How to Choose the Right Wheelchair0 USER TIPS ADD YOUR TIP
Finding the right wheelchair for someone can be a daunting task that depends on a variety of factors ranging from a person’s cognitive ability to their height and weight. When you’re choosing a wheelchair for someone who is seriously ill or frail, it’s also important to consider a caregiver’s size and strength, since they’ll be the one transporting the chair or pushing the person around.
“A person’s functional abilities, their size, their disease processes, how much time of day they’re spending in the wheelchair, whether or not they need a leg rest—all of these are influencing factors,” says Maria Torroella Carney, MD, chief of the Division of Geriatric and Palliative Medicine at Northwell Health, in New Hyde Park, New York.
Start with a physical therapist evaluation
You’ll want to start with an evaluation by a physical therapist or a physiatrist (a medical doctor who specializes in physical therapy). These experts are rehabilitation specialists who work in hospitals, offices, and nursing homes and can help a person and their caregiver find the right type of wheelchair with the right features. A primary care physician can provide names of qualified physical therapists and physiatrists.
If the person in need of a wheelchair is living full-time in a care facility, you can often talk directly with the physical therapist on staff there, Carney says. The facility may even supply the wheelchair for them. If they’ve been in a nursing home temporarily—rehabbing from a fall, for example—and they are ready to head back to their private home or your home, you can speak with the discharge planning department at the facility about ordering an appropriate wheelchair.
When it comes to brands and cost, there’s a broad range of styles and numerous chair manufacturers and suppliers. Your physical therapist or physiatrist can help you choose the right fit and order one. Or they can direct you to a medical supply store or supplier in your area or online—these are often referred to as DME (durable medical equipment) suppliers.
A few questions to consider before investing in a wheelchair:
- How will the wheelchair be used? Will the person use it around the house or only when traveling outside the home?
- Is the wheelchair easy to transport and store?
- Does the wheelchair have a warranty?
- Will insurance cover the cost?
Wheelchair costs and how to pay
Wheelchair prices can range anywhere from a little over $100 for lightweight transport wheelchairs to more than $10,000 for motorized versions. If a doctor provides a prescription and establishes a medical need, Medicare and private insurance companies will cover the cost—or most of it, minus a deductible, says Carney. “Most of my patients will get a chair [that costs] whatever their insurance will cover,” says Carney. Because insurance usually pays for it, most people buy a wheelchair rather than renting.
Where to buy a wheelchair
Your doctor, hospital, physical therapist or physiatrist, or other medical provider can recommend trusted suppliers or brands. You can also call 800-MEDICARE or go to the Medicare Supplier Directory to find a Medicare-accredited DME supplier. The Cleveland Clinic recommends that people only buy wheelchairs and other assistive devices from companies that meet the following criteria:
- The company is accredited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO).
- The company’s representatives are members of the National Registry of Rehabilitation Technology Suppliers (NRRTS).
- The company’s representatives are accredited by the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA).
- The company’s representatives often work with physical therapists and patients to figure out the best wheelchair style for that person.
It’s also possible to get a used wheelchair via Facebook, Craigslist, and other local groups, or from friends and neighbors. But before you use one, have it checked out by a doctor or PT to be sure it’s the right fit. An ill-fitting wheelchair can cause serious health issues, such as skin problems (including sores from pressure and rubbing), blood clots, and posture issues.
Finding the right fit
It’s important that you work with a medical expert to be sure your wheelchair has the proper seat depth, width, and height. Arm and foot rests need to be positioned correctly, too, says Carney.
To determine if a chair is supporting a person properly, look at them in their chair from the front and check that their weight is evenly distributed and they’re not leaning to one side or the other. Check back regularly to be sure that the chair is still fitting well, including a check of the person’s posture in the wheelchair, the arm and foot rests, and the wheels—to be sure parts haven’t worn down and need replacing. It’s been estimated that 80 to 90 percent of people are not properly fitted for their wheelchair as their bodies and needs change over time.
Types of wheelchairs
Standard lightweight wheelchair
Carney says this is the first line of wheelchair she typically orders, and she often requests leg rests for patients. “It’s pretty sturdy, but not too heavy,” she says. “Most of my patients are frailer and have a lot of congestive heart failure so they use a wheelchair for long periods of the day. The leg rests are helpful because you can change leg position.”
A standard lightweight wheelchair typically weighs about 25 pounds. While that may not sound “light,” Carney says it’s a little easier to move compared to a standard wheelchair. Manually propelled by the user or a companion, it can carry a person who weighs up to 300 pounds. The least expensive models start at around $100 and can go as high as $1,000 or more depending on how you customize it.
Carney says her patients usually have older spouses and daughters as their caregivers, so a lighter weight wheelchair is easier for them to maneuver and transport. “They’re not easy to put into cars, but they do fold up,” she says.
This type of wheelchair is also manually propelled but made with a slightly heavier steel frame than the lightweight wheelchair, and tends to weigh about 35 pounds or more. As with a lightweight wheelchair, prices can go from $100 up to $1,000 or more.
Carney’s second wheelchair of choice is a transport chair. It’s thinner and lighter weight (about 20 pounds) than the standard lightweight wheelchair and can carry a person who weighs up to about 250 pounds, but weight limit may vary by chair manufacturer. “It’s good for transporting someone from a car to a store or a doctor’s office,” she says, noting that where she practices, in the suburbs of New York City, it’s a popular model because it can be folded and stowed in the back of a vehicle.
Transport chairs are usually made of steel or aluminum and tend to have smaller back wheels than a standard or standard lightweight wheelchair, so the user needs to rely on a companion to push them from behind. Transport chairs range in price from a little over $100 to more than $1,000.
Motorized (or power) wheelchair
Motorized wheelchairs are less commonly used by people at the end of their lives. “You need to be cognitively able to use it. For your insurance company or Medicare to cover one, they have strict justifications, so not everyone qualifies,” says Carney.
One of the benefits of a motorized chair is that it can cover long distances without requiring help from a companion or caregiver—standard wheelchairs can’t do that, Carney notes.
Motorized wheelchairs are battery powered and the user relies on a joystick to propel the chair around. Their frames are typically heavy, which makes transporting and storing them more difficult. They range in price from about $1,000 to more than $10,000.
There are times when a person needs a wheelchair with special features. Bariatric wheelchairs are available for people who need a chair with a wider seat and/or more weight support. High back wheelchairs can be purchased for tall people. Reclining wheelchairs and chairs with headrests and seatbelts are designed for those with poor neurologic function who may need additional support for their chest, neck, and head. And if your loved one dreams of an afternoon at the beach but doesn’t think it’s possible because they are wheelchair bound, it’s worth doing a little research. Some waterside locations, such as Golden Gate National Recreation Area in San Francisco and the City of San Diego’s Park & Recreation Department rent beach wheelchairs.
Increasingly popular with older people in recent years, these battery-powered scooters belong in a category of their own. They feature a wide seat, anywhere from three to five wheels, and a handlebar for steering. Depending on the make, a scooter can be ridden either indoors (though not all buildings allow them), on a paved sidewalk, or on a road. They have accessories such as a horn, lights, and space for storage. To use one, a person needs to be able to walk and get themselves on and off of a seat. The drawback of scooter use is that it may discourage people from walking, some research suggests.
Mobility scooters can be purchased at medical supply stores, and online through Amazon and Walgreens, among others. Talk with a health care provider first to be sure it’s a safe choice. A mobility scooter is not a good option for people with dementia, for example.