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      Proper Etiquette Towards Those In Wheelchairs

      Proper Wheelchair Etiquette

      You can rest assured that no one is using a wheelchair because they want to. In fact, those who are using wheelchairs are in a unique position in which they must use the wheelchair in order to get around. It’s not proper etiquette to simply make assumptions and lean on preconceived ideas as to why someone is in a wheelchair and to assume that they can and can’t do specific things. To avoid crossing boundaries or offending anyone, you’ll have to try and be helpful and understanding to anyone who is using a wheelchair. Here are some ways that you can be more helpful.

      Don’t presume that just because someone is in a wheelchair they can or can’t do something. They may not be fully paralyzed and they may be able to take a few steps on their own. You really don’t know unless you know the person well. Many use a wheelchair simply because they can’t stand for long periods of time. If you see someone who is in a wheelchair stand or take a few steps, don’t question why they’re using a wheelchair. You really don’t know the extent of their disability or their abilities. Don’t act surprised.

      Greet and interact with the person in a wheelchair just as you would anyone else. They’re still a person, even if they are using a wheelchair to get around. Don’t talk to their companion about their condition, that is simply rude. Instead of asking their companion if they require assistance, ask them directly. That’s much more appropriate. Address them directly and inquire as to how you may be of assistance. If there is seating nearby, take a seat so that you’re at their level. Otherwise, stand a few feet from them so that they won’t have to crane their neck to see you.

      Instead of avoiding terms like “let’s take a walk” or “run along” go ahead and use them. These are figurative terms and not literal. Even someone in a wheelchair understands this and will appreciate that you’re not trying to make adjustments to the language just to accommodate their disability. It also shows that you’re focusing on them and not on their disability.

      Avoid voicing your observations such as “what happened that you’re in a wheelchair?”. This is rude. If they want you to know, they’ll tell you. It’s that simple. Don’t draw negative attention to them and strive to treat them just as you would any other friend that you have. Avoid focusing on any issues they may have getting around. Instead, focus on how you can help them and don’t share stories about others in wheelchairs or who are disabled. They really don’t need to hear this. It just puts their situation in the forefront and is a rude way to avoid talking directly to them. Think before you speak, just like you would with any other friend. If they want to discuss their condition with you, they’ll bring it up.

      Never pat them or touch them or the chair without their permission. Just because they are in a seated position doesn’t mean that you should treat them in this fashion. It’s rude and condescending. Instead, ask permission first. Also keep in mind that if they have a nerve disorder, spinal issue or back issues the lightest touch may cause them excruciating pain. This is also true of touching their wheelchair, the slightest jostle unexpectedly may cause pain as well. It’s also an intrusion to their personal space. As teens would say, “personal bubble issue”. Many people in wheelchairs consider the wheelchair to be an extension of themselves.

      Always be respectful of those in wheelchairs. Even if you’re not interacting with them, give them space to maneuver their wheelchair and move about. Don’t be difficult about giving them room to move about. Be thoughtful and polite. Avoid using disabled parking if you’re not supposed to, this may take up a spot for someone who desperately needs it. Even if you’re only going to be in the spot for a few minutes, be thoughtful and park in legal parking spots and avoid taking up the wheelchair spots unless you’re in a wheelchair yourself. Anyone who has a mobility disorder will appreciate your thoughtfulness.

      Don’t make their lives more difficult by parking too close to their parking areas so that they can’t get out or into their vehicles. No one in a wheelchair should have to accommodate you, even if you’re only going to use the spot for five quick minutes. It’s not right and it’s not fair. One day, it may be you who is in the wheelchair and you’ll appreciate that other are thoughtful. Remember, they don’t need the exercise of parking in the far corner of a parking lot. You, however, have two good legs and can walk the distance easily. Imagine how long it would take them to roll their wheelchair to the entrance of a store not to mention the danger of cars that may be pulling in and out and not watching for wheelchairs. It’s just common courtesy to keep the handicapped spots available for those who truly need them. Don’t be selfish. Be thoughtful and considerate. Make it a daily habit to be more considerate of those with mobility disabilities and you’ll find that soon, it becomes a good habit. Being in a wheelchair isn’t a picnic. It takes dedication to get to and from where you’re going and a little consideration will go far.

