How to Keep Your Equipment Clean

Guest blog post by Bob Vogel

One of the perks of being a journalist is having the opportunity to attend many wheelchair events — like the Abilities Expo. One of the things that puzzles me — you may have noticed it, too — are wheelchair users who have a disconnect between how they dress and how they care for their mobility equipment. I could never figure out how somebody takes the time to be clean and dress well, but neglects cleaning their chair. A quick reminder — spending a few minutes wiping down your chair with a damp cloth or having your personal care attendant clean it for you — does wonders for your appearance.

People DO notice whether your chair is clean — or not. My wife — now ex-wife, good friend — said one of the things she noticed about me when we first dating was that I kept my chair clean. To her, this is a sign of self-confidence and comfort with my disability. She found this attractive.

Even more important than keeping your chair clean is making sure to keep your cushion clean! Keeping a cushion clean is something I rarely hear mentioned, but it is important — a cushion can get pretty funky if you don’t clean it now and then. We get used to our own odor, so if our cushion starts smelling rank, we probably won’t notice it. However, other people do notice the odor. To make matters worse, it is unlikely that even your close friends and family will tell you because there doesn’t seem to be a polite way to say it. Here is a hint — if people seem to give you a lot more personal space than everybody else, you may want to do some cushion cleaning.

The first step in avoiding cushion odor is to wash your cushion cover on a regular basis. After all, we change our underwear every day — I hope. I have two cushion covers and I change mine every couple of days. Standard size ROHO cushion covers can be purchased at authorized online retailers or The ROHO Store. Cushion covers can also be purchased at your local DME dealer. I find washing the covers on the “gentle” cycle and hang drying them helps them last much longer.

To purchase a cover for a custom size ROHO cushion, call customer service at 800-851-3449. The average cost of a custom cushion cover is around $70. Be sure to have the serial number of your cushion handy when you call. It’s printed on the white tag on the bottom of the cushion.

The next step to avoiding cushion odor is cleaning your cushion on a regular basis. With a ROHO cushion this is a quick and easy process. I give my cushion a quick clean every week or two when I’m in the bath or shower. I grab my cushion (still inflated with the valve closed) remove the cover and take it into the tub or shower with me. I clean it with a washcloth and soap — I use Irish Spring — by gently scrubbing around all the air cells, rinse thoroughly, especially around each cell and then towel dry around each cell. The process takes about 3–5 minutes total.

In-depth cleaning instructions can be found on The ROHO Group’s website at Cleaning and Disinfecting ROHO^® DRY FLOATATION^® Products.

For stubborn odors, like dreaded bladder or bowel accidents, go to the section on deodorizing under Cleaning and Disinfecting ROHO® DRY FLOATATION® Products.

Here are the directions:

• Deflate the cushion and close the valve(s). Make a mixture of one tablespoon of baking soda per quart of water (25 gm/l) or a solution of 1 part vinegar in 10 parts water — make enough to soak the cushion in deep wash basin.
• Soak the cushion in the basin for several hours, rinse and let dry. For really stubborn odors you may need to repeat the process.

I find using some type of weight — I use a small barbell — keeps the cushion immersed in the solution. It helps if you have an extra cushion — see “How Often Should You Replace Your Cushion?” — to sit on while the other one is being cleaned.

Remember to keep your mobility equipment clean. Here is to hoping that a significant other — or potential significant other — notices the effort!

 

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Bob Vogel, 51, is a freelance writer for the ROHO Community blog. He is a dedicated dad, adventure athlete and journalist. Bob is in his 26th year as a T10 complete para. For the past two decades he has written for New Mobility magazine and is now their Senior Correspondent. He often seeks insight and perspective from his 10-year-old daughter, Sarah, and Schatzie, his 9-year-old German Shepherd service dog.

 

How Often Should You Replace Your Cushion?

Guest blog post by Bob Vogel

Two questions I’ve frequently been asked at consumer shows is, “How often should I replace my cushion?” and, “How often will insurance pay for a new cushion?” These are important questions. Every brand, make and model of cushion will break down over time. When this happens the cushion no longer supports and protects your skin the way it was designed — putting you at risk of a pressure sore. It is important to replace your cushion long before this happens.

A good rule of thumb is to replace your cushion every three years — which is how often most insurance companies will pay for a new one. To arrive at this answer, I turned to Dave McCausland, Senior VP of Planning & Government Affairs for The ROHO Group. McCausland says in general, Medicare sets the trend for how often a new cushion will be paid for — Medicaid and private insurance companies tend to follow Medicare’s lead. McCausland has studied Medicare guidelines and says although they don’t specify an exact length of time on how often they will pay for a new cushion, he is confident they will pay for a new one ever three years.

Another reason to request a new cushion every three years is that the ordering process is slow. It’s much better to be evaluated by your clinician and order a new cushion while the cushion you are sitting on is still in good condition and you are in no hurry. Waiting too long to order a new cushion may risk developing a pressure ulcer from sitting on an older cushion that may be breaking down. Getting a new cushion every three years has other benefits as well. You can keep your old cushion for back-up use, use it as a spare to sit on while you are cleaning your newer cushion, and you can place it on the seat of your car for extra skin protection.

