own environment as quickly and as independently as possible. The assessment is essential for setting your child’s rehabilitation goals and determining the recommended length of stay in our facility.

Therapy times

Therapy times for the week will be communicated to you, or you may be assisted to complete your child’s own timetable. Although every attempt is made to keep to the set times, they may need to be amended on the day as schedules can be affected by your child’s ability to engage at the time, emergencies and other unforeseen circumstances.

Your child’s active participation in each therapy session is very important.

Visiting hours

Visiting hours in the hospital are between 10h00 and 20h00. Please understand that should your child’s visitors arrive during their therapy times, therapy takes priority. It is, at times, beneficial for family members to be present in therapy, but it can also be very disruptive to have many visitors in the gyms. Please allow the treating team to guide when your child’s visitors are allowed to observe or participate in therapy sessions; this will also be done with your best interests in mind. Remember that resting between therapy sessions is also very important.

Family meetings

A family meeting is usually arranged in the first two weeks following admission, depending on your family’s availability. The purpose of this meeting will be to give you feedback on your child, explain the progress and goals of therapy and start planning for discharge. It is a good opportunity for you and your family to ask questions so please feel free to do so.

Special services

Apart from the two major paediatric therapeutic approches, there are a variety of additional special services available in the hospital. These are prescribed by your child’s treating therapists as and when necessary.

Home visits

A home visit will be done, when appropriate, usually prior to your child’s first day or overnight trial at home. For logistical reasons, homes outside of a 50km radius from the hospital are generally not able to be visited. The family will then be asked to provide pictures of the home environment and take measurements, as requested by the therapists.

Weekend leave

As part of the rehabilitation process, children are encouraged to visit home over the weekends. The team will decide when this is appropriate for your child and how long the visit should be. We generally do not recommend a visit in the first week of admission as we will probably not yet have an accurate picture of how safe such a visit would be. An indemnity form will need to be completed and signed prior to your child leaving the ward. In order to benefit from the full daily therapy sessions, children may not leave for a weekend before 15h00 on the Friday and must return to the hospital on the Sunday afternoon/early evening.

Weekend therapy

Weekend therapy is not a standard part of our rehabilitation programme. Weekends are an essential time for children to rest, be with their family and be involved in normal social and recreational types of activities. It is also an ideal time for your family to spend time with your child and for you to practise the skills learnt in therapy during the week. However, for certain children it is necessary to have therapeutic intervention on a Saturday and/or if there are restrictions on length of stay. This will be determined by the treating therapists who will prescribe a specific intervention for that day. The session provided will not be as intense as the therapy offered during the week. Emergency and chest physiotherapy is provided on Sundays if required.

Peripheral Nerves

Talita Hamers — Thu, 25 Oct 2018 12:01:52 +0000

Peripheral Nerves

Nerves carry information from the brain to the rest of the body, and vice versa. The arm and leg contains numerous nerves that transmit information for muscle contraction, sensation, and reflexes. The nerves that innervate the arm leave the central nervous system (spinal cord) through several areas in the neck, and form a complex structure called the Brachial Plexus. The same occurs for the leg. The nerves are larger near the neck / lumbar spine, and eventually divide to form smaller branches in the upper arm, forearm, and hand and thigh, calf and foot.

Injuries to the nerves can be one of the following:

neurapraxia – the nerve is stretched and damaged but not torn
rupture – the nerve is torn at a point along its length
axonotmesis – the nerve is partially damaged. Natural recovery is possible, so these injuries can often be managed conservatively with support and physiotherapy.
neurotmesis – the nerve is completely severed. There is no prospect of natural recovery, so this type of injury requires surgery to restore function.

There are 3 different nerves in the arm. When these nerves are injured they present differently:

The Median Nerve

The median nerve runs from the armpit, down the front of the arm to the wrist and into the hand.

