DME Decision-Making
The choice of DME is large and the decision may appear confusing. Among other things, do make sure to consider patient’s ability to pay for DME. These are not cheap, except for small items like canes ($10-15 at Walmart, or Drug Stores). Unlike healthcare that cannot be denied, DME certainly can be denied if no payment source. Do not promise DME without verifying payment source available.
- Walkers
- Wheelchairs
- Bedside Commodes
- Shower chairs & benches
- Oxygen – arranged by Respiratory Therapists on written prescriptions of Physicians
Types of DME with Discussion
Walkers
Walkers Decision: Always best to have rolling walkers in cardiopulmonary cases. A rolling walker decreases the workload by not having to pick-up and advance the device.
Rollators make for the best option in patients with heart failure – it has 4 wheels, and a seat, often with a basket, that is helpful for various purposes.
Wheelchairs
Wheelchairs: Some patients will no longer be able to tolerate gait. One must think of wheelchair-level mobility for these patients.
These are covered by insurance.
Exercise some analytical thought. A standard vs. a large wheelchair? (Often patients with advanced heart failure are also overweight or obese).
Can the patient push the wheelchair themselves? If they cannot, do they have someone to always help? Can the patient be more functional AND be productive if they are independent in pushing the wheelchair by themselves?
In such scenarios, a power wheelchair may be an option. However, analytical considerations in deciding a power wheelchair must ponder over life-expectancy, among other things. If patient is younger or has a chance at longer life-expectancy, then a power wheelchair expense makes sense. Be careful in promising equipment for which you cannot determine patient’s longevity, or, ability to pay for.
In many cases a factor of decision in power-wheelchair selection is the drive mode – front vs. rear vs. other. While beyond the scope of this discussion you can find more information here.
Keep in mind that a cheaper option to a power wheelchair is a scooter which are bulkier but cheaper.
Bedside Commodes
Bedside Commodes: A patient who is not safe to ambulate to the bathroom for any reason will need a bedside commode if they are not bed bound.
There are many types. These are covered by insurance. Consider the types available (see the link – these will evolve over time as new kinds are engineered – so stay abreast of new equipment). A bedside commode (BSC) is best if they have removable buckets which then transforms into a raised toilet seat (RSC) that can be placed above a regular commode in the bathroom. There are BSCs with removable arm-rests if one would serve the cause better.
Shower Chairs
Shower Chairs: Shower chairs are NOT COVERED by insurance. Apparently, they are not considered “essential” items for life. These are not cheap either. One work-around is that a bath/transfer bench is ordered that is actually covered by insurance. With a transfer bench, a patient sits down on the bench outside of a bathtub, then swings legs over into the bathtub. Check the link for examples of Shower Chairs vs. Transfer Benches. Some patients will opt to buy shower-chairs out-of-pocket.
