Ensuring Preventive Care for Patients with Spinal Cord Injuries
Caring for a person with a spinal cord injury can pose many challenges. From the injury itself to the psychological, social, and role changes experienced, both the patient and the caregivers can easily become overwhelmed. Unfortunately, this sometimes means that a particular area of care can fall through the cracks, affecting the health and even the lifespan of the individual with an SCI—preventive care services.
Obtaining Preventive Care for Individuals with an SCI
Preventive services are those services that address the secondary level of prevention—finding disease early so that interventions can be promptly initiated. Think about the preventive services that you or your family routinely receive. These probably include:
- Eye exams
- Hearing tests
- Colonoscopies
- Mammograms
- Pap smears
- Testicular exams
- Blood pressure screenings
- Weight monitoring
- Skin checks
Additionally, if you or someone you care for in your family has diabetes, regular preventive care also includes A1C checks, urine protein testing, foot exams, and neurological testing of the extremities. For people with asthma or COPD, pulmonary function testing and blood gas testing are important preventive services.
In addition to all of these, persons with an SCI require even further routine monitoring for systems such as the urinary tract and pulmonary system. Yet when we are teaching the new SCI person in rehabilitation, do we teach about or routinely order these exams for our patients with an SCI or other disabilities? And are the facilities that perform these exams accessible to a patient in a wheelchair who requires assistance with transfers?
Providing Equitable Care for Individuals with SCI
Women with disabilities have noted that they are often treated as asexual and not offered gynecological services.1 Persons in wheelchairs often visit providers who have no way to measure weight if the person cannot stand. Exam tables are often fixed objects that are inaccessible for lateral transfers. Clinic staff are often not trained to perform lateral transfers for persons with paralysis and may also lack the transfer equipment to do so.2
As healthcare professionals, we have the responsibility to:
- Examine the accessibility of our own facilities for preventive exams along with the facilities to which we refer our patents with SCI.
- Train our staff on transfers and care of the person with an SCI.
- Order preventive care exams on the schedule recommended by the United States Preventive Services Task Force (USPSTF) or other specialty organization.
- Teach our patients about the need for these tests.
- Advocate for community education about preventive services.
- Monitor and follow up to ensure completion of preventive services by all patients with SCI and other disabilities.
To learn more about rehabilitation care for the person with a spinal cord injury, watch my MedBridge course, “Rehabilitation Nursing for Spinal Cord Injury.”
- Taouk, L. H., Fialkow, M. F., & Schulkin, J. A. (2018). Provision of reproductive healthcare to women with disabilities: a survey of obstetrician-gynecologists’ training, practices, and perceived barriers. Health Equity, 2(1), 207–215.
- U.S. Department of Justice. (2010). Americans with Disabilities Act: Access to Medical Care for Individuals with Mobility Disabilities. Retrieved from https://www.ada.gov/medcare_mobility_ta/medcare_ta.htm