If the median nerve is damaged near the elbow, then the index, middle finger and the thumb, are unable to flex (bend) to make an “OK” sign. Thus, they present with the Benediction sign.

Fig 1:Benediction sign – median nerve injury

If the injury is near to the wrist (Carpal Tunnel Syndrome) or in the hand, you may get pain, weakness of the thumb and fingers leading to dropping items (like cups) and a feeling of swelling in the hand.

Sensation is normally decreased in the thumb, index and middle fingers, and palm on the thumb side.

The Ulna Nerve

The ulna nerve runs from the armpit, passes at the back of the elbow (funny bone) and enters the wrist on the little finger side. The ulna nerve is most commonly damaged at the elbow or wrist or due to a fractured humerus.

If the injury is at the elbow (Cubital tunnel), then the person generally presents with pain / pins and needles and a weak grip.

If the injury occurs at the wrist, then weakness of grip, and sensory loss mainly over the ring and little finger is evident.

Where there has been significant injury due to a fracture, then an ulna claw is evident. This is where the ring finger and little finger, predominantly, are unable to straighten.

Fig 2: Claw hand with an ulna nerve injury

The Radial Nerve

The radial nerve passes from the armpit, at the back of the arm, close to the humerus, and into the top surface of the forearm. The most common cause of radial nerve injuries is a humerus fracture, a direct blow or sustained pressure (i.e. from incorrect use of a crutch).

Injuries to the radial nerve result in a wrist drop (unable to lift the hand), inability to lift/open the fingers and a small area of decreased/lost sensation on the top of the hand (over the thumb, and index and middle fingers).

Fig 3: Drop wrist with radial nerve injury

Other Nerves:

Sciatic Nerve (leg)

This nerve is the largest nerve in the human body and the continuation of the sacral plexus

It is most commonly injured due to the following:

Direct trauma
Stretch
Compression due to hematoma (serious bruising)
Unknown (40%)
Uncommon (0-3%), complication following THR

Peroneal Nerve

30% of peroneal nerve palsies are from knee dislocations. The following signs and symptoms may be evident:

Decreased sensation, numbness, or tingling on the top of the foot or the outside border of the upper or lower leg
Foot drop
Toes drag while walking
Weakness of the ankles or feet
Prickling sensation
Pain in shin
Pins and needles sensation
Slapping gait. This is when the foot cannot lift off the ground properly, so when one tries to put the heel down first, it slaps onto the ground.

Femoral Nerve

The Femoral nerve is the major nerve supplying the front of the thigh.

The following is a number of reasons for femoral nerve injuries:

Direct injury
Tumor or other growth
Prolonged pressure / immobilization
Pelvic Fracture
Radiation to the pelvis
Haemorrhage into the retroperitoneal space
Catheter placed into the femoral artery
Diabetes may cause femoral neuropathy.

The following signs and symptoms may be present

Numbness / tingling in the front and inner aspect of the thigh
Dull aching pain in the genital area
Weakness of hip movements
Difficulty straightening the knee due to quadriceps weakness
Sensation that leg or knee is going to buckle

Treatment of peripheral nerve injuries in general:

Imaging:

To test the nerves in the arm or leg, the doctor may request an Electromyelography (EMG). This test uses needles and electrodes to test the electrical conductivity of nerves. If more information is needed, a CT Scan or an MRI may be requested. This will help explain what type of injury has occurred and the prognosis for recovery.

Therapy:

Depending on what type of nerve damage has occurred, the therapists can help with splinting, exercises and strengthening, pain management or compensatory strategies if function doesn’t improve. Treatment and recovery will depend on the severity of the injury.

The therapists will educate you with regards your specific nerve injury and resulting treatment plan.