      How to Choose the Right Wheelchair For You

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      When people start looking for the perfect wheelchair, a few things come to mind including pricing, comfort, and your daily needs.

      We can provide you with a variety of standing wheelchairs, caregiver-propelled wheelchairs, and self-propelled wheelchairs.

      To choose the right wheelchair you need to have a good strategy. This will help ensure you get the right wheelchair. You should use research to ensure you’re getting the right type of wheelchair for your needs.

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      Manual Wheelchairs

      This category can cover more than 10 types of manual wheelchairs. Some of these wheelchairs are caregiver-propelled, and others are self-propelled.

      Most wheelchairs in this category are self-propelled. The exception is the Transport and Travel wheelchair. These chairs need to be pushed by the caregiver, the rear wheel size does not allow for the user to reach the wheel.

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      Ergonomic Wheelchairs

      These foldable wheelchairs feature ultra-lightweight frames made of T6 Aircraft Grade Aluminum and feature a Patented Ergonomic S-Shaped Seat Frame. These seats relieve pressure from the body and prevent lower back and bottom concerns.

      The ergonomic wheelchair series has Aegis Microbe Shield cushions. This provides anti-microbial barriers that offer protection from deterioration, staining, and odor which are caused by a fungus, bacteria, and other types of microorganisms.

      Karman Healthcare has received raving reviews on this series. This positive customer feedback makes it one of the most popular wheelchair series in the industry.

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      Ultra-Lightweight Wheelchairs

      These ultra-lightweight wheelchairs feature weights from 25 to 34 pounds. This is a great choice for people who need a durable, foldable, and lightweight wheelchair.

      This category covers many various wheelchair accessories and options. If you’re looking for a wheelchair that offers perfect performance, style, and fit. These wheelchairs offer stock and optional components that are adjustable and removable. You can include a height-adjustable frame and swing-away footrests.

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      Lightweight Wheelchairs

      The Manual Lightweight Wheelchair is an upgrade, over the heavy wheelchairs. The heavier units can worsen your condition which may lead to additional physical problems. Over the last decade, foldable and lightweight wheelchairs have become the industry norm.

      Lightweight wheelchairs range from 29 to 34 pounds. These chairs can cover a wide range of lifestyle options and conditional needs which may cater to you. Although these ultra-light wheelchairs are light, it offers several advantages over generic wheelchairs, which are more portable and easy to fold.

      This series offers wheelchairs in ranges from 14-inches to 30-inches high, with a 550-pound weight capacity.

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      Transport Wheelchairs

      Transport wheelchairs are foldable, making them the perfect solution for people who are looking for a portable lightweight frame, featuring smaller rear wheels, which will allow for more portability.

      Since smaller wheels are used, these chairs are designed to be propelled by caregivers or other individuals. This explains why they are often called “companion chairs”. The chairs in this category weight 18 to 29 pounds. Most of these wheelchairs have side panels, fixed armrests, and swing leg rests.

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      Standard Wheelchairs

      Standard Manual Wheelchairs are the most common type of wheelchair in use. If you need a standard wheelchair with long-lasting support and durable frame, check out our standard wheelchairs.

      A Standard Wheelchair may weight over 35 punts, have a 16 to 20-inch seat width and features detachable or fixed armrests. Many wheelchairs are made of steel frames and may be a consistent and economical mobility choice. Most standard wheelchairs can support as much as 250 pounds.

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      Recliner Wheelchairs

      A reclining wheelchair is designed to allow users to recline at incremental angles comfortably and safely. Some of the reclining wheelchairs come with stock Elevating Leg Rests. On some reclining wheelchairs, these leg rests are optional.

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      Tilt Wheelchairs

      Tilt Wheelchairs can help to prevent some serious health issues, including pressure sores to allow a wheelchair user to tilt the seat position to find a comfortable setting. If you balance the weight of the user in the tilting motion, the pressure on the user’s bottom and back is significantly reduced.

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      Active Wheelchairs

      This is also referred to as a Sports Wheelchair. This active wheelchair is great for users that have an active lifestyle or who enjoy playing sports. The ultra-light frame is well suited for a person’s daily needs. One of the many features of this series is Seat Height adjustment.

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      Bariatric Wheelchairs

      This is also called the Extra-Wide Wheelchair or Heavy-Duty Wheelchair, known for these reinforced cross braces, and extra weight capacity. We offer a maximum weight capacity of 550 pounds and a 30-inch maximum seat width.