Sometimes circumstances require a new cushion before 3 years. It is crucial to check the skin on your butt with a mirror every evening and every morning. If you start seeing that your skin is red after a long day of sitting, it is important to ask your doctor for a referral to a seating clinic for a seating evaluation with a clinician — a PT (physical therapist) or OT (occupational therapist).

“Anytime the cushion you are on is proving ineffective at protecting your skin you should look into getting a cushion evaluation for a new or different cushion,” says Jim Munson, District Manager for The ROHO Group. Munson adds that anytime you have a documented change of medical condition that effects your skin, such as weight gain, weight loss, or the cushion you are on is no longer effective, insurance should pay for a new cushion.

So three years have passed and it’s time to get a new cushion — how do you go about it? First of all — be a squeaky wheel — ask! Munson says the usual, and easiest route is to go to your local DME (durable medical equipment) supplier and tell them you need a new cushion — they will be happy to guide you through the step-by-step process of getting a cushion based on your seating needs.

If you don’t already have a working relationship with a DME supplier, locating one is your next step. ROHO makes this easy. To find a DME supplier go to www.therohogroup.com/where_to_buy.jsp and click on Buy from an Authorized Retailer Near You.

You can find Medicare DME provider(s) in your area by going to www.medicare.gov On the main page pull down Resource Locator, scroll down to Medicare Supplier Directory, from there type in your zip code and hit submit. On the next page check Wheelchair Seating/Cushions and hit view results. The “default” setting on View Results is 10 miles — to find more DME supplier options it is helpful to expand the View All Suppliers Within (on the right side of the page) to a larger distance in order to find a Medicare DME provider that is also a ROHO authorized retailer.

Your DME supplier will team you up with an ATP (Assistive Technology Professional) certified through RESNA (Rehabilitation Engineering and Assistive Technology Society of North America). It takes experience, training and testing to earn an ATP certificate. It is a cool idea to ask the person working with you with if they are an ATP — a certified ATP will be proud you asked.

The ATP will gather your information, current wheelchair, cushion, insurance information, etc. They will contact your physician and get a referral for a clinician to do a seating evaluation.

The goal of the seating evaluation is to find out if your present cushion is still appropriate, or whether your body changed that may require an adjustment in cushions — say going from a ROHO® LOW PROFILE® Cushion to a ROHO® HIGH PROFILE® Cushion. Following the seating evaluation, the clinician takes the information and writes a Letter of Medical Necessity to submit to the insurance company for your cushion.

As I mentioned in an earlier blog, Why You Need to Ask For Your Cushion by Name during your seating evaluation it is vital to speak up and tell the clinician that the Letter of Medical necessity and the doctor’s prescription needs to include your exact seating needs, for example ROHO® HIGH PROFILE® Single Compartment Cushion (4″). Make sure that the dimensions of the cushion needed is included on the prescription, for example 16″ x 16″. This ensures your new cushion is the exact cushion you need and expect.

From there the ATP gathers and organizes all the documentation and the DME supplier submits the paperwork to the insurance company for approval. If all goes well your cushion is ordered and you are soon styling around on a new cushion.

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Bob Vogel, 51, is a freelance writer for the ROHO Community blog. He is a dedicated dad, adventure athlete and journalist. Bob is in his 26th year as a T10 complete para. For the past two decades he has written for New Mobility magazine and is now their Senior Correspondent. He often seeks insight and perspective from his 10-year-old daughter, Sarah, and Schatzie, his 9-year-old German Shepherd service dog.

Two ROHO Employees to Present at European Seating Symposium 2011

Dave McCausland, Senior Vice President of Planning and Government Affairs, and Bart Van der Heyden, PT, Director of European Training and Education, will present at the European Seating Symposium in Dublin, Ireland, from November 7–10, 2011.

Dave McCausland will be presenting “Cushion Characterization” on Wednesday, November 9 from 12:00–1:00 p.m. in the Dublin Room, Liffey A with Dave Brienza. The session will cover risk factors for developing pressure ulcers in nursing homes. It will also discuss a randomized control trial on the prevention of pressure ulcers with wheelchair cushions.

Bart Van der Heyden will be presenting “Why Similar Seating Problems are Solved Differently Across Europe” on Thursday, November 10 from 12.00–1.00 in the Eindhoven Room, Liffey Meeting Room 2. The presentation will discuss how perception of disability impacts medical care, with a focus on seating assessments. The perception of disability has shifted from a ‘medical model’ to a ‘social model.’ The ‘medical model’ treats the physical problems and tries to find a way to fix it. It focuses on how to cure. By distinguishing between impairment and disability, the ‘social model’ and creates an environment of inclusion and promotes a person’s abilities, rather than disabilities. The key learning objectives are:

• Understand how perception of disability impacts service delivery and AT provision
• Understand the importance of respecting the individual’s wishes, even when there are medical concerns that need to be addressed
• Assess the relevance of different seating assessments
• Seating techniques and seating interventions on several case studies in multiple care settings

The Symposium will be held that The Convention Centre Dublin off the River Liffey in Dublin, Ireland.

Click here for the European Seating Symposium’s program.

The ROHO Group will be exhibiting at booth F7 at the back right corner of the Exhibition Hall. Stop by the booth and say hello to the ROHO team members.