Case study: David
"My name is David. I am 51 years old and sustained a spinal injury in 1977 in a sporting-related accident. At the time I was 19 and thought I was 'bullet proof' & that nothing could hurt me permanently.
My accident was a big awakening and after 12 weeks of acute care for my body to adjust, I started to realise that injury was nothing like a broken leg and that this paralysis was permanent.
Initially, my level of disability was classified as a "C5-6" complete quadriplegic. But in 1993 I had a fall in my wheelchair which caused further trauma to my neck and a fracture of my hip that did not heal well, resulting in poor posture. To complicate things further, I then developed a spinal cord syrinx which caused a deterioration of my injury to a C4 quadriplegic. I have had to adapt my life around the continuing changes to my body shape over the years which in turn have affected my sitting arrangements in the wheelchair.
With my original accident in 1977, it didn't take too long for me to realise how important the health professionals and clinicians would be in my rehabilitation and ongoing care. Associated with this was the ongoing role of the seating clinic and how it would require a long term relationship for advice and guidance with regards to caring for my skin in particular.
The seating clinicians helped overcome problems with pressure sores and this in turn gave me confidence of not having to worry about spending long periods of time in my chair and the consequences of a pressure ulcer, such as long periods in bed for pressure management and not being able to work.
When being assessed by clinicians, I found it important that my thoughts and suggestions were taken into account. Having confidence in the staff, especially on a professional level, means a lot to me because there were times when I have had to trust their recommendations and professional judgement.
The time spent working through seating and wheelchair issues over the years has reinforced how important it is to be treated as an individual. I used mouth sticks to access my phone and computer on my wheelchair tray. Small things make such a difference especially when it comes to pressure care and sitting posture that allows me to do things in my home and my work."
We would like to thank David for sharing his experience.
David’s account describes the changing nature of seating and wheeled mobility requirements over time for a person living with SCI. Medical complications and ageing have further impacted on David’s functional, postural and pressure care needs. It is a high priority for him to be safe and properly positioned in his power wheelchair so he can drive and use other assistive technology in his environment. He notes the importance of effective communication with, and trust in the therapist to achieve positive outcomes. This perspective concurs with the client-centred approach and the need for the systematic assessment and intervention processes described in the following study modules.