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      Pediatric Wheelchairs

      We offer pediatric wheelchairs that cater to caregivers and parents who care for young people with various conditions and disorders. Our wheelchairs offer assisting technology for many disorder types. The rehabilitative Benefits are outlined in our pediatric stand-up wheelchair series.

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      Standing Wheelchairs

      Power Stand Up Wheelchairs features electrically powered drive. The wheelchair can be set in multiple positions from standing mode to sitting mode and all the angles in between.

      Many Standing Power Wheelchairs have an easy access joystick controller and many other features. This series allows a user to drive while in the standing position.

      Wheelchair Dimensions and Sizing

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      Wheelchair Seat Width

      The first thing you can do is look into the available seat widths. This is important since there is a specific size each person needs. The most common size for wheelchair models are 16-inches, 18-inches, and 20-inches. However, some models only provide an 18-inch seat.

      Pediatric Wheelchairs may have an average 14-inch seat width. Bariatric wheelchairs may have a 30-inch seat width.

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      Seat Depth

      The Wheelchair Seat Depth is the measurement from the front of the wheelchair seat to the back of the seat. If you want to right seat depth for the wheelchair, while the user is sitting straight, measure the back of the user’s pelvis to the back of their shins.

      The easiest method for finding the new wheelchair’s seat depth is to use a previous wheelchair that was comfortable before. Measure the previous wheelchair’s wheel depth.

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      Seat to Floor Height

      You can determine the right Seat to Floor height to measure from the floor to the seat. Depending on the wheelchair user’s needs, it’s important to determine if the person’s feet are dragging on the floor, dangling on the floor, meaning the seat to floor height is too low or too high.

      If a person is used to propelling themselves using their feet, then getting the right Seat to Floor height is important, since their seat will need to be lower than the standard height.

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      Back Height

      You can determine the backrest height by measuring from the top of the backrest to the top of the seat, which is also the bottom of the backrest. The back height can be extended with optional accessories, which makes the backrest higher, which may be needed by a tall user.

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      Armrests

      Basic wheelchairs armrests come in two categories: full length and desk length. Full-length arms offer extra arm support. Desk length arms allow a wheelchair user easy access to desks and tables.

      There are optional armchair features available for most wheelchairs, including adjustable height arms and removable or flip-back arms which allow for easy transfers.

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      Leg Rests

      There are two leg rests including elevating and swing away models. Swingaway leg rests allow the user to get in or out of the wheelchair because the leg rests rotate to the side.

      Elevating leg rests include a calf pad. These pads are used to raid legs and prevent swelling. With both of these models, the leg rests are completely removable. Some of these models have leg rests that include tool-free adjustments which can change the leg rest length.

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      Adjustable Backrest

      Some wheelchairs offer adjustable height backrests which provide user comfort. If a user is shorter or taller than average, then this feature will be appreciated.

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      Dual Axle

      The dual axle wheelchair allows you to adjust a chair from standard to hemi height, which is about 2-inches lower than standard. Hemi-height allows the user to propel the chair using their feet. It allows the seat height to be lowered for users under 5 feet in height.

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      Quick Release Wheels

      Some wheelchairs have a quick release button to remove the rear wheels for transport and compact storage. This feature is designed for people who are looking for ultra-portable wheelchairs.

      Other Resources

      There is plenty of information available on the web on how to choose the right wheelchair to meet your requirements and personal needs. Here are some resources that can help you in finding the best wheelchair for you.

      Wheelchair 101

      self-propelled-wheelchairWheelchair Basics

      People aren’t “confined” to their wheelchairs. In fact, their wheels actually liberate them. A paralyzed individual can get around just as fast in a wheelchair as anyone else can who is able to walk. Wheelchairs provide people with access to shopping and working as well as any other traveling outside of their homes.

      A wheelchair in some ways is like a bike: there are many styles and designs to choose from including racing models, lightweights and imports. The chair is similar to a pair of shoes as well – there are distinctive styles for specialized purposes like rugged trail use or tennis. If it isn’t the right fit, then the user won’t be able to achieve maximum function or get completely comfortable.

      Choosing the right chair can be quite confusing, particularly for those who are using a wheelchair for the first time. Working with an occupational therapist (OT) with extensive experience with different types of wheelchairs is always a good idea.

