The OT’s Perspective: Powerchairs – The key things you need to consider
If you recall, a couple of months ago I wrote about mobility scooters and some of the key questions that we all need to ask to make the right choice for our clients. And I sincerely hope it helped. But the reality is that for some clients, mobility scooters just aren’t appropriate.
That’s where powerchairs come in.
When are powerchairs the right choice?
You might know them as ‘electric’ or ‘powered’ wheelchairs and they’re ideal for clients who perhaps don’t have the strength and stamina to use a self-propelled wheelchair but don’t want to rely on being pushed.
What Options Are There?
When it comes to powerchairs, there’s a huge amount of choice so it’s worth thinking carefully about why it’s needed and what it’s going to be used for.
Typically, it’s best to divide powerchairs into three categories:
Indoor/Portable: These chairs can be used in a home or in places with smooth flooring, like indoor retail outlets. If the chair is going to be used in multiple locations, it’s important to ensure that it’s easy to fold so it can be transported.
Outdoor: Generally speaking, these chairs possess bigger wheels which help them to deal with variable ground and some of them feature suspension, making the ride more comfortable.
Although they are typically designed to be used outdoors, it’s worth bearing in mind that because they’re bigger and sturdier than indoor chairs, they won’t always fit through doorways.
Indoor/Outdoor: These chairs are hybrids that offer a balance between both the indoor chairs and the outdoor chairs.
Things to consider when matching a client with a powerchair
How long will the client be out in the chair?
Before choosing a chair, it’s vital that you ensure that it’s going to be comfortable enough for long journeys. Lots of chairs may appear to be comfortable when you first sit on them but it is important for your client to test what the chair will be like on an ongoing basis.
Does it fit in the car and can it go on holidays?
Pretty much all powerchairs fold so it’s usually relatively easy to get one in a car but it’s well worth considering which vehicle the chair will go in and how much space it will take up when being transported.
Because of the motor, generally, the frame will be heavier than a standard wheelchair.
What do they need the chair for?
Is it for popping around the corner or doing the shopping? The answer to this question will inform the type of chair you choose; indoor, outdoor or a hybrid.
Similarly, if they’re out and about then it is worth bearing in mind that there’s a large selection of wheelchair specific accessories designed to improve the client’s experience.
How is it controlled?
Most ‘drive controls’ for powerchairs are essentially joysticks mounted on one of the armrests. These can take a while to get used to and may be over/under sensitive, so it’s vital to ensure they’re right for your client and that they are used to the level of sensitivity.
Where will it be stored?
Storage is important – it needs to fit comfortably in the client’s home and – ideally – stored near a socket, allowing overnight charge.
Some outdoor powerchairs may not fit in a home and as such will need a garage or another outbuilding to house them.
Is the client looking to travel on public roads?
There are two types of power wheelchairs: Class 2, which can be used on pavements and Class 3, which can be used on roads as well as pavement.
Are there any kerbs or obstructions on usual journeys?
Larger wheeled chairs are best in this scenario, as well as purpose-built chairs designed to overcome kerbs and obstructions.
Will the chair be used around the home?
If so, the client may be eligible to apply for a Disabled Facilities Grant to adapt the home for ramped access and widened doorways.
Does it work ‘off the rack’?
Wheelchair manufacturers are pretty flexible which means that there’s a good chance that there’s room for manoeuvre and customisation. On the whole, you can safely assume that you’ll be able to customise the seat size and length, the level of cushioning, as well as footplate and armrest height and position.
Some powerchairs allow you to buy a headrest as an optional extra, as well as storage bags designed to fit somewhere on the chair.
Highway Code for powerchairs
If a client is planning to use their chair on public highways then they must abide by the specific section of the Highway Code that deals with powered wheelchairs and mobility scooters.
Your client may be able to secure funding to help finance the purchase or part of the purchase of a powered chair. Commonly, the funding is released on a means-tested basis, and, on the basis of a GP referral, the money is provided through the local NHS trust.
The best first step for the client is to speak to their GP and get the ball rolling.
Stuart Barrow of Promoting Independence is a member of the British Association of Occupational Therapists panel and a recognised contributor in the field of home adaptations. His experience is sought by manufacturers and service providers looking for an expert opinion. He also runs the Occupational Therapy Adaptations Conference
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