Home Access:

How to Outline a Checklist for Patient Lift, Ramp Installations

• Jul 01, 2010

For many patients home access lies at the heart of homecare. In HME providers’ quest to ensure that patients are able maximize their quality of life enjoyment and fulfillment being able to ensure patients live in their homes is the penultimate concerns. And to do that, patients must be able to easily access their home.

Two key pieces of home access equipment that make that possible are vertical platform lifts (VPLs) and modular access ramps. However, deciding which access method, lift or ramp, best suits the patient’s need depends on a variety of criteria.

Initial Assessment

The process of determining which home access device is best for the patient begins with assessing their home in person. A key requirement is space. The area must be large enough to accommodate a ramp if need be, and if there isn’t enough space, then a VPL might be the right choice.

Also, the patient’s mobility capabilities might not be as compatible with one device or another. “You might have a manual wheelchair user, and to travel 50 feet might be a little daunting for that person,” notes Valerie Gann Cox, owner of American Medical Mobility LLC in Gainesville, Fla. “You want to know what equipment they might be using on a ramp.”

Aesthetics are another consideration. A patient might not like how a lot of aluminum ramp might look in the front yard. And if there is a home owners association, then there might be rules in place governing the look and placement of home access devices, and obtaining approval for a ramp or VPL might be required. Likewise, if the patient is renting, then the landlord will need to approve.

Another consideration for access methods is whether or not the patient moves from time to time. Modular ramps do not require a building permit, assembled at the house, and, if the patient moves, the ramp can move with them. “All we have to do is change out the platforms and ramp sections to accommodate the new location,” Cox explains.

Obviously, cost can be a factor as well. While a very short, low ramp is going to
be more economical than a VPL, as the length and height of a ramp installation
increases, so does the cost. At that point a VPL might make economical sense or be
a more practical solution and close enough in price that it becomes the best choice.

Safety Considerations

A primary area of concern is ensuring a safe installation. Essentially a self-contained elevator, VPLs range in height from approximately 4 feet to 14 feet and sit next to the stairs leading to the patient’s home. A concrete pad for where the VPL will be positioned is required in order to anchor the device to the ground. “When it’s in the raised position, you’re going to have a center of gravity issue, so you need to have it safely anchored,” Cox says.

To also provide safety, VPLs also include electronically locking gates to ensure that the gates remain closed to ensure no one could fall down from the top of the VPL’s “shaft” when the pad is in the lower position.

For power, VPLs are plugged into a dedicate outlet, which means some wiring could be involved. They also come in AC and DC version to provide an optional battery backup in the case of a power outage. (VPLs include a manual crank for emergencies, but many users’ conditions might limit them from using this option; especially the taller ones.)

To ensure a safe installation for ramps, there must be a foot of ramp for every inch of rise between the ground and the 5-foot-by-5-foot platform that is placed in front of the entryway (the platform provides a level spot for the patient to open and close the door.

“But you also have to look at the lay of the land,” Cox says. “Let’s say you have 12 inches of rise. We take a string level from the front door and see what is the actual measurement 17 feet out. If the ground falls away, say to 20 inches, then you actually need 20 feet of ramp.”

Because American Medical Mobility is in Florida, Cox says her business also installs hurricane anchors on its ramps to enhance safety and prevent them from being damaged by extremely strong winds.

Similarly, durability is important. Ramps and VPLs should support heavier weights if the installation is for a bariatric patient. Materials should also stand up to weather and the elements.

Lastly, there will be installations in which a patient requests both a ramp and a VPL. Sometimes patients will opt for both a ramp and a VPL so that a ramp serves as a backup for the VPL,. “No matter what you do, things can go wrong … so having a ramp at another door is a nice option so that patients can always have a way to get out of the house,” Cox adds.

This article originally appeared in the July 2010 issue of HME Business.