ISS 2019 Pittsburgh: Bridging the Gap.
I was privileged to be able to present twice at ISS this year, a definite personal best.
Equipment Abandonment:
The first presentation was a co-presentation with one of Numotion’s experienced ATPs, Anne Kieschnik, and Numotion’s Manager of Training and Education Susan Johnson Taylor. Susan is a well-respected member in the OT community and a RESNA fellow. Our topic was designed to create discussion around and allow self-reflection and reevaluation of our practices in the assistive technology industry as clinicians and ATPs alike – and more importantly how they may influence the occurrence of Equipment Abandonment.
Equipment Abandonment is when a client does not or will not use a piece of prescribed equipment. This happens for a variety of reasons. The most common, according to research (and our personal experiences) is a poor communication during evaluation and fitting/training, as well as not actively including the client in the decision making process. Our presentation therefore focused on verbal and non-verbal communication throughout the evaluation and fitting processes. The incidence of equipment abandonment is about 15-20%, in the USA.
Therefore addressing this topic and encouraging discussions about how to avoid this is vital to ensuring our clients are provided with most appropriate equipment to enable them to participate in meaningful activities, while reducing equipment abandonment.
24 hour Posture Management: A Toolkit:
The second presentation, was with another esteemed OT colleague Tamara Kittleson-Aldred. Our presentation focused on how postural asymmetries occur and the shared responsibilities we all hold in the complex rehabilitation realm to provide early input and intervention, to correct asymmetrical postures and even prevent these harmful postures by addressing the individual’s lying and sleeping position.
Twenty-four hour posture management focuses on the postural orientations available to the individual; lying, sitting and standing over the twenty-four hour period. For example: if an individual is seated in a supported posture in their wheelchair for eight hours a day, and then spends the remaining sixteen hours of the day in an unsupported posture - consider the destructive forces of gravity on the individual’s posture. Gravity will have twice the opportunity to undo all the gains that may have been achieved in the seated posture – merely by the time spent in an unsupported posture. The presentation acknowledged that even in settings such as the USA, there are still resource limitations – which result in individuals not having access to the appropriate intervention, equipment, or funding sources.
The presentation focused on our shared responsibility to provide intervention, even if resources are not available. The call to action was to start intervention, and the course gave a flavor of how to get started – a no excuses approach. The Montana Postural Care Project a locally funded postural intervention project, now in its 4th year as well as charitable work in Peru were referenced as resources where this “back to basics” approach to postural intervention is successful. The acknowledgement that destructive postures can be positively altered with gentle positioning and time, along with the use of re-purposed every day household items. These items such as pillows, towels, blankets and other informal supports can be used to address and support postures outside of the wheelchair, either while awaiting more formal equipment – or in the event of not having access to formal equipment. Change is possible – act now!
Looking forward: A co-authored publication in May in the OT Specialist Interest Section (SIS) and co-presenting in June at the RESNA conference on 24 hour posture management – Looks like every month is OT month at Numotion!
Lee Ann Hoffman
O.T., MSc, ATP
Clinical Educator Numotion