- a person who thinks or behaves in their own original way
- a single person or thing, especially when compared to the group or set to which they belong
Last week saw Permobil launch their latest brand video ‘Innovating for Individuals’ which includes a message that goes beyond marketing and extends into good clinical practice.
‘We are all individuals with unique interests, needs and goals.’
‘Instead of searching for the things that we do the same, lets champion the things that set us apart.’
Humans are interesting creatures, many of us love being a part of something greater than ourselves – we take great pride in the sports teams we follow or the ethnic or religious groups we associate with, however we also love being seen for who we are as individuals. None of us like being referred to by a label, nor are we happy when others make an assumption about us based on a group that we may belong to.
As therapists we are typically loyal to our profession and will often playfully tease other professional groups, however each profession is made up of a diverse range of individuals.
The same holds true of those with a disability – some may associate strongly with others with the same condition, but each is an individual with their own unique hopes and dreams.
In recent years there has been a shift in how we refer to those who access health services, from ‘patient’ to ‘client’ to more recently the ‘person’, reflecting the person who exists outside their need to access health care. The person who has a family and friends, hopes and dreams, wishes and desires like each of us reading this blog. The person wants to be seen for who they are, not by the health challenge they have or the intervention they require.
As therapists we know this to be true, however sometimes the nature of how organisations operate or the funding models we obtain equipment from can impact on how well we ‘see’ a person – we might be contracted to provide an intervention that may or may not be what the person actually needed or wanted, or we may be focused on ‘functional’ or ‘essential’ mobility instead of a person’s goal to play cards with their friends at the local bridge club.
Thinking of a person as an individual is incorporated into the ICF model, in particular identifying the personal factors about that person. ICF personal factors include gender, age, coping styles, social background, education, profession, past and current experience, overall behaviour pattern, character and other factors that influence how disability is experienced by the individual.
Taken from the ICF manual, ‘the functioning of an individual in a specific domain reflects an interaction between the health condition and the contextual: environmental and personal factors’, with a complex, dynamic and often unpredictable relationship between these entities. In other words, how the different aspects of the ICF interact with each other is complex, with a person’s environmental and personal factors helping give context to how the person is functioning.
Like the other ICF domains, personal factors include factors that are modifiable and non-modifiable, with aspects such as age, race, and time since injury being non-modifiable. Other factors such as level of education, marital status and personality are deemed modifiable, reminding us that as humans a part of us will change over time. The review by Smith, Sakakibara and Miller (2016), which explored factors influencing participation in social and community activities for wheelchair users, the one personal factor identified related to the level of education. Higher levels of education were associated with increased access to employment opportunities, which is likely linked to greater levels of participation in the community in general.
These personal factors can be what makes clinical practice meaningful – many of us enjoy meeting and getting to know new people and helping them achieve their goals in what can be some challenging times. The personal factors mean that providing a power wheelchair for a person with Cerebral Palsy becomes facilitating Andy being able play with his friends on the field at lunchtime. Or providing a manual wheelchair for a person with Multiple Sclerosis becomes helping Jane remain employed in a job she loves.
I still remember the lesson from physio school about how different people with the same problem can present differently – the example given was how 10 people with a sprained ankle may need 10 different strategies to manage their injury. The same holds true for wheelchair prescription. 10 different people with the same presentation of Motor Neuron Disease may require 10 slightly different solutions and these differences can be the difference between a person achieving their goals and thriving, or potentially abandoning their equipment. An example that comes to mind was the mother who requested a manual tilt in space chair in place of a power wheelchair – as they did not have the means to transport a power wheelchair, and being able to watch her children play sport was more important to her than independent mobility around her home.
- to develop a new design, product, idea etc
- to introduce changes and new ideas
Innovation is what has helped the industry move forward with new solutions, often prompted by wheelchair users wanting to achieve more. As science and technology move forward so do our solutions – we have power assist solutions that are lighter weight, more reliable and more durable. We have manual wheelchairs that are lightweight yet strong, and we have power wheelchairs that are ‘smarter’ and going further. However, the journey towards better products is ongoing, with manufacturers continuing to show innovation either with developing new products or improving on their existing, not content that what we have now is the best that can be achieved.
Innovation can be also something we strive for in clinical practice, particularly when we have a person who requires more than what off the shelf items can offer. It might be that we are modifying an existing item, repurposing an item or having an item custom fabricated by a technician or manufacturer. Whether it’s the arm support that sits at just the right height in just the right place to maintain an independent transfer, the custom swing away tray that allows a person to carry items independently but also transfer independently out of their chair. Or the alternative drive controls that set up and programmed just so to keep a person driving.
While the “Innovating for Individuals” brand video is ultimately a great marketing tool, it has also captured the sentiment of the industry, an industry many of us are part of as:
‘We believe everyone should have the right to live the life they want for themselves’.
Smith, E.M, Sakakibara, B.M. & Miller, W.C. (2016) A review of factors influencing participation in social and community activities for wheelchair users. Disabil Rehabil Assist Technol. 11(5): 361-371
How to use the ICF – A practical Manual for using the International Classification of Functioning, Disability and Health (ICF) downloaded from https://www.who.int/classifications/drafticfpracticalmanual.pdf
Clinical Education Specialist
Rachel Maher graduated from the University of Otago in 2003 with a Bachelor of Physiotherapy, and a Post Graduate Diploma in Physiotherapy (Neurorehabilitation) in 2010.
Rachel gained experience in inpatient rehabilitation and community Physiotherapy, before moving into a Child Development Service.
Rachel moved into a Wheelchair and Seating Outreach Advisor role at Enable New Zealand in 2014, complementing her clinical knowledge with experience in NZ Ministry of Health funding processes.
Rachel joined Permobil in June 2020, and is passionate about education and working collaboratively to achieve the best result for our end users.