When is it time to get a electric wheelchair or scooter for inside and outdoor movement?

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When is it time to get a electric wheelchair or scooter for inside and outdoor movement?

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Mom has serious mobility issues. Has bone on bone arthritis in one knee and has had 3 replacements of left hip. Due to post surgical infection, (as well as her age and general medical condition) she can not have knee repaired. She also has severe spinal (lumbar) and cervical stenosis.

She is in constant pain and we always must choose between pain coverage and mental status...so sensitive to pain meds that she usually takes just advil or tylenol...and suffers.

PT folks have said there is no hope in getting her stronger...so when is it time? And who (which Doctor) orders this so that we can get some coverage for the needed equipment?

* If you have done this with your loved one, how did it go?
* How did you keep them able to transfer independently?
* Did you need to get a wheelchair van/car etc for transportation?
* How did you parent deal with the idea of being "chair bound"?

Thanks for your help and ideas!

Mobility

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I am an OT who works in this area of training, etc. FIrst of you all you need to go to an OT who works in rehab for an evaluation for what you need, as there are strick criteria now from Medicare due to the over use by the Scooter Store (who finallly was taken over by the FBI) but that has made it much wore on others The criteria now is that a person must use their motorized chair for a daily living activiity. The paperwork is very detailed about why they need this and not something else, like a manual chair, Once this is done, then a Dr appt is set for a face to face with paperwork to be filled out by Dr.Your OT should have contacted the service provided to get that paperwork. Then you are on your way. Do not do the Dr. visit first as he will not have this paperwork and Medicare does not allow a past visit. So there are two ways to do this:
1. contact outpatent rehab for OT who deals with electric mobility as you are currently seeing a PT, ask them.
2. if you dont have an OT, call local service provider who supplies these and they will contact at OT for the assessment.
Then onto Dr. Good luck. These can take 90 day or more for approval.

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There is great advice here. I would encourage you to discuss if the electric is needed or if there are benefits to a regular wheelchair. I'm sure it depends on her medical condition.

I would add that when my cousin, who has severe dementia, went to a wheelchair, it wasn't as I had expected. She was already disabled due to arthritis, when she kept falling and fractured many bones, including her spine. She also has osteoprosis. To my surprise she did very well in a regular wheelchair with the foot rests removed. She is able to propel herself with her feet, even though she can't walk and at times use her hands to propel the wheelchair. It gives her good exercise and keeps her circulation going.

I had noticed that most all the foot rests were removed from the wheelchairs in the assisted living and Memory Care facilities. Then I saw why. Only a few had motorized wheelchairs and they were mainly amputees. I would inquire if your mom is able to use a regular wheelchair or if she does need electric.

Even though my cousin can't walk, keeping her feet moving in the wheelchair has allowed her to keep enough strength to be able to transfer pretty well. She can stand up to get in and out of her bed, in and out of the car (her wheelchair folds and fits in the trunk) and on to the toilet. She has trouble stepping onto a scale, but can manage with a lot of help. I'm not sure how long this will last though.

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Oh yes. I forgot to add. The pain can be terrible, but my cousin received a great relief of pain when she went on Cymbalta. It's for depression, anxiety and PAIN. I don't think it causes any sleepiness like a regular pain pill would. I haven't seen any negative side effects with my cousin. I saw a huge difference in her comfort level after going on this medication. It's taken daily and she reports no pain. It also causes contentment and a sense of well being. Of course, different things work for different people, but I would inquire about it. It was a miracle drug for my cousin.

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I'm pretty familiar with this and OTJenn obviously knows and has given good advice on how to start. A skilled OT working with a PM&R doctor will know how to outline "why" she needs this and help avoid an easy insurance coverage denial that fall under the "want" column. One thing to consider is that therapy isn't just about getting better or stronger, having her perform as much as possible during the day will help her maintain what she has. Bone density and circulation are even more important than getting stronger. Pain management is the key driver here so I would suggest discussing this in more detail with a doctor to see about the options to keep her up and mobile. I'm not a drug advocate but there are many options that could provide better comfort and relief than the OTC advil she is taking now.

