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Functional Mobility & Wheelchair Assessment
HOME ENVIRONMENT: House Condo/town home Apartment Asst living LTCF Own Rent Lives alone Lives with others - Hours without assistance: Home is accessible to patient Storage of wheelchair: In home Other Comments: COMMUNITY : TRANSPORTATION: Car Van Public Transportation Adapted w/c Lift Ambulance Other: Sits in wheelchair during transport
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Functional Mobility & Wheelchair Assessment
www.numotion.comThe least costly alternative for independent functional mobility was found to be: Crutch/Cane Walker Manual w/c Manual w/c with power assist Scooter Power w/c std joystick Power w/c alternative control Requires . dependent care. mobility device . Functional Processing Skills for Wheeled Mobility
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