Are you an #OT wondering when it is best to recommend a Broda vs a Geri Chair? Top tips to help you and your patient decide what is best for them! | Seniorsflourish.com #occupationaltherapy #SNFOT #homehealthOT #OTlove

When to use a Broda Wheelchair vs a Geri Chair

Mandy Chamberlain MOTR/L Education & Tips for Independent Living 6 Comments

As occupational therapy practitioners, sometimes making the recommendation for a wheelchair can be hard, especially for a person that doesn't quite fit the norms of a standard seating and positioning.

One of the questions that I get asked is "How do you know when to recommend a Broda Wheelchair over a Geriatric (“Geri”) Chair?" So I went right to the source and teamed up with Broda to help answer this question!

But first, let's define what each of these are.

Broda is a wheelchair company that traditionally offers tilt-in-space positioning chairs with the Comfort Tension Seating® system which prevents skin breakdown through reducing heat and moisture for people in any type of healthcare setting, but commonly used in long term care/skilled nursing facilities or home care.

Many times, I choose a Broda product for people that need a high level of positioning or special adaptations due to things such as severe scoliosis, knee contractures, skin breakdown, Huntington's or if they have had repeated falls. 

Broda products are classified as Durable Medical Equipment (DME) Class1 Mechanical Wheelchairs (IOR), which means in some cases and jurisdictions Broda’s chairs and wheelchairs are available for funding! Because they are categorized as DME, they require premarket clearance based on a much more extensive validation, established guidelines and standards, ensuring high safety, mobility and patient outcomes. 

EXAMPLE OF A BRODA PRODUCT: THE SYNTHESIS TILT RECLINER

Example of a Broda Product: The Synthesis Tilt Recliner

 

Broda's Comfort Tension Seating® System

Broda's Comfort Tension Seating® System

Conversely, Geri Chairs (like the Drive Medical Recliner) are classified as mechanical chairs (INN) which does not require FDA clearance or testing based on consensus standards. It is designed to allow someone who is mainly in bed, to be able to sit comfortably in a variety of positions while being fully supported. 

Many times I may recommend a Geri chair because the patient may need a more substantial, and many times less restrictive, seating platform than is provided by a conventional wheelchair.

For clients that are non ambulatory, Geri chairs can be comfy, roomier, recline and are easier to "lounge" in.

Example of a Geri Chair: Clinical Care Geri Chair Recliner by Drive Medical

Example of a Geri Chair: Clinical Care Geri Chair Recliner
by Drive Medical

Let's go through some of the times you would want to use Broda wheelchairs vs a Geri chair and then I will highlight some of the features that I love about Broda:

When to Recommend a Broda Wheelchair:

1. Change in Condition

As the patient’s condition progresses/changes, it is important that they are reassessed to assure they continue to use equipment that will meet their needs, provide them comfort and keep them safe. The need for reassessment can be identified by:

BRODA’S SYNTHESIS TILT RECLINER WITH HUNTINGTON’S SPECIAL PADDING

Broda's Synthesis Tilt Recliner with Huntington's Special Padding

2. Change in Medication (dosage, frequency, etc.)

Patients that are utilizing equipment that no longer meets their needs can result in symptoms and conditions that may cause a change in the use of medications. This can be identified by verbal and non-verbal cues such as:

  • Increased reports of pain
  • Complaints of new pain
  • Behavior changes due to discomfort, pain, and inability to verbalize need
  • Increased symptoms such as; swelling of the upper and lower extremities, numbness of the upper and lower extremities, back pain and hip pain
  • Increase in use of pain, psychotropic and other medications due to the above
BRODA’S SYNTHESIS TRANSPORT CHAIR

Broda's Synthesis Transport Chair

3. "Behavioral" Changes 

Prolonged discomfort can cause increased pain and exasperate other symptoms facilitating a change in the patient’s behavior. For patients who are unable to verbalize their needs, these changes may show in the form of frustration or aggression. This can be identified by verbal and non-verbal cues such as:

  • New or increased signs of aggression
  • New or increased episodes of frustration
  • Increased attempts to exit the chair increasing fall risk
  • "Behavioral" changes such as aggression, crying, frustration, yelling etc.
  • Implementing use of restraints to keep patient seated safely
  • Increase in use of psychotropic medications (to calm patient)
Broda's Encore Pedal Rocker

