By Jean L. Minkel, MA, PT
How you get around has a big impact on what you can do and where you can go.
Many people who have lived with a disability for a long time have found that careful consideration of the best way to get around has been a key to their independence. For some people the solutions have included multiple devices—different environments, different devices—a manual wheelchair in the home, a scooter for work, and even a handcycle for exercise.
Mobility assistance equipment comes in many forms, shapes and sizes. The options include:
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• Assistive devices for ambulation-items to help you when walking-cane, crutches, and walkers
• Manual wheelchair-including a chair with moveable wheels to improve your ability to self-propel, as well as chairs designed to be pushed by someone else.
• Power assist devices-devices added to manual wheelchairs to make it easier for the wheelchair rider to get around.
• Scooters-three wheeled (some are available with 4 wheels) devices with a tiller for steering, which help in getting around, but do not look like a wheelchair.
• Power wheelchairs-front wheel, mid-wheel and rear wheel drive options, controlled through a joystick or an alternate control device and available with multiple seating options including power seating.
Be an informed consumer. Ask other users about their experiences. Ask lots of questions.
Very often mobility assistance equipment is purchased through a third party payer, for example-medical insurance, Medicare/Medicaid, VA, or vocational rehabilitation. Each payer has their own set of “coverage criteria” and a system for purchasing. As you explore the mobility options available, keep in mind that you can purchase all of these products directly. If you have the resources, your private pay purchase can offer you greater selection, at less than manufacturer’s suggested retail price (MSRP) in a more timely fashion-no need to wait for “authorization.”
As you explore options, you may find it helpful to consult with a health care provider with experience in mobility devices. There are occupational and physical therapists (OTs and PTs) who specialize in assistive technology. There are certified rehab technology suppliers (CRTS), who specialize in individualized fitting and service of the devices. Ask other users, they are often a great source of information for locating the people in your local area who may be able to help you.
“My physical functioning was unchanged, just my mind and my world had finally opened up. With the scooter, I could get around again. And I loved the freedom.” In her recent book, When Walking Fails, Dr. Lisa Lezonni eloquently articulates the challenges faced by persons for whom the “acceptable” method of mobility—upright walking—is less than functional. Dr. Lezonni speaks from personal experience as a woman with multiple sclerosis (MS) who, after many years of assisted ambulation, first with one cane and then with two canes, decided to try a scooter. Adding a wheeled mobility device to your mobility options is a lot like looking for a new car.
There are so many options and choices, how can you begin to make an informed decision? To be really satisfied over time, requires you do some homework up front. There is no one best chair. The best choice is the product (or products) that allows you to go where you want to go, when you want to go! To achieve that goal, you need to consider the environments where you will be using the device and what things you will be doing. Some users have no choice about using a chair, it is the only form of mobility available to them. For others, a wheelchair may be “augmented mobility,” allowing for longer distance travel, without fatigue or fear of falling.
Options to think about. Do your homework!
Jean L. Minkel, MA, PT, is an educator and master clinician widely recognized for her expertise in assistive technology. She currently directs Minkel Consulting, a company providing educational and consulting services to clinicians, consumers, manufacturers and payers. This article was adapted from United Spinal Association’s assistive technology blog, Wheelchair Diffusion (www.usatechguide.org/blog).