      Many individuals select their first wheelchair based on the fact that it was the one that their insurance company said they would pay for. However, the second one is frequently chosen based on its performance, styling and other features preferred by the user.

      Manual Wheelchairs

      Typically individuals who have upper body strength use a manual chair. Of course it gets propelled by the user pushing his or her arms forward while their hands are gripping the wheel rims.

      Just over one generation ago, a standard wheelchair was a chrome-plated giant weighing more than 50 pounds. Today’s standard wheel chair weighs half that or less and is available in every color imaginable.

      The modern chair has been designed to provide superior performance – today’s chair is a lot easier to push and rides truer than yesteryear’s clunkers. The lightweights, whether a folding frame or rigid frame, are also much easier to lift into and out of a vehicle.

      In general, a rigid frame (one that doesn’t fold up) will transfer more of the energy of a rider into forward motion compared to a folding unit. However, the main advantage provided by a folding chair is its portability; there are some folding units that will even fit in an airplane’s overhead bin.

      Chair makers in recent years have added on a suspension system as an extra option, which considerably smooths the ride. The trade-off for this improvement in ride quality is a higher price and weight (a couple of pounds are added by the shocks).

      Aftermarket products (such as Frog Legs) are available as well for providing the front forks with added suspension. They are quite popular and Medicare has approved them for reimbursement. Another important innovation has been utilizing super-light titanium for wheelchair frames. It is better for one’s shoulders when the wheelchair is light. The leader is in the U.S. is Ti.

      There are many different options for tires and wheels as well, including innovations for high style, off-road traction and performance. The company Spinergy has developed a higher performance wheelchair rim line. They stay true and are lightweight. Recently the company introduced an innovative push rim. FlexRim, which is a kind of soft rubber, provides a bridge between the tire and rim, which allows for a low impact, easier push that helps to protect the arms and hands from impact.

      Alternatives for propulsion: It isn’t necessary to push the wheel rim in order to make your chair go. The market also has a few lever-driver chairs that are available. They claim that your shoulders won’t get damaged the way they might when pushing a standard rim.

      The quick-release rear wheels on manual wheelchairs can be replaced with the Pivot Dual Lever Drive. The Pivot has comes with five effort levels.

      The Wijit Wheelchair allows the user to push half that they normally would when a conventional wheelchair is used.

      Power Chairs

      An individual who is unable push might need to have a scooter or wheelchair that is powered by batteries and and electric motor and controlled with a joystick.

      There are several basic styles of power chairs. The traditional style has the appearance of a standard issue wheelchair that has been beefed up, in addition to the extra bulk from the control and motor systems as well as the batteries. There are platform-model power chairs available as well that have a captain’s chair or ordinary-looking seat on top of the power base. When it comes to scooters, they are available in four- and three-wheel configurations, and are mostly used by individuals not needing them on a full-time basis.

      Twenty or so years ago the power chair market only had a couple of models and brands available. The choices have been expanded due to innovation towards more powerful, lighter and much faster chairs. A majority of power chairs come with rear-wheel drive, but front-wheel and mid-wheel drives have been taking increasing shares of the market. It is easier to turn them and in tight spaces they are very nimble.

      There are also off-road ready and rugged models that are available, along with models that fold for traveling. In addition, power chairs are available that can be customized to meet even the most complex needs of individuals with paralysis. When it comes to the best choice for a user, is definitely based on a lot more than just style.

      Having a power chair configured and fitted to one’s individual needs required expert assistance, from a reputable medical supplier or OT. How can you locate a good supplied? Read active gear forums online, ask an OT or other people you know.

      Do you need a wheelchair? You will need to work with your rehab supplier, seating specialist and funding sources in order to find the chair that suits your needs the best, and for defending your choice in case your reimbursement is denied.

      For any durable medical equipment purchase, reimbursement is definitely an important issue, particularly for an item like a power chair (which may cost more than a Honda that is fully loaded). The power-mobility industry has been targeted for Medicare fraud by federal investigators.

      A 2011 government report stated that 80 percent of power wheelchair Medicare claims didn’t meet its coverage requirements and that Medicare shouldn’t have paid for them. Medicare has made changes to some of its reimbursement rules to try to curtail fraud. The disability community has put up much resistance to this in addition to the choice-limiting competitive bidding system.