Broda's Encore Pedal Rocker

4. Increased Time in Bed (Decrease in ADLs and Social Participation)

The patient’s sitting tolerance and ability to socialize may change due to using a wheelchair that no longer meets their needs. Over time, modular seating systems no longer provide the comfort they once did. When patients become uncomfortable sitting in their wheelchair they begin to spend more time in bed potentially increasing their risk for pressure ulcers, fall risks, and other issues. This can be identified by verbal and non-verbal cues such as:

  • Increased pain
  • Increase in use of pain and psychotropic medications
  • More time spent in bed, inability to socialize (resulting in isolation and depression)
  • Postural changes such as slumping, sliding and lateral lean while seated
  • Increased symptoms such as; swelling of the upper and lower extremities, numbness of the upper and lower extremities, back pain and hip pain

Some of my Favorite Broda Features:

  • Ability to drop seat height much more than a traditional wheelchair to get the person's feet in a good position on the floor if they are a "foot ambulator.”
  • The Encore Pedal Rocker provides a caregiver activated gentle rocking motion for people that need the sensory input to reduce agitation. I have also used this feature to compensate for fluctuating rigidity or spasticity since it "moves" with the patient.
  • They are pretty indestructible  - I have had some of my most physically challenging patients use a Broda product because they have destroyed some of the other wheelchairs due to hypertonicity and severe tremors.
  • You don't need additional cushions! The Comfort Tension Seating feature provides all the pressure relief required.
  • It can recline flat! This can certainly come in handy when a carepartners needs to assist in individualized toileting needs.
  • Great for people that are difficult to position such as someone with severe kyphosis or chorea due to Huntington's Disease.

When To Recommend a Geri Chair:

Are you an #OT wondering when it is best to recommend a Broda vs a Geri Chair? Top tips to help you and your patient decide what is best for them! | Seniorsflourish.com #occupationaltherapy #SNFOT #homehealthOT #OTlove

1. Comfort is Top Priority

When no other wheelchair can create the comfort required, a Geri chair is a good option. It is comfortable for long periods of time and perfect for patients that would otherwise spend most of the day in bed.

2. Cannot Tolerate Sitting Upright

If a wheelchair is not comfortable, even in a reclined position, a Geri chair provides a carepartner to get the person out of bed, be comfortable and enjoy socialization out of the bedroom setting. It's use is mainly in long term care facilities.

When do you like to recommend using Broda vs a Geri chair?

Comments 6

  1. Do you have any insight into how to get a facility to order a new wheelchair for a patient? We have multiple Broda chairs and Geri chairs, but they are in use for LTC residents. So when another resident experiences decline I have to go on a scavenger hunt for some chair that *might* be appropriate. Brodas are so expensive, so we’ve never ordered a new one.
    Also any insight into Rock N Go chairs? I use them very often as an only option for declining patients.
    This article was very helpful and made me feel more confident in the decisions I was already making for pts positioning!

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      It is so hard sometimes! I think sometimes you have to advocate HARD or talk to your DME provider to see if there are any options for insurance to purchase a wheelchair. When someone lives in a SNF, it is their home and so it is the facility’s responsibility to provide the basic needs of the resident. It is a grey area where the facility starts deciding what is “medically necessary.” Some states’ (I have heard) medicare/medicaid systems are different, so it might be helpful to be educated on your state’s rules and regs regarding wheelchair purchase in SNF.

      I do not have experience with the Rock n Go wheelchairs – does anybody else have insight into these? Do not know about the pressure relieving features, but I am glad that you are able to have something that makes the patient comfortable and more mobile.

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  2. High back chair with elevating legrests will allow for multiple position changes and are more cost effective. They do not have a tilt in space function which could be approximated with a wedge cushion.
    Keep in mind that tilt in space function can/has been considered a restraint just like a seatbelt and you will need documentation to use it.
    Difficulty with gerichairs is that nobody fits into them and they are impossible to push. There are multiple chairs on the market that have the tilt in space function, and reclining back. Wheelchairs are included in the reimbursement rate for nursing home patients so most facilities have a one size fits all consequently fits none.
    But to answer your question simply based on ease of propulsion if both are available I’d take the easier to propel one but advocate for a well fitted one.

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