Therapy & Treatment Programs

Therapy Units

Dementia/Alzheimer’s

Talita Hamers — Thu, 25 Oct 2018 09:01:23 +0000

Dementia / Alzheimer's

Dementia is the term used to describe a set of symptoms that occur when the brain is affected by disease. Most of us are at least somewhat familiar with Alzheimer’s disease. It is the most common type of dementia, but it is only one of many forms. Each type of dementia has a different cause and affects people in different ways. It may be difficult to tell which type of dementia a person has because they all have some symptoms in common. A thorough doctor’s examination is needed to make a correct diagnosis.

A commonly asked question is how can a person with Alzheimer's disease or dementia benefit from rehabilitation when they don't even recognize their own family or places that should be familiar to them?

Physical therapy, occupational therapy and speech-language therapy services can be beneficial to the person with dementia as well as their family and caregivers at various stages of Alzheimer's or dementia.

In the early stages, rehabilitation services can help your loved one be as functional as possible for as long as possible. The focus of physical therapy (PT) with dementia care is to improve balance, muscle strength, and mobility and provide pain management. Another goal of PT treatment is preventing falls. People with Alzheimer's or dementia are at greater risk of falls and mobility problems due to muscular weakness, history of falls, gait, balance deficits and cognitive impairment. Safe physical activity, including exercise, will maintain strength, balance, ability to walk and ability to get into or out of a chair or car.

Both the physical and occupational therapist may assist you in changing and enhancing your loved one's environment to improve function and safety. Environmental modifications such as adding signs on bathroom doors and labelling drawers for socks and shirts may allow a person with dementia to function at the highest level possible for as long as possible.

In the mid-stages of Alzheimer's and dementia, challenging behaviours are most often present during bathing, toileting, dressing and eating – all areas of expertise for an occupational therapist. Occupational therapists can provide instruction on how to manage these daily tasks safely and with as minimal stress as possible. Even if you believe your loved one now has a limited ability to learn new things, occupational therapy treatment can be helpful.

Physical therapy can assess one's ability to walk safely, the risk of falls, and other functional tasks. The therapist will develop a treatment program, including exercise, to help maintain your loved one's current abilities, which also has the effect of reducing the burden on the caregiver. A person does not need to remember having engaged in an exercise program to reap the benefits of exercise – they just must participate.

In the late stages, the role of physical, occupational and speech therapies change yet again. Rehabilitation therapists can recommend and help you obtain a custom wheelchair to maximize comfort and function for seating and positioning. Skilled therapists can also help prevent and manage the shortening of muscles or joints, and train you in overall care for your family member at the end-stages, including proper feeding.

Speech-language pathologists have a primary role in the assessment, diagnosis and treatment of swallowing disorders associated with dementia. These specialists also can assess a person's cognitive and communication abilities and recommend strategies to help manage difficulties.

Rehabilitation services have much to offer at all stages in the disease process to maximize function, manage day-to-day activities, reduce the burden of care, reduce caregiver stress and improve the quality of life for all.

Therapy & Treatment Programs

Therapy Units

The most common types of dementia can be explained in brief by the following:

Alzheimer’s disease

Alzheimer’s is by far the most widespread form of all dementias. It affects memory first and later progresses to affect other cognitive (brain) abilities, such as speech, ability to reason, and movement. Current treatments for Alzheimer’s disease can help boost the levels of chemical messengers in the brain, which can help with some of the symptoms.

Vascular Dementia

Second only to Alzheimer’s, vascular dementia is another commonly diagnosed form of dementia. It occurs when there is an interruption in the blood flow to the brain often caused by a stroke, heart disease or diabetes. Onset of vascular dementia is often sudden. Symptoms depend upon area of brain affected, but often memory and other cognitive functions, such as decision-making, are impaired.

Lewy-Body Disease (LBD)

Dementia with Lewy bodies (DLB) is a type of dementia that shares symptoms with both Alzheimer’s disease and Parkinson’s disease. It may account for 10-15 per cent of all cases of dementia. It occurs as the result of protein deposits that build up on nerve cells in the brain stem. It results in muscle rigidity, behavioural issues, cognitive decline, hallucinations and tremors.

