2016 HME Handbook

How to Assess a Client's Ramp Needs

Approaching a ramp install starts with an assessment that should incorporate various elements.

• By David Kopf
• Jun 01, 2016

Truly grasp the patient’s needs. The goal of assessment is a holistic understanding of the patient’s circumstances, so take some time and ask questions to get a solid sense of your patients’ condition, needs and how they plan to use their ramps and how often. For instance, there is a good deal of difference between a younger person with an athletic build using a manual chair, and a patient in a powered complex rehab chair with a seating solution. The weights are different, the centers of gravity are different and the user capabilities are different.

That said, don’t let your eyes fool you. A young person might seem totally fine to go up a long ramp using his or her manual chair, but if he or she is entering and leaving the home repeatedly then the patient still might get tired as the day wears on, so a ramp with some landings might be advisable from a safety and convenience standpoint. Also, what if the patient has a degenerative condition? There are many factors involved in each patient’s need. This is why a good place to start with patients is to get a broad sense of their situation.

Safety is the top priority. Starting with the basics, there must be a foot of ramp for every inch of rise between the ground the entry way. But the ground in front of a house is rarely flat, so the provider will need to survey the lay of the land, and adjust accordingly. For example, let’s say there is 12 inches of rise. The provider can simply go 12 feet out and start installing the ramp, it needs to see what the terrain is like over that 12 feet. A good way to do that is through a string level. The provider might discover, for example, that the ground falls away by that 12 feet by another 8 inches, so the provider will actually need to install 20 feet of ramp. Furthermore, the ramp can’t simply butt up to the front door. There needs to be ample space for the patient to come to a stop, open the door and enter.

Make economic use of the available space. That last thing a patient wants is a ramp that completely dominates the front of the home. The ramp should have as small a “footprint” as feasible. A simple corner with a landing can radically reduce the space a ramp takes up. Likewise, it can also decrease the amount of “visual space” that a ramp consumes, which can be important in terms of aesthetics. That means the provider needs to have a solid understanding of the modular ramp offerings available so that an installation takes up as little space as possible.

Aesthetics are an important consideration. Chances are, your client place a good deal of emphasis on the ephemeral concept of “curb appeal” — how a home looks from the street. That shouldn’t come as a surprise, given that it is there home. For instance, a patient might not like how a lot of aluminum ramp might look in the front yard. Also 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.

That means you want to offer a range of solutions that will complement the residences in the areas you are serving. The goal is to provide something that pairs well with the exterior looks of the home while still providing serviceable access to it. Regularly take the time to review what is available from various ramp vendors and consider whether or not your businesses should expand its range of offerings. Also, make sure you’re up to speed on local homeowners associations’ covenants, conditions, and restrictions, as some might have specific rules regarding access equipment and installations.

Durability is a key factor. If you’re looking to build a client relationship that will last for years, then the ramp has to stand up to years of abuse. That means you have to balance your patients’ design sensibilities with durability priorities. The ramp must stand up to the elements. Make sure the materials and fittings will stand up to the local weather, and that high-traction, no-slip surfaces are installed to ensure safety. Bearing this in mind, have solid familiarity of each product’s suitability for the weather, and each vendor’s warranty in this regard.

Understand the patient’s complete access situation. While you’re there to assess the patient’s ramp needs, that doesn’t mean you should stop at the ramp. For instance, starting at the front door, you will need to install a threshold ramp to ensure a mobility patient can safely get through the front door and into the home. And, in some cases the patient might need a wider doorframe.

And that’s just at the front door. Access to other parts of the home, bath safety and related accessibility concerns could be factors as well. Take a careful study and ask probing questions, but at the same time, don’t overwhelm the patient with upsales attempts. Focus on the ramp, and consider how you might make a proposal later on.

This article originally appeared in the June 2016 issue of HME Business.