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NAME: Daisy Smithson
DATE OF BIRTH: 8/23/41
DATE PREPARED: 6/1/02

 

LIFE CARE PLAN - POSITIONING NEEDS

Wheelchair/Support Type

Age/Year of Purchase

Replacement Schedule

Purpose

*Base Cost and Vendor**

Invacare Arrow Power Wheelchair with "Tilt-in-Space" System

58         6/02

1 X 5 Years

Mobility, Seating

$12,300 - $16,295

Quickie Manual Wheelchair with "Tilt in Space" Systems

58         6/02

1 X 5 Years

Mobility, Seating

$8,900 - $10,200

J-Active Wheelchair Cushion

58         6/02

1 X 2Years

Reduce Pressure while sitting

$400 - $415

Maintenance of Wheelchairs 58         6/02 1 X Year Repairs $2,120 - $2,649

* All growth trends to be determined by an economist.

**Price quotes obtained from: Interphase Medical Equipment, Professional Home Health Care