To whom it may concern:

(Your name) has been a patient of mine in outpatient weekly psychotherapy since (date). (Your name) suffers from Multiple Sclerosis and presented with various concerns related to this condition. Medically, the illness has progressed to the point where she no longer has the use of her lower extremities. Other symptoms include fatigue, rigidity, and difficulty balancing. As a result of these symptoms, (your name) has become totally dependent upon a wheelchair. Before the illness progressed to its current status, (your name) had been able to do limited walking with a walker and only a manual wheelchair was required for safety and mobility assistance.

The psychological effects of this shift to total dependence upon a wheelchair have been profound and have caused a significant deterioration in her emotional well being. Leading her to seek my services. (Your name) meets the criteria for three separate disorders from the DSM-IV of the American Psychiatric Association that have stemmed from this shift to total wheelchair dependence. These include: Adjustment Disorder with Mixed Anxiety and Depressed Mood (309.28), Adjustment Disorder affecting the course of Multiple Sclerosis (316), and Partner Relational Problem (V61.1). The implications of these diagnoses are that (your name) is suffering significant anxiety and depression as a result of this loss of mobility and that these symptoms of anxiety and depression are further affecting her ability to cope with the Multiple Sclerosis and appear to be intensifying her medical symptoms.

For example, (your name)'s self-esteem as a parent has been seriously hampered because of her total dependence on attendant care and inability to engage in many home and community parenting activities. The negative health effects of her inability to stand have also contributed to her emotional distress. These include reduced muscle tone, decreased ease of respiration, reduced cardiovascular conditioning, impaired digestion and motility, and reduced skin protection. Finally, the medical and psychological effects of these changes have negatively impacted her marriage in numerous ways. These include her dependence on her husband to take over most parenting and home maintenance duties, the negative physical effects upon her husband of having to lift and maneuver (your name) physically, and the emotional distress caused for both of them by (your name)'s reduced mobility and inability to be left alone.

It is my professional opinion that each of the above negative emotional consequences will be addresses and that (your name) emotional and mental health will be significantly improved by the use of the LifeStand Compact, a power chair equipped with a standing device. As the adaptive wheelchair will enable her to maintain optimal mental health while dealing with the degenerative neurological disease, her emotional well being will improve concurrently. The negative physical effects of being totally wheelchair dependent have directly contributed to her psychiatric disorders. Further, the greater motility and independence provided by the LifeStand wheelchair will undoubtedly increase her self-esteem in general, including as a parent, and will significantly reduce the martial tensions. Her increased physical endurance will also give (your name) increased psychological health for the entire family. The LifeStand Compact wheelchair will also produce considerable savings through the concurrent improvement in her medical and psychological condition.

Sincerely,

Your Psychologist/Psychiatrist