Power Wheelchair Assessment - Virtual

Patient Information Johnathan Smith 123456789 15 March 1965 Reason for Visit Johnathan requires a power wheelchair due to severe osteoarthritis, which limits his mobility and causes significant pain when using manual aids. Medical History - Osteoarthritis - Hypertension - Total knee replacement in 2018 Current Mobility Status Johnathan currently uses a manual wheelchair, but experiences fatigue and difficulty navigating uneven surfaces. Home Assessment The home entrance has three steps, and there is no existing ramp. The garage is not wheelchair-accessible. Proposed solutions include installing a ramp at the main entrance. Power Wheelchair Assessment Johnathan demonstrated ease of use with the power wheelchair, though adjustments are needed for posture. - Seat width: 18 inches - Seat depth: 20 inches - Seat to floor height: 19 inches - Backrest height: 22 inches - Cushion type: Gel cushion for pressure relief - Footrest adjustments: Required for optimal comfort Patient Physical Assessment - Height: 175 cm - Weight: 85 kg - Upper body mobility: Adequate for power wheelchair operation - Cognitive assessment: No impairments noted Recommendations - Proposed power wheelchair specifications: Model X200 with custom gel cushion and adjustable footrests - Suggested home modifications: Install a ramp at the main entrance and widen doorways for accessibility Follow-up - Next steps for application process: Complete funding application and submit necessary documentation - Instructions for accessible ramp planning: Consult with a contractor for ramp installation Payment Information - Payment method: Insurance coverage with supplemental government funding - Billing details: Invoice to be sent to insurance provider