      Batteries

      A critical issue for users of power chairs is battery life. If the power source is not managed properly it can lead to annoying or sticky situations, especially if you happen to be far away from home.

      It is important for power chair batteries to be deep-cycle 24-volt, that can be discharged for long period of time, as opposed to the 12-volt car battery that is used for short power bursts. There are several sizes of deep-cycle units that are available: e.g. Group-27, Group-24 and Group-22. The larger that the group number is, the more power the battery stores and the larger it is.

      There are three different kinds of batteries used in wheelchairs:

      “Wet” or lead-acid batteries generate electrical energy whenever sulfuric acid and lead interact. The battery cells must be filled up with distilled water periodically, perhaps once per month. The lower cost is the major advantage offered by a wet-cell battery. The major disadvantage is that special handling might be required, especially whenever you fly.

      There is no liquid to top off or spill with gel batteries. They cost ore than wet batteries, but have a longer life cycle and a lot better for flying on airplanes.

      Like gel units, absorbent glass mat (AGM) batteries, work fine for flying and don’t require maintenance. They last twice as long compared to standard lead-acid batteries, hold a charge much better, and are quite rugged.

      Sometimes wheelchair batteries are the same ones that are used for boats. If you are paying for batteries out of your own pocket, you may be able to save some money through buying marine deep-cycle batteries. Make sure you check your wheelchair manufacturer’s specifications first.

      Power Assist

      You can trick-up a standard lightweight manual with a powerful, small motor attached to the wheel units or base of the chair. Whenever the assist is turned on, when the hand rim is pushed forward it provides the chair with a strong boost.

      The Xtender is available in two versions on some Quickie models, one increases the force that is applied to the hand rims by 3 times and the other that boosts it by 1.5 times.

      A fair amount of weight is added to the chair by the assist hubs (from 38 to nearly 50 pounds) as well added expense ($5,000 – $8,000). However, the advantages are great, particularly for lower-level quad as well as anyone who has achy shoulders who won’t need to struggle trying to get up steep hills any longer.

      The range of the rider will increase significantly when the assist is used, saving a lot of wear and tear on your rotator cuffs as well as personal energy. The chair also doesn’t resemble a beefed-up power chair. It basically looks normal.

      There is a newer power assist option called SmartDrive for manual chairs. It is an 11 pound portable drive wheel that hooks up fairly easily to the base of the chair and the battery fits underneath the seat.

      MagicWheels is another option that doesn’t have a motor or batteries. They are two-gear wheelchair wheels with a lower gear to use when you need to on hills, by just a click on the hub. They only cost around a third of the price of a power assist units.

      Many insurance companies, including Medicare, will cover them if the user emphasizes the possible increased health benefits like saving the shoulders that power assist devices provide.

      Chairs for Kids

      Children’s bodies are constantly changing and growing, which means that their chairs need to be replaced or adjusted more frequently compared to adult chairs. Chairs are not exactly cheap and quite often limitations are placed on replacement by insurance providers, so adjustable chairs are offered by most manufacturers for accommodating growing children.

      Quite often wheelchair companies provide chairs for children that don’t have a “medical” appearance. They updated looks frequently offer different frame colors, cooler upholstery and more streamlined designs.

      Colours offers the Chumpe and Little Dipper. The Invacare Orbit and Sunrise Quickie Zipper are made for younger wheelchair users who like riding in style.

      Positioning and Seating

      Individuals who live with paralysis are at great risk for getting pressure sore, so the usually need to have special seating systems and cushions to provide some relief to the skin.

      There are several different types of cushion materials. They each have benefits for specific kinds of users: liquid (e.g gel), foam or air, a variety that has moving parts and is more dynamic.

      There isn’t one product that can do the job for everyone. Having the proper cushion can prevent pressure sores, offer correct positioning and provide comfort. However, it still won’t meet every users specific criteria.

      An ambulatory individuals who uses a wheelchair only for shopping will not have the same needs that a high-level quad does who needs to spend eighteen hours a day in their power chair. That is why it is very important to completely understand what your requirements are and choose the cushion that is most appropriate for you, after weighing the pros and cons of various styles.

      For a cushion, the least expensive material is foam. In addition, it doesn’t lose air or leak, and is very lightweight. Over time, however it loses its compression and wears out.

