Paul was a 54 year-old male who had been diagnosed with Multiple Sclerosis for about 20 years. He had been institutionalized in a long-term care facility for about 10 years, and had declined to the point of near-immobility. Paul had short-term memory loss but was very social. At on time, he had been the hallway “ambassador” for his unit, greeting people as they entered. He had attended almost every social activity and outing.
Paul’s condition declined to the point where he required a mechanical lift for transfers. He was unable to propel his wheelchair. His skin integrity was so fragile that the decision was made by nursing that he could only get out of bed for one meal every other day: any more time spent in his wheelchair would result in a pressure sore.
Paul’s social interactions were extremely limited, and he resorted to hollering out at people as they walked by his room or pushing his call button frequently to attain social contact. He was unable to feed himself while semi-reclined in bed, and had begun to choke on his food. In one episode his choking was so severe that he became cyanotic and was sent to the emergency room. The nursing staff obtained an OT consult, specifically requesting a Broda chair. Although Paul had been unable to propel a standard wheelchair, it was felt that he would be able to propel a Broda chair, which moves with less effort. Therefore, the chair was ordered with big wheels as well as a basic padding package. Paul got his “Cadillac”, as he called it.
The result of having this chair was that Paul was able to be out of bed for meals every day without skin breakdown. He was able to sit in the hallway and socialize, rather than be confined to his bed, sometimes facing away from the door. He was able to resume feeding himself because he had the strength to do so while sitting upright, and he was able to go off of his unit for social activities. Paul’s breathing improved, outlook improved, and the staff was less frustrated. Paul was even able to propel his wheelchair about 50 feet, using airline tubing wrapped around the push rims to improve his grip function.