HealthInfo Canterbury
Deciding to use a wheelchair can be a difficult and emotional decision, and people come to it at different times. But if a lack of mobility is preventing you doing the things you enjoy, you should definitely consider using a wheelchair.
You can think of the wheelchair as just another tool that helps you do the things you need and want to do. Many people find that having a wheelchair can open life up to them again.
Having a wheelchair doesn't mean you have to use it every day. Many people continue to walk when they're comfortable to do so and keep their wheelchair as a backup or for longer outings.
Think carefully about how often and where you think you'll need a wheelchair. Te Whatu Ora – Health New Zealand funds wheelchairs for some people. This is administered through Enable and you can check with Enable to see if you're eligible. If you need a wheelchair for more than a few hours on any day, it's highly recommended that you arrange an assessment with a therapist through your general practice team.
If you're eligible, you'll need to be assessed by an accredited assessor (a physiotherapist or occupational therapist). Your general practice team can refer you for this.
In general, you're eligible if you need a wheelchair to get around your own home, work or school or if you need a specialised wheelchair due to a disability. If you only need a wheelchair to get around in the community to do things you enjoy, you probably won't qualify for funding and will need to buy or hire one yourself.
This guide is intended to help people looking to buy or hire a wheelchair for occasional use (daily or otherwise).
Wheelchairs have different types of wheels for different environments. You need to consider where you'll mostly use it and discuss this with the person you're buying it from.
For example, small hard wheels (castors) at the front are great on a smooth surface but useless on gravel. Hard wheels don't get punctures but can cause you to feel every little bump. Air-filled wheels are more comfortable but can get punctures that need repairing. Back wheels can be big (called self-propelling) or small (called transit wheels).
Big wheels make the chair easier to push and control but are heavier when lifting the wheelchair.
If you've decided to get a wheelchair, you may want to consider whether an electric wheelchair could suit you. These are more expensive and heavier if they need to be lifted into a car. But they give more freedom to the user as another person isn't needed to push them. Safety is an issue, so have a test drive to make sure you can comfortably control the wheelchair before you buy one.
If you'll ever need to take your wheelchair out in the car, make sure the person who'll be lifting it has a practise before you buy it. You need to check that they can manage the weight and that it fits your particular car. Many wheelchairs have wheels that can pop off and armrests that lift out to make the job easier.
Some electric wheelchairs have batteries that lift off to allow the chair to be folded.
Your wheelchair should be just wide enough that you can still fit into it if you wear a jacket, but you shouldn't be able to slip your fist down either side. A wheelchair that's too wide won't offer enough support and will often cause the user to lean to one side.
When you sit in your wheelchair with your bottom right back, your thighs should be well supported, and the seat should come to about 1 inch behind your knee. Any closer and your legs will rub against the edge, causing you to slump down. If the seat is too short for your thighs, you won't be comfortable for long, and your posture will suffer.
When you sit with your feet on the footrests, they should be able to sit flat and be well supported rather than dangling. You also need to check they aren't too high, which you can do by looking at your knees. If your knees are higher than your hips, the footrests are too high – they can usually be adjusted easily by the person in the shop or a wheelchair therapist. Make sure the footrests can be taken off altogether if you need to put the wheelchair in a car.
You should feel comfortably supported by your back rest. Take a moment to lean back into it and check that the support goes all the way up your spine. It should not be so high that it interferes with you moving your arms or head.
You should be able to comfortably rest your elbows without leaning forward (armrest too low) or hunching your shoulders (armrest too high). The armrests should be adjustable, so get the sales assistant in the shop or a wheelchair therapist to adjust them if necessary.
It is a good idea to consider having a seat belt in your wheelchair for extra security. It should sit low on your hips and not push into your stomach. You should be able to undo the seatbelt yourself without relying on anybody else.
Most wheelchairs only have basic upholstery to sit on, so it's worth considering buying a fitted cushion to give you comfort. The cheapest cushions are made of foam (which may become flat and unsupportive within a couple of years or so and need replacing). It's worth buying a spare washable cover and you may find a waterproof cover helpful as well.
As a guide, your wheelchair cushion should be as comfortable as your couch or armchair cushion. It's possible to get air- or gel-filled cushions, but if you don't need these at home, you shouldn't need them in your chair, unless you're going to be sitting in it for long periods. If this is the case, you should have a proper assessment as outlined above.
A wheelchair can be a life-changing purchase, but it's common to see people out and about in a wheelchair that just doesn't fit them properly or suit their needs. It usually only takes one or two sessions with a wheelchair therapist to be properly measured and fitted in a wheelchair.
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This leaflet lists where you can buy or hire wheelchairs, where you can get them repaired and the malls that have them available for loan.
Written by Jessie Snowdon (physiotherapist), On the Go Physio, Christchurch. Copyright 2011. Adapted by HealthInfo clinical advisers. Last reviewed November 2022.
Review key: HIDAH-120231