Meaningful and purposeful occupation is the key domain of concern within occupational therapy practice. Therefore as each client’s experiences and needs are unique, taking into consideration their transition and their aims for future occupational participation is important. According to Curtin, Molineux & Supyk-Mellson (2010), occupational therapists aim to enable clients to achieve a state of ‘occupational competence’ which in turn provides them with a sense of control and achievement that can increase their sense of well-being.
http://www.grandchallengestories.org/36/
In order to achieve these outcome for clients and make their transition into being a ‘full time’ wheelchair user smooth, it is crucial that the appropriate chair, being it manual or power is chosen through careful consideration and collaboration with the client and significant others. This is where the POE is comes in, ensuring the environment is taken into consideration along with the uniqueness of the person and their valued occupations.
For clinicians to gain a working hypothesis as to what type of wheelchair may suit a certain person, it is important to consider the following aspects when evaluating an individual for a wheelchair:
- Patient history
- Clinical impairments
- Functional abilities
- The unique body shape of the client
- Any existing wheelchairs (they may already have a manual)
- The person’s physical and social environments
- The nature of their preferred occupations
PATIENT EXPERIENCE: Transition from pre stroke to post stroke
A study that investigated the occupational experiences of a group of stroke survivors asked participants and their caregivers to discuss their occupations lost and new occupations started since the introduction of the wheelchair into their lives. Physical environmental challenges such as access, the psychosocial environment (emotions), and incorporating the wheelchair into their sense of self (acceptance) were just a few of the challenges they were faced with throughout their transition (Rudman, Hebert & Reid, 2006).
Reflecting on this study regarding patient’s experiences shows us how wheelchair use can both facilitate and restrain participation in occupations and that contextual factors can both enable and disable wheelchair use and participation in occupations. It also shows us that we as occupational therapists have a significant role in providing our clients with the necessary equipment to enable engagement in everyday living and developing sense of identity.
Batavia, M. (2010). The Wheelchair Evaluation: A clinician’s guide (2nd e.d.). Sudbury: Jones & Bartlett Publishers.
Curtin, M., Molineux, M. & Supyk-Mellson, J. (Eds.). (2010). Occupational Therapy and Physical Dysfunction: Enabling Occupation. England: Churchill Livingstone Elsevier.
Rudman, D., Hebert, D, & Reid, D. (2006). Living in a restricted occupational world: The occupational experiences of stroke survivors who are wheelchair users and their caregivers. The Canadian Journal of Occupational Therapy, 73(3). ProQuest Nursing & Allied Health Source.