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I've been dealing with insurance coverage for wheelchairs and other DME for quite some time and find it interesting how the Scooter Store seemed to have this "carte blanche" system in play where myself and most others have to fight hard to get coverage for items. I know of many others (including myself) who had to go through months of evaluations, testing and multiple LMN to get even basic needs met. I'm sure there was some shaddy deals made but I don't buy into the innocent doctor being bullied to write a script story. Lets face it....how is that really any different than the drug rep "promoting" his product to the doctor?
The end result with these situations is the insurance companies use it as a platform to delay and deny coverage under some fraud prevention umbrella making it harder for the real claims to get processed. Watch how the criteria for scooter coverage changes in the interest of fraud prevention and the effects it will have on those who need them.

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Depends on her cognition - if she's able to handle one of those. Personally I think it's best to stay away from those scooters as much as possible. The more a person depends on these devices, the less they can move around. Getting in an out of a car will become impossible unless one has a transporting van and is one step closer to being bed ridden which will follow incontinence. Instead of a motorized scooter try for a walker. Medicare will pay for a walker. I got one for my mom with a doctor's prescription (and also need a documented page that justifies needing the walker), but I found one at Goodwill store for $35 and it's a lot better than the new one. Now those electric scooters are very large and cumbersome. So unless you have a moving van...good luck.

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It sounds like your mother has some really debilitating issues going on and she could use a scooter. Generally, a person should be able to move as much as possible because the longer a limb doesn't get exercise, the muscle wastes away over time. A few years ago, I was in a similar situation with arthritis in all the joints, recent total knee replacement surgery in both knees and I had 5 rounds of rehab exercises. I first had a walker which is fine for short walks but it's burdensome to the walker to have to pick up and put down over and over, especially if she is in pain or under the influence of pain meds. A rollator is similar to a walker in that you push it but it have larger wheels and a seat that sits down over a basket that can hold many items or it may have a larger basket in front and the seat sits on a couple of bars. I rejected it at first because I didn't want to depend on that but once I use it, I realized I could walk farther than ever before and could sit down to rest for a minute or two before getting up and walking again. I had to strengthen my legs after knee surgery or I would lose the muscle completely. If she is in that much pain, she needs much more than Advil. Get her to a pain doctor who will assess her condition and give her the pain meds she needs. She need to get a rollator which can be pushed easily by someone in the family and also be used by her to scoot along when she's alone. She really doesn't need to be walking much with her health issues and when you get her comfortable with pain meds, she MAY experience dizziness from them, but that's better than living with constant pain. If you can afford it or you want to go thru the paperwork, get her an electric scooter so she can get around by herself. That just makes her independent that much longer. Eventually the time will come when she will need constant care and won't be able to transfer to the scooter but as long as she's able, she will be happier and you will be to if you make it easier for her to go where she wants to go with minimum difficulty.

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Lots of interesting info and good advice. If she can transfer at all into a car, most cars can be fitted with a hitch and carrier for the scooter to take with you wherever she goes so you won't necessarily be needing a van (which have all kinds of adaptions required for strapping in a wheeled chair for safety). The hitch for our car $180 installed. The platform a bit more. Your climate may mean a cover to protect the chair when it's on the lift. Talk with the OT and PT about your concerns of pain, mobility, circulation, etc. Quality of life was the biggest consideration in my mom begrudgingly getting an e-scooter as she couldn't enjoy anything or really manage getting out of the house with the other solutions like rollators. When she couldnt leave the house it was definitely time. After some adjustments it helped her a LOT overall. She saved her energy everday for doing things she hadn't enjoyed in a while, like a real vs. sponge baths, talking with friends, etc. she gained strength vs staying in bed bc it was all too hard before. But everyone is different. Good question. Best of luck.

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PS. My regret is that I wished I had been more open to the idea and understood/considered the quality of her daily life sooner.

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Yes, true, cars can be fitted with lifts, etc. Check with the dealer on the torque of the car frame, because some (not all) cars will need to have heavy duty shocks and struts installed, eventually, or risk being pulled out of alignment, if the chair is transported every day or regularly. I have been using one for about twenty years or longer and am care giver for an elderly family member...I have been through it with chairs (and we hire folks for some things i can not do.....). There is a place called wholesale batteries direct dot com that supplies batteries for half the price as what is charged for replacement batteries at the medical supply store. They usually last several years, but are not cheap to replace.

That being said, i am so grateful to not be falling daily, and not having so much pain. I can actually get my own dinner cooked and laundry done in a safe manner now. There are other tools that can help a person transfer to the car...handles for the car, transfer boards for the bathroom, etc. depending on what a person can do on their own. overall, it has been a blessing for me.

When is it time to get a electric wheelchair or scooter for inside and outdoor movement?

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