Frontotemporal Dementia

Another form of dementia, Frontotemporal impacts the front and side portions of the brain. The result can be impaired speech, memory impairment, and behavioural problems. It often causes a loss of inhibition that is difficult for family caregivers to control.

Parkinson’s Dementia

When Parkinson’s disease (PD) progresses, it can lead to dementia. This causes memory loss and other typical dementia symptoms in addition to the already tough symptoms of PD.

Huntington’s Disease

Huntington’s disease is a genetic disease that is associated with or may lead to dementia. Huntington’s disease generally begins earlier in life, between ages 30 and 45, and is characterized by mood swings, lack of coordination, and involuntary movement of the head, trunk and limbs. Also, people with Huntington’s may develop dementia symptoms as the disease progresses.

Mixed Dementia

Mixed dementia is when a person has two different types of dementia. Many researchers believe a significant portion of people who live with dementia suffer from more than one type. The most common combination is Alzheimer’s disease and vascular dementia.

Functional Mobility

Talita Hamers — Thu, 25 Oct 2018 08:08:20 +0000

Functional Mobility

Functional mobility is seen as the ability to move around in your environment allowing you to take part in daily activities. Functional mobility includes bed mobility, transfers from the wheelchair to the bed, floor, toilet, shower or bath as well as moving from one area to another – this can either be by walking or with the use of an assistive device, such as a walking aid or a wheelchair.

Due to injury or illness, muscles become weak or paralysed and even pain may limit movement or functional mobility.

Rehabilitation focuses on improving functional mobility, either by addressing difficulty in bed mobility and transfers and/or as gait retraining (training on standing and walking). Wheelchair skills training focus on improving one’s dexterity and confidence as a wheelchair user.

Our seating clinic makes use of dedicated expertise of rehabilitation therapists from various fields to assess posture and pressure distribution when seated in a wheelchair. Problem solving and demo setup of a seating system is used to ensure the most appropriate and cost-effective setup of a client’s seating system (wheelchair, backrest and wheelchair cushion) prior to purchase. This is done to help identify the best possible seating solution to prevent secondary complications. Wheelchairs are procured and delivered to the clinic, for the client to try out prior to purchase.

Condition

Therapy Units

Geriatric Rehabilitation

Talita Hamers — Wed, 24 Oct 2018 08:32:44 +0000

Geriatric Rehabilitation

Older Adults and Geriatric Rehabilitation

Disability, or limitation in the ability to carry out basic functional daily activities, becomes increasingly common with advancing age.

The changing demographics of our population due to improvements in healthcare services has also increased life expectancy. The increasing numbers in this population, is often associated with an apparent increase in disability related to musculoskeletal disorders, diabetes, and neurologic disorders, affecting mobility-related activities.

There are numerous factors causing an increase in disability in the older adult population, but a few of the more common causes include:

Stroke
Reduced recovery from surgical intervention
Reduced strength and mobility following hospitalization for a medical condition
Multiple chronic conditions that compound together and affect independence and wellbeing
Recovery from a fall

Using a patient centred approach, at RHP care is provided by a multidisciplinary team whose expertise includes helping participants improve their strength, mobility, balance and walking. Therapist shall provide falls prevention education and advice; carer training and certain strategies to manage changes associate with aging.

The emphasis in this area of rehabilitation is to maintain and optimize independence in activities of daily living. The more the family is involved and understand the importance of how to facilitate activity the better. The team supports participants to optimize their function, transition back to their home and community environment and provides training for families and carers. The team can also support the process of placement, should the pre-morbid home environment no longer be appropriate.

Condition

Therapy Units

Guillain – Barre Syndrome (GBS)

Talita Hamers — Wed, 24 Oct 2018 08:02:42 +0000

Guillain - Barre Syndrome (GBS)

GBS is an acquired immune-mediated inflammatory disorder of the peripheral nervous system.

