The OT’s Perspective: What’s the occasion?
An Occupational Therapist’s perspective on helping clients choose the right wheelchairs for occasional use…
I’ve written extensively about walking aids in the past and I’m a firm believer in them to preserve as much independence and autonomy as possible.
But sometimes, walking aids just don’t do the job and that’s when wheelchairs come into the conversation.
In previous editions, I’ve spoken about how to select wheelchairs, and this time I want to focus on the “occasional use” wheelchair.
You see, just because a client may need a wheelchair some of the time, that does not mean that they are confined to it – for example, if a client has a condition like Spina Bifida, they may struggle with long distances but may not be dependent on a wheelchair for every part of their day.
The issue that those who occasionally need a wheelchair have come across is the struggle to be eligible for wheelchair funding through the NHS – if they’re not deemed to be reliant on it, then funding is harder to come by.
Unfortunately, this has led a lot of people to head online to search for the most cost-effective solution, and if you’ve ever Googled “private purchase wheelchair,” you’ll know that it’s a minefield, with a lot of results and plenty of unsuitable products displayed on the search results page.
There is a benefit to jumping onto Google though – typing in “private purchase wheelchair” will lead you to the Disabled Living Foundation, who provide a comprehensive and easy-to-navigate list of what to consider – you can find this here
The truth is that, unless you know exactly what you require, wheelchairs should not be purchased online, for all sorts of reasons – not least the fact that an incorrect wheelchair can actually make a condition or medical problem worse.
So, if Google isn’t the right place to go, then the next step is into a shop, which is where you can come into your own and the question turns to, which equipment is right for your client?
The presupposition for the purposes of this article is the client has no cognitive impairment and has a physical impairment that is mild or moderate and may or may not fluctuate.
What to consider when assisting a client with choosing a wheelchair:
Can the client sit in the chair and propel themselves?
They may be able to walk a little and want a chair for around the home but ultimately, if the client cannot wheel themselves around the shop, its likely they would not manage the wheelchair at home.
If the client needs help, an attendant-propelled chair may be better (the chair with the smaller wheels). Again, the client needs to try the chair and then the person who is most likely to propel them should wheel them around the shop.
There is no point having a strong son or daughter wheel the patient around the shop if the carer who is likely to push the client around the home or outdoors is likely to struggle.
It is also important to discuss the environment the client lives in at home. A great self-propelled wheelchair may be unsuitable if the client lives at the top of a steep hill, similarly, the same applies to attendant-propelled wheelchairs that mean a carer would struggle to safely support the patient and the chair up or down hills.
If the attendant-propelled option is not suitable, perhaps an electric wheelchair is the next step.
A quick drive around the shop, however, will not suffice. A road test around the shop car park, up and down the street and perhaps, if possible, a home visit and demonstration, should be provided to ensure the property is suitable for the wheelchair.
You also need to consider environment…
Which environments does your client regularly find themselves in? Do they spend a lot of time at home or in a school or college? Where do they work? What tasks do they need to complete most days? Do they travel regularly? What activities/hobbies do they have? At what point do they most regularly need a wheelchair?
Other key things to consider when choosing wheelchairs for occasional use:
- VAT relief is available for disabled clients, terminally ill clients and those with diagnosed long-term conditions
- Some organisations hire wheelchairs so purchase may not be necessary
- Remember to consider both indoor and outdoor uses
I hope you’ve found this useful! If you’ve got any other questions, please feel free to fire them over to email@example.com
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