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262 HANDBOOK OF ELECTRONIC ASSISTIVE TECHNOLOGY

Another reason to allow enough clinic time is to ensure that the person is provided with
a fair assessment of whether or not they are able to operate a powered wheelchair. If provi-
sion is to be declined, this could be devastating due to the potential for:
• Loss of independence.
• Reduced self-esteem.
• Increased requirement for funded care.
• Increased dependence on a partner or family member.

All of these factors could reduce the ability of the person to participate in society (World
Health Organisation, 2001). In many cases it will be entirely right that provision is declined
if the person is unsafe. However, this decision must only be taken when the assessor has
furnished themselves with a full set of assessment data, and has had the time to carefully
evaluate the full set of circumstances of the individual.
Clinical assessment is not formulaic. It requires the assessor to evaluate and to synthe-
sise the collated data and information prior to making a decision. As such, an assessment
tool should be used as that alone, a tool to help. Nonetheless, a tool is important because
it provides a template within which to work, and acts as an aide-memoire. Even the most
experienced assessor will require a prompt from time to time. Table 9-1 includes common
assessment areas and rationale.

Table 9-1 Assessment Areas for Powered Mobility and Rationale
Assessment Area Rationale
Aims and expectations, including It is critical that these are understood right at the start of the assessment so that
any problems currently being the person and their situation are integral to the process.
experienced, and related to
occupation and leisure activities
Current equipment and 24-hour Are there other wheelchairs or forms of seating in use? Will their use change
positioning context with the provision of a powered wheelchair? How much of the day is spent in
the wheelchair and how much in bed? How does positioning in bed influence
posture in the day?
Diagnosis This will provide information about the prognosis for the person together with
their capabilities, which will be helpful in guiding equipment selection (it will not
necessarily be definitive).
Current state of health If the person is in particularly poor health, a rapid response may be indicated.
Respiratory status This question may yield information to suggest provision of powered tilt-
in-space. Orientation of the throat/chest to the vertical is critical in these
circumstances and so the need for the equipment to assist may be indicated.
Eating/drinking/swallowing Points as per respiratory status; additionally:
• Will the chair need to be driven underneath a table/kitchen surface?
• Is there an indication for a tray?
• Is there likely to be a need for a mobile arm support to be fitted to the chair
(typically, but not exclusively, for people with motor neuron disease/muscular
dystrophy) and, if so, what are the hardware requirements for having this
fitted (Frank and De Souza, 2015)?