Question
What would you recommend in terms of frequency of reassessing a client when you’re dealing with a chronic or a more fixed condition, like a fixed kyphotic posture or a fixed scoliosis? What would you generally recommend in terms of periods of reassessment of their positioning, not so much for acute conditions, but for longer-term, chronic conditions?
Answer
One of the things you have to consider when you put somebody into a positioning system, you need to determine whether or not there’s anything else you can do for them as far as a restorative nature of treatment or if this is a permanent contracture that you are compensating for. That will be important in helping you to determine how regularly you will be re-assessing them. It also depends on the age of the person and the setting. Some settings where you have an individual that is a captive audience, such as in long-term care, a regular assessment on a three-month basis is probably the best example, because people will continue to go through changes and need to be re-assessed.
But, when you are working with people outside of an institutional setting, like an outpatient setting, it’s that caregiver education piece that comes into place, and the patient education piece where you’re educating on them on checking skin integrity issues, checking areas where they feel more pain or discomfort. Then they will come back to you and let you know what they feel or what they see, which is the signal that it is time for you to re-assess them. So, I think the setting is the critical piece, and in an outpatient or non-institutional setting, it is important to educate both those caregivers and the clients, because they’re the ones that are going to notice a change or problem quicker and should be able to tell you that they need to be re-assessed, which is a more effective approach instead of just saying, “Why don’t you come back for reassessment and I’m gonna look at you in three months. It doesn’t take long for skin to break down, so I think it’s critical that you educate them so that they can come back to you whenever they need you.