As a result, neurological signals are slowed, altered or blocked altogether, resulting in paraesthesia (e.g. numbness, tingling, “crawling skin”), loss of sensation, progressive muscle weakness, often general fatigue, sometimes pain and other possible secondary complications.

Disability caused by GBS generally progresses over the course of a few days to four weeks. At the peak of the condition’s progress, many patients experience flaccid paralysis of nearly all skeletal muscles, with talking, swallowing and breathing frequently being affected.

Many patients will walk without help after three months and experience only minor residual symptoms by the end of the first year following the start of the disease. Nevertheless, recovery can be extremely slow (from six months to two years or longer) and five to twenty percent of patients are left with significant residual symptoms that lead to long-term disability and prevent a successful return to their prior lifestyle or occupation.

The goal of rehabilitation is to get patients moving at the earliest opportunity.

Rehabilitation Services

Patients with GBS benefit greatly from the comprehensive rehabilitation services of RHP

Physiotherapy and occupational therapy to assist the patient to achieve optimal muscle use and help patients with residual impairments to resume independent activity as close to their previous lifestyle as possible.
advanced technologies and activity-based interventions, including hydrotherapy, locomotor training and neurostimulators to help patients gradually rebuild neuromuscular control
training with adaptive devices, such as a wheelchair or braces; if needed
speech therapy for patients who have trouble swallowing or talking
individualised home programme training for ongoing rehabilitation facilitated by the patient, family and caregivers

Physiotherapy and occupational therapy are integral parts of the recovery and management of GBS. Their involvement can help a patient minimize pain, increase strength and endurance and prevent secondary complications and overuse damage to muscles and joints while improving balance, mobility and restoring functional activity at home, work and play.

Therapy & Treatment Programs

Therapy Units

Work ability Assessment Reports

Talita Hamers — Thu, 04 Oct 2018 14:21:33 +0000

Work ability Assessment Reports

A key part of vocational rehabilitation is assessing the work place, work station and analysing the job description to match that to the person’s abilities and make recommendations with regards to their ability to return to work.

A work site assessment will include the following aspects:

Assessment of the physical work environment to ensure accessibility for persons with mobility / physical disabilities
Assessment of work stations to ensure correct ergonomic setup
Assessment of the organisational structure and interpersonal / social requirements within the work place
Assessment of work flow and work tasks to provide recommendations on alteration of tasks or use of strategies if required.
Observing colleagues or the person with the illness / disability performing key tasks within the job to analyse the need for adaptations or reasonable accommodations
Observation of other jobs within the work place to assess for the possibility of an alternate job / position.
Analysis of the full job description to match with the person’s functional abilities
Meeting and discussion with the employer to determine their ability and willingness to provide reasonable accommodations within legal allowances.

A work site visit or assessment may occur at any stage in the rehabilitation process and at times a meeting without an assessment of the environment is sufficient to manage the process and provide the recommendations.

The person’s abilities (physical, cognitive or social) with regards to the demands of their job will need to be assessed in addition to the work site assessment. This assessment may at times be able to be conducted within the workplace to trial actual components of the job.

The occupational therapist is usually the team member best equipped to conduct this assessment and provide the recommendations. To do this, they require an understanding of the legislation with regards to employment and reasonable accommodations as both the person with the illness / injury and the employers have rights and responsibilities. They are skilled at balancing these rights and responsibilities to find a tailored made solution for each case and facilitate the return of the worker into the work place where possible.

Therapy Units Associated With This Service

Functional Mobility

Talita Hamers — Thu, 04 Oct 2018 14:20:49 +0000

Functional Mobility

Due to injury or illness, muscles become weak or paralysed and even pain may limit movement or functional mobility.

To improve functional mobility the prescription of assistive device is sometimes needed. The RHP Rehab therapists are skilled in assessing and prescribing the correct device to aid independence in functional mobility. Assistive devices include walking aids (crutches, walking frame) as well as wheelchair. (there is a whole section on assistive devices, they list a whole lot of things. Not sure if perhaps here one should just refer to that section in stead of “repeating” some of the info? Not sure if that will be one of the built in functions of the website?