      Air flotation cushions, like the popular ROHO model, offer support through the use of a rubber bladder that has evenly distributed air inside. They do work well but may leak. Whenever you change altitude you will need to adjust the air.

      The Vicair Vector is another style of air cushion that works by employing multiple, small air cells that are permanently sealed.  The user can adjust the cushion by using the handy zipper to open the cushion and add or remove air cells. BBD is a single-chamber model that is very popular and provides pressure relief inexpensively. The Jay is an example of a gel cushion. These cushions are quite effective and popular. The provide good skin protection, but the gel filling makes them quite heavy.

      Dynamic cushions work by use of an oscillating pump that causes the internal pressure of the cushion to alternate. Aquila is a good example of this type of cushion. The concept behind dynamic cushions is that alternating the pressure of the seating surface can help alleviate damage done by sitting for long periods of time. This type of cushion is heavy because of the pump and the batteries needed to run it. This causes it to be a bit cumbersome for users.

      The Ease cushion is also a dynamic, pressure-changing model. Users may find a great deal of benefit from obtaining a cushion that is customized to fit the lines of the body. One such cushion is the Aspen, which is made using a thin plastic shell that is contoured following a mold of the user’s actual silhouette.

      If you would like a list of the seating systems and cushions that are available, you can refer to USA TechGuide or AbleData. Both of these publications provide comprehensive reviews of products related to wheelchair use. To get just the right product for your circumstances, you should consult an expert in positioning and seating.

      Tilting & Reclining

      Some users find that specialized wheelchairs that are designed to distribute pressure more evenly can help reduce chances of developing skin sores. These types of chairs make sitting more comfortable.

      One such chair is named “Tilt In Space”. This model changes the user’s orientation while keeping fixed angles of hips, knees and ankles in place. Basically, the entire seat tilts. There are other chairs that can help change orientation by reclining. With this model, the angle of the back can be adjusted in relation to the seat. The chair can actually be flattened out to provide a complete reclining surface. Some chairs can even provide leg elevation.

      Tilting systems help by redistributing pressure from the derrière and the backs of the thighs to the head and upper and lower back. With this type of system, posture remains consistent. Additionally, it reduces the risk of damage caused by tissue being dragged across a moving surface. This is known as “sheering”. One problem with this type of system is that it cannot be employed while the user is sitting at his or her work station. Tilting the entire chair back would result in having knees and/or footrests collide with the underside of the work surface.

      A reclining system works by opening up the angle between the seat of the chair and the back of the chair. Additionally, those reclining wheelchairs equipped with elevated leg rests open the angle of the knee. Reclining systems are nice for activities such as transferring, dining or simply stretching out for a rest. They are also quite helpful to attendants performing bladder and bowel care programs.

      For the most part, reclining systems provide better relief of pressure than tilting systems, but they do present increased sheering risk. Users who suffer from edema are sure to benefit from the ability to elevate their legs. To get either a tilting or reclining chair system, the user must be evaluated and fitted by an expert in positioning and seating. These chairs are available by prescription only.

      Standing Chairs

      This type of wheelchair can perform all the functions of a standard wheelchair, along with having the ability to assist the user into a standing position. The ability to “gain height” can come in quite handy at home, work, school and in the community.

      There are some types of manual wheelchairs that are equipped with power assist that activates the rising mechanism. These power chairs help the user to stand up and communicate with ambulatory people eye-to-eye. For more information, refer to Redman or Permobil.

      The main problem with standing wheelchairs is that they are quite expensive. They are also quite heavy and are not a good choice for getting around on a day-to-day basis. Nonetheless, there are physical benefits involved in being able to stand from time-to-time. Standing can improve range of motion and circulation. Being able to stand also helps prevent problems with pressure sores. Additionally, standing has been shown to help reduce instances of muscle contractions and spasms. The reason for this is unclear.

      Several years ago, a representative from the Hines VA said that in their experience, patients who were able to stand for half an hour or more every day experienced a significantly better quality of life. These patients had fewer bladder infections and bedsores. They also experienced better bowel regularity and better ability to flex and straighten their legs.

      It is also possible to get a standing frame. There are several models offered by EasyStand. There is even one designed for children. There are a few motorized models (e.g. the Stand Aid). There are also some very simple models that just consist of a non-moving frame designed to support a person with paralysis in a standing position.

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