Introduction:
Selecting the most suitable mobility aid is critical in supporting independence, participation, and safety for people with mobility limitations. In clinical practice, decision-making between a power-add on and a powered wheelchair is often complex, and variations in clinical reasoning can lead to suboptimal outcomes. Funding constraints frequently limit access to multiple wheelchair options, creating a process of compromise and forward planning. For Occupational Therapists, limited access to structured guidance and decision-making frameworks can make it challenging to match equipment to both immediate and long-term needs. This presentation explores evidence-informed considerations for selecting powered wheelchair configurations, highlighting common challenges in decision-making and prescription.

Method:
Factors influencing decision-making between power add-on and powered wheelchair options were identified through clinical experience, consultation with industry representatives, and literature review. These insights informed the development of a decision-making framework to support clinicians in selecting powered wheelchair configurations for optimal client outcomes.

Discussion:
Successful wheelchair prescription was supported by a holistic understanding of the person’s functional needs, supports, future needs, and transport requirements. Equally important was fostering collaborative decision-making with clients and their families to explore how they wish to live and participate now and into the future.

Conclusion:
Wheelchair prescription is complex and requires time to understand the factors influencing individual needs and goals. When supported by decision-making frameworks, outcomes can be life-changing, enhancing independence, participation, and quality of life.