Therapy Units Associated With This Service

Wheelchair Ergonomic Assessments

Talita Hamers — Thu, 04 Oct 2018 14:20:11 +0000

Wheelchair Ergonomic Assessments

The aim of wheelchair ergonomic assessments and our seating clinic is to provide a service to people with long term mobility impairments. SIT Lab* technology is used to assess best seating options for our patients requiring a wheelchair and cushioning to prevent postural and pressure complications.

The service includes the following:

Comprehensive wheelchair and postural needs assessment
Prescription of equipment
Motivation to the funder
Fitting and set up of equipment
Training with the equipment
Follow up and further support

Therapy Units Associated With This Service

Wheelchair & Cushion Procurement

Talita Hamers — Thu, 04 Oct 2018 14:19:38 +0000

Wheelchair & Cushion Procurement

Wheelchair and cushion procurement is defined as the process through which individuals obtain equipment or education designed to improve their wheelchair or wheelchair seating system.

For the wheelchair user, the wheelchair represents a variety of aspects of living. The wheelchair becomes part of the users’ self-identity, part of the work environment as well as an integral part of the physical and cultural environments of the user. Wheelchair procurement, therefore, requires careful consideration of all these elements, because the type of wheelchair selected, and its configuration have a powerful impact on the lives of wheelchair users.

Rapid changes in wheelchair technology and wheelchair seating options in conjunction with funding issues and demands for accountability have complicated the wheelchair procurement process for clients and therapists.

Wheelchair procurement rarely involves only the wheelchair user and the prescriber; often a variety of individuals have input during the process.

Choosing the wheelchair cushion is just as, if not more important as choosing the appropriate wheelchair. The wheelchair cushion must be able to provide you with optimum pressure relief. It is not recommended that you decide on a wheelchair cushion solely on subjective features such as texture, colour, cost. One of the most objective and reliable measures to help you decide on the correct cushion is a pressure mapping assessment as discussed below:

Seating Information Technology Laboratory – SIT LAB

The SIT Lab makes use of the dedicated expertise of rehabilitation therapists from various fields, in the use of state of the art technology. This technology is in the form of the Force Sensitive Application™, or FSA. Use of the FSA System enables the clinicians to make an informed decision regarding pressure distribution, postural symmetry and the effectiveness of the seating system and pressure relief in an objective and scientific manner.

This is achieved through measuring the pressures between the client and the cushion or backrest of the wheelchair in real time and is represented through a pressure map of the client.

All wheelchair cushions marketed in South Africa are available in the SIT Lab used to perform the pressure mapping. This is done to help identifying the best possible pressure relieving cushion for each client prior to purchase. Wheelchairs are procured and delivered to the clinic, for the client to try out prior to purchase.

Also included in our SIT Lab service:

• Client and family education programmes
• Appropriate wheelchair and cushion procurement
• Medico-legal assessments and reports
• Motivation for equipment
• Research and development
• Product assessment, reporting and endorsements

It is in your best interest to familiarise yourself with what your funder allocates for a wheelchair and a wheelchair cushion and how often they are willing to replace this equipment. Sometimes, it is fully covered and sometimes you do require to supplement the amount to get what is prescribed. There will be some funders that may not pay for equipment at all and you may need to save and budget for this and you may also have to settle for the next best option or second -hand equipment.

Every funder and funding system (WCA/ RAF) is different. Usually quotations from suppliers are required. Your therapy team will give you the names of the suppliers of the wheelchair and wheelchair cushion. Sometimes your suppliers will assist you with the application. In most cases there is a waiting period for an authorisation or approval before you can receive your wheelchair and cushion. Again, it is in your best interest to follow up with your funder as you ideally want to be discharged with your wheelchair and cushion.