From: xxxxxx@xxxxxxxxxxxxxxxxxxxx [mailto:xxxxxx@xxxxxxxxxxxxxxxxxxxx] On Behalf Of Amy Roman
Sent: Wednesday, July 16, 2008 2:02 PM
To: xxxxxx@xxxxxxxxxxxxxxxxxxxx
Subject: RE: [Assistive Technology] Mounting, eye gaze and Advanced Stage ALS- vote for comb

Hi,

I will add my vote even though I gave it to you this morning during a phone chat.  :-)

I am a big fan of combo mounts (wheelchair/rolling) for most clients with ALS since people often spend time in their beds, ez chairs and power chairs. Most of the vendors do offer a combo package that gets billed as one mount and therefore we can take care of our client's home and community communication needs more thoroughly.  I am so happy that the availability of combo mounts means I don't need to make clients choose where it is more important for them to be able to communicate with their SGDs anymore. 

The key with rolling mounts is to actually take some measurements of all the places they are going to be used.  Clearance under furniture is easy to overlook but important.  If they can't slide under a client's favorite ez chair then an offset rolling mount may need to be ordered. Sometimes they will fit under a low bed or chair if you just take off the wheels and put felt on the bottom.   Also, they need to have a long enough arm to allow the client to be centered in the bed.  In addition make sure the mount allows for tipping the eyegaze system in all directions.  If a client's head is resting on his right shoulder, today's eyegaze systems needs to be tilted just like the head.  Finally do you want it to be tall enough that it can go over the client's head if the client is fully reclined?   Ordering longer poles and offset versions is often required.   

In reality I don't see/hear that many of my clients are taking their power chair mounted eyegaze systems out of their homes frequently.  Mainly, like Amy W. mentioned, they are using them in their power chairs at home.  I think these systems may head out the front door more often as we begin to provide them earlier in the diagnosis and as they become more streamline and handle head movement better.  Pure speculation.

Amy

Hi Margaret,

I doubt that this is the trend…

Of our advanced stage PALS who are currently using an eye-gaze system, 7 are wheelchair mounted and 3 are on rolling mounts.  

Recently, our patients have verbalized a preference for wheelchair mounting when given the option.  In some cases, we’ve had to spend a considerable amount of time getting the wheelchair mount just right for calibration accuracy and to ensure that caregivers can easily work around it or remove it as needed.   We’ve also done quite a bit of “rigging” with spare mounting parts.  

These are folks who, though they may be vent-dependent, are still getting out of bed on a regular basis and spend a considerable amount of time in their wheelchairs.   Since positioning can be problematic when trying to calibrate, a wheelchair mount seems to offer more stability and consistency. 

One patient, who does spend the majority of his day in bed, has his wife drive his chair over to him and swing the mount around so that he can access his system from bed. 

I’ll be curious to hear your thoughts!

Amy    

There is something I’ve been curious about for a while.-

I’ve been thinking about eye gaze systems, mounting, and folks with advanced stage ALS.

I wanted to take an informal survey - do people think that most folks with advanced ALS would generally be using a rolling mount for an eye gaze system, or a mount attached to a wheel chair?

(I have my own thoughts on what I think most PALS would be using, but I thought I would check with the group first ;-)

Thanks for your help with this-

Margaret

Margaret Cotts, MA, ATP

DynaVox Technologies & Mayer-Johnson