Prescription and funding: pressure redistribution mattress

In this phase, the trained health professional should support the person with a spinal cord injury (SCI) to make an informed decision about their final assistive technology (AT) selection. The trained health professional should then provide clear recommendations with clinical justification to the relevant funding body about the AT selection for the person with SCI. 

Prescription

The trained health professional is responsible for finalising the AT prescription. This step formalises and clearly defines the chosen AT, including all necessary features and accessories. Input will be required from all stakeholders, including the person with SCI, their support network, and the product specialist – especially for more complex and high-cost AT. 

Specific considerations for prescription of ​pressure redistribution mattresses​: 

• Identify the eligibility criteria and submission requirements for the relevant funding source/s. 
• Gather all evidence needed to support the recommended mattress. This may include trial outcomes, clinical observations, and detailed specifications of the recommended item and associated accessories (e.g., custom bed box). 
• Include any formal outcome measures used (e.g., comfort, functional ability, sleep quality) and any interface pressure mapping completed as part of the assessment or trial. 
• Provide clear clinical justification for the recommended mattress Address the purpose of each feature or accessory listed as an additional cost on the quote. 
• Describe how the prescribed mattress: 
  – fits the person’s environment of use 
  – supports participation and independence in transfers, feeding, toileting, intimacy, or other bed-based ADLs 
  – supports access for assistance from support network (where relevant) 
  – meets safety needs 
• – allows the person to transfer on and off safely 
• Specify any additional funding sources when the primary funding body does not cover the full cost. 
• Include all quoted freight, delivery, and setup costs provided by the supplier. 
• Outline expected ongoing maintenance and servicing needs and associated costs. 
• Explain how the mattress configuration aligns with the person’s body structure, function needs, and rehabilitation or participation goals. 
• Confirm that the person with SCI is within the mattress manufacturer’s safe working load limits. 
• Describe how the mattress will integrate with other AT, such as the bed base, hoist, or mobility devices. 
• Comment on how the mattress will be used in the person’s home and community environments, including transport considerations when relevant (e.g., travel). 
• Describe how the mattress will support the person and/or their support network, including any capacity building needs related to safe use and pressure care. 
• Identify whether the person or support network will require education or training in mattress features and use following delivery. 
• Discuss risk mitigation strategies, including: 
  – pressure injury prevention 
  – spasticity management 
  – respiratory management through positioning 
  – autonomic dysreflexia considerations (e.g., thermoregulation) 
  – emergency scenarios (e.g., CPR requirements). 
• Address any anticipated changes in need, including ageing with SCI or previous history of pressure injuries. 
• Outline whether the mattress is expected to reduce risks, funded supports, or care needs (e.g., improved microclimate management or reduced need for overnight repositioning).