The Love Connection

Choosing the wheels of your dreams

by Kathy Wechsler on March 1, 2007 - 11:18am

QUEST Vol. 14, No. 2

Do you want your mobility device to share long strolls on the beach with you, or quiet evenings at home? Should it be practical, or are looks more important to you?

Deciding whether you want a manual or power wheelchair or a scooter isn’t quite as complex as choosing a mate, but it does involve many factors. When you select a set of wheels, you undertake a costly, long-term partnership that may affect almost everything you do.

Jeff Cupps, a rehab technology supplier (RTS) at Chesapeake Rehab in Baltimore, says you should always consult your neurologist, physical or occupational therapist, and RTS to get a good overview of your options.

Physical abilities

Your diagnosis and physical capabilities play a big part in deciding which mobility device is best for you, says Cupps, an RTS for 18 years.

“If your disease is progressing, then choosing the right equipment can mean all the difference in the world,” he says. “It depends on your diagnosis and prognosis, and which [piece of equipment] is going to meet your needs for the next five years.”

Using a manual wheelchair requires that you have good trunk and head control, some arm strength and the energy to propel the chair in your environment.

A power wheelchair could be a better choice if you have limited strength in your hands, arms and torso or are experiencing frequent fatigue, which can make it difficult to propel a manual wheelchair without help. And only with a power wheelchair can you get power tilt and recline or other power functions.

With a power chair, you don’t need to ask someone to push you, which gives you a whole lot of freedom and independence.

“With a power wheelchair you can do a lot more things than you can with a manual wheelchair,” Cupps says. “The whole functionality of a power wheelchair, I think, is essential for anyone to lead an active lifestyle.”

Or you can compromise by getting a power assist wheelchair or power assist add-on unit for your manual chair to give you a motorized boost.

If you want power to get around, but you don’t need the support of a power wheelchair, a scooter may work for you. Scooters offer the same sense of freedom as power wheelchairs, but they’re best for someone with a stable prognosis, trunk control and upper arm strength.

Environmental and transportation issues

In choosing a mobility device, Cupps recommends considering where you live and how you spend your time. Besides these environmental issues, you also need to think about your form of transportation.

“If you live in a city or you live on a farm makes a big difference in the kind of equipment you need to get around,” says Cupps. Do you live or work in tight quarters, or is your home or workplace spread out? Both manual and power wheelchairs, especially mid-wheel drive power chairs, are better for navigating narrow hallways and tight spaces. Scooters are big and bulky and most comfortably used outdoors or in malls.

Think about the terrain outside your house. It can be difficult to propel a manual wheelchair over uneven surfaces such as mud, gravel and grass, or up steep inclines, while a power wheelchair can handle a more rugged terrain. Although most scooters travel best on even surfaces, there are specialty 4-wheel drive scooters for off-road trips.

If your vehicle isn’t wheelchair accessible, and you can transfer into the driver or passenger seat, you can get a lightweight rigid manual wheelchair or a foldable manual wheelchair with a cross-brace frame. These chairs can easily be put in your car. Some have quick-release axles so you can take the wheels off.

Although most power wheelchairs and scooters are heavy, don’t fold and can’t be easily taken apart, you can find foldable power wheelchairs and scooters. Most people find them impractical to fold and dismantle. Another option is a wheelchair lift for the back of your vehicle.

Do you have an accessible vehicle or use public transportation? In this case a power wheelchair is perfect because you can stay in your chair while traveling in your vehicle. Cupps warns against sitting in a scooter while riding in a vehicle because it can tip over even when tied down.

Accessible vehicles are expensive, with the price of a new van ranging from $40,000 to $70,000. A used van can cost $25,000 to $30,000.

Cost and maintenance

Power wheelchairs are the most expensive of the three mobility choices. They can cost up to $20,000, depending on the features. But you may spend only $1,100 to $4,000 for a scooter, while the price of a manual wheelchair runs from $500 to $4,000. (MDA will contribute up to $2,000 toward a wheelchair prescribed by an MDA clinic physician.)

Since insurance providers, some state Medicaid programs and Medicare only cover one piece of mobility equipment every five years, choosing the right device is very important.

“Medicare wants to know that the chair is unrepairable, so it’s not only just 5 years old now, but it’s also got to be broken down beyond repair or require so much work that it doesn’t make sense to repair it,” says Cupps. “So if you have a 5-year-old lightweight wheelchair, and it just needs tires and armrest pads and maybe a little cleaning up, then that’s all they’re going to pay for.”

Manual wheelchairs don’t need as much maintenance as power chairs and scooters because they’re simpler and don’t have motors. You’ll have to get the power wheelchair or scooter repaired more often, which will add to the cost. Then there’s the expense of buying a new battery every two to five years.

Control and maneuverability

Power wheelchairs have more options for control and maneuverability than the other two choices.

If a standard joystick doesn’t work for you, try a hands-free device such as a sip-and-puff or head array device, says Cupps. But there’s no alternative way to drive a manual wheelchair or scooter.

A power wheelchair with mid-wheel drive has a 22-inch turning radius that makes it easy to maneuver. Scooters are difficult to maneuver because they’re larger and only have rear- or front-wheel drive.

Power wheelchairs can travel 15 to 20 miles before recharging compared 10 to 15 miles for scooters.

Try two

Some people prefer to have a manual wheelchair to use at home and a power wheelchair for outside. Others may use both a manual wheelchair and a scooter.

Of course, this depends on your financial resources, since insurance won’t purchase two.

But at least no one will gossip about you for having two sets of wheels. Just try juggling two mates at the same time.

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