Wheelchairs and Mobility

[caregiver222]

Some comments about wheelchairs. Any additional input welcome.

[caregiver222]

I am by no means an expert in wheelchairs, but this is my two cents worth. The government and insurance programs often provide a single wheelchair with a large set of rear wheels and a small set of front wheels and hard plastic tires. This is totally inadequate. Wheelchairs come in two basic types. (1) Those that have for small wheels (2) Those that have a big wheel in the back and small wheels in the front. Within these types there are three varieties of tire. (a) totally pneumatic (b) resilient elastomeric (c) hard plastic. For outdoors the totally pneumatic are best, but they are similar to bicycle tires and get flats. I choose the middle ground. The resilient elastomeric. These have a sponge-like interior that absorb the bumps. The difference in ride between these and the hard plastic wheels is significant. Two wheel chairs are required. The small four-wheeled chair is used for transfer around inside the house. From the bed to the chair, for example. The one with the large wheels for outdoors. As far as accessories you need a back-pack. You also need an inflatable cushion plus a foam cushion plus a soft blanket. The foam cushion goes down first. Then the blow-up-pneumatic. Then the blanket. On top of that sits the patient. You have noi idea how uncomfortable little bumps can be for little people.  For the interior four-wheeled chair I cut off the seat-belt. I have a rule that she is NEVER EVER to be left alone in this wheelchair, thus there is no need for a seatbelt. She eats in this chair, however an aide or myself are with her at this time. The arguement is the seat-belt is for "safety", however it makes my little one VERY upset and she claws at it infrustration. I'd rather have her happy and contented. The best wheelchairs can be disassembled. You should know, if custom ordering they come in numerous sizes. The biggest problem is when you are outside the patient's feet can get caught either in front of the steps or fall between the foot-rests. You need to purchase a pair of two-inch wide velcro belts at about a buck each. When the wheelchair is set up place these BEHIND the legs. If you find the feet slip out in front get a piece of one quarter inch plywood and make an extension for the foot-rests. Dimensions are not critical.  Cover this in soft cloth. The extension will be attached to the two foot-rests by two drilled holes, a short bolt and a wing-nut on the bottom. Such an extension will prevent foot injury. Without such an extension you have to constantly check as you push along for the position of the patient's feet. In the back bag, whever we go out I have a thermos with a beverage, a number of two and half ounce disposeable cups, and a ripe banana.

[swampcritter]

There is a lot that goes into selecting a wheelchair.

Some important considerations are already hinted at in your post: where will the wheelchair be used? For how many hours a day will the person have to be in it? How will they transfer out of it?

If you need to take the person in a vehicle, think about the kinds of anchors and relative ease of getting it in and out. Wheelchairs differ considerably in their maneuver and now well they position.

Not least, there are issues relating to how comfortably a human can sit in the chair. Many people need additional support and will lean or slip. Pillows help, but they are not the complete answer, having air cushions, or even for some people a custom fitted seat, may be a requirement.