Limitation of dependent operation of wheelchair within environment

Difficulty bending forward to pick up object from the floor

Difficulty folding or unfolding wheelchair

Difficulty leaning forward to reach for something above head

Difficulty locking brakes on manual wheelchair

Difficulty maneuvering wheelchair sideways

Difficulty moving wheelchair out of an elevator

Difficulty navigating through hinged door

Difficulty operating battery charger of power wheelchair

Difficulty operating power wheelchair on a decline

Difficulty operating power wheelchair on an incline

Difficulty operating power wheelchair on curbs

Difficulty operating power wheelchair on even surface

Difficulty operating power wheelchair on uneven surface

Difficulty operating wheelchair backward

Difficulty operating wheelchair forward

Difficulty operating wheelchair in corners

Difficulty operating wheelchair motors

Difficulty operating wheelchair on a decline

Difficulty operating wheelchair on an incline

Difficulty operating wheelchair on curbs

Difficulty operating wheelchair on even surface

Difficulty operating wheelchair on stairs

Difficulty operating wheelchair on uneven surface

Difficulty operating wheelchair while carrying an object

Difficulty performing pressure relief

Difficulty performing stationary wheelie position

Difficulty putting feet on the footplates of the wheelchair

Difficulty rolling across side-slope while in wheelchair

Difficulty selecting drive mode on power wheelchair

Difficulty selecting speed on power wheelchair

Difficulty shifting weight

Difficulty sitting on wheelchair without losing balance

Difficulty stopping wheelchair before bumping something

Difficulty transferring from wheelchair

Difficulty transferring to wheelchair

Difficulty turning in place while on wheelie position

Altered mood

Cognitive dysfunction

Environmental constraints

Inadequate adjustment to wheelchair size

Inadequate knowledge of wheelchair use

Insufficient muscle strength

Insufficient physical endurance

Neurobehavioral manifestations

Obesity

Pain

Physical deconditioning

Substance misuse

Unaddressed inadequate vision

Individuals using wheelchair for short time

Individuals with a history of fall from wheelchair

Older adults

Musculoskeletal impairment

Neuromuscular diseases

Vision disorders

Level 1 Advanced Focused Assessment

Wheelchair assessments should be completed by nurses in rehabilitation or physical therapists.

The individual will report satisfactory, safe wheelchair mobility as evidenced by the following indicators:

• Demonstrates safe use of the wheelchair.
• Demonstrates safe transfer to/from the wheelchair.
• Demonstrates pressure relief and safety principles.

Interventions

Consult with Physical Therapy for a Collaborative Plan

Monitor Pressure Points of Elbow, Sacrum, Coccyx, Ischial Tuberosities, and Heels of Seated Individuals

Refer to Home Health Nurse and Physical Therapist for Evaluation of Home Environment

R:Wheelchair accessibility and other barriers to safe wheelchair use need to be assessed. Research has reported falls with sustained injuries and failure to make home modifications in a home with an individual in a wheelchair.

For more specific information regarding wheelchair use and components, refer individual/family to www.uab.edu/medicine/sci/daily-living/mobility/wheelchair-a-seating.