A recent post by a visitor to Spinal Cord Advocates raises the issue of spending on equipment that has preventative attributes such as standing devices or “Standers” as they are commonly referred to.

Andy from Washington DC states the following:

“I run up against this with my work with standing products. The insurance company will sometimes not pay for a stander when the client needs one to preserve or improve their range of motion, but they will pay for the wound care from poor sitting in the wheelchair or from the poor positioning in bed resulting from the contractures. Or often they will pay for pain medication, but may deny the person the ability to stand to alleviate pain.

The cost of wound care or pain medication will be more expensive in the long run, besides much more of a hardship on the individual, but our health care system is set up to pay only for the hole in the patient, not for the whole patient.”

I certainly agree with Andy regarding the ounce of prevention strategy. When it comes to standers I have come to realize that society’s focus on standing has a lot to do with how these devices are perceived. The focus, when it comes to standers, is on standing and not the other benefits that are related to standing- Pressure reduction, improved circulation, improved respiration, edema reduction, contracture control and prevention, pain management, self image, and a host of others.

We as Americans have elevated standing to almost a patriotic level, or at least raised it to a level beyond that of other positions. For example, there is a very positive inference in “Stand up and be counted”. There is similar status in “Stand up for your rights”. Compare that to the negative implications of “Are you going to take that lying down” or “Are you going to sit still for that”. I guess you can’t be an activist from any position other than standing. Tough break wheelchair users!

All kidding aside, what standers have going against them is their success at doing what they are designed to do, that is standing people up. It’s very dramatic and fulfilling to see a person sitting one minute and then a minute later (with little effort these days) they are up and staring you right in the face. It’s hard to think and visualize beyond that event and to consider all of the other benefits that are not visible and not obvious at that moment. The user and most clinicians understand the array of physiological benefits associated with standing. The public sees and appreciates only the physical act itself.

Be cool,
Ziggi