Choosing an Active User Wheelchair

INTRODUCTION

For people who spend most of their day in a wheelchair an active user chair is one that offers adjustability and manoeuvrability and can be configured to meet the specific needs of the user. These chairs provide the user with independence and mobility and have helped to dispel negative attitudes towards wheelchairs.

This type of chair is often regarded as sporty and suitable only for young, fit wheelchair users who play sport and can push for miles. Active user chairs meet these needs very well but in many ways they are as suitable for the older or possibly frailer user who is finding it increasingly difficult to propel a standard manual wheelchair.

Active user chairs are more flexible than the standard chairs and can be adjusted to meet the individual requirements of users so that he/she can achieve the maximum amount of mobility. They have quick release wheels, multiple axle positions and frames that are available in a wide variety of sizes.

Originally designed for sport, they are lighter than standard chairs and are therefore easier to propel and transport. Also, the large rear wheels can be brought forward to alter the weight distribution so that the user needs much less energy to propel the chair.

In addition, the above features make it much easier for someone else to push these chairs, so that they are being used increasingly as attendant-propelled chairs.

Remember that one wheelchair may not provide all the answers. Compromises may have to be made once the priorities of each need have been weighed up. Some users may require two different types of wheelchair, each for a different range of activities - one self-propelled wheelchair for everyday use and another for sports purposes; or a self-propelled wheelchair for use indoors for short distances, and a powered electric wheelchair for long distance outdoor use.

The information contained in this document is strictly for information purposes only. There are hazards with all equipment and the suitability of any solution is totally dependent on the individual. It is strongly recommended to seek professional advice and assistance before you consider buying any type of equipment mentioned in this Information Sheet.

For up-to-date information on specific products and suppliers in Ireland, visit the ‘Products Directory' and 'Suppliers’ sections of the Assist Ireland online database (www.assistireland.ie). The information in this resource can also be accessed using the telephone support service on 0761 07 9200 during office hours, or by emailing support@assistireland.ie.

WHAT DOES THE USER NEED?

A stable seating base

All wheelchair users who propel themselves need a comfortable, stable seating base. They cannot be expected to propel efficiently if part, or all of their energy is being channelled into trying to sit up straight. Many users waste valuable energy either shifting or fidgeting in the chair to maintain a comfortable posture or constantly heaving themselves up as they slide forwards or sideways. It is important that users are able to save as much energy as possible so that, having propelled themselves from A to B, they still have enough energy to carry out whatever activity is necessary. For people with mild to moderate seating difficulties, the correct size and positioning of the wheelchair seat unit components may be all that is needed to provide them with a stable seating base. For wheelchair users who do not have the ability to sit unaided, and those who lose that ability, perhaps as the result of a progressive disabling condition, a wheelchair that is used in conjunction with a more sophisticated seating system may be needed.

A stable seating base can be achieved if the following factors are considered:

Seat size

Arrows indicating the width of a user for choosing an appropriate seat size

Maximum stability will be achieved if the body of the user fits comfortably into the chair seat. If the seat is too wide, the user may not sit symmetrically; if the seat is too narrow, there is a risk of pressure sores.

If the seat is too short, the full length of the thighs will not be supported and too much pressure will be transferred onto the buttocks.

If the seat is too long, a pressure area may develop behind the knee, and the user may not get adequate support from the backrest.

Active user chairs are often supplied with a range of seat depths.

Shape and angle of seat

The seat needs to be level to achieve a good sitting posture. A sagging wheelchair seat canvas will cause users to sit asymmetrically with their thighs and knees rolled together. This will cause undue pressure and 'shearing' - the term used when the outer layer of skin is pulled in a certain direction while distorting and restricting the underlying blood vessels. This may lead to pressure sores.

The tension of the seat canvas on many active user wheelchairs can be adjusted to keep the seat level. However, if a sagging canvas cannot be tightened, and the canvas cannot be replaced, a flat sitting surface can be achieved by placing a piece of hardboard straight onto the frame providing a solid flat base on which to place a cushion.

The stability of the pelvis is determined by the angle between the thighs and the trunk, which, in turn, affects the ability of the user to maintain a good-seated posture. An angle of 90° is considered best for most people undertaking daily activities. The easiest way of achieving this is by using a ramped or contoured cushion, ie very slightly lower at the back to accommodate the buttocks.

However, on most rigid and some folding active user chairs, the seat angle or rake can be adjusted so that the rear seat height is lower than that at the front of the seat, thus creating a 'bucket' effect. The backrest will usually have to be inclined forwards slightly to stabilise the pelvis. This set up will improve the user's stability and performance since the centre of gravity is now lower to the ground.

However, disadvantages include causing greater strain on the spine, increased pressure and 'shearing' under the bottom, and potentially more difficult transfers as the user will need to move themselves forward up the slope before transferring out of the seat.

All wheelchair users should sit on a cushion that has been chosen at the same time as the wheelchair and fits the wheelchair seat. Full-time wheelchair users will probably need a pressure relief cushion; occasional users may only need one for comfort.

To fully stabilise the lower body, the foot support needs to be considered next.

Footrest length

If an angle of 90° between the hips and thighs of the user is achieved, most people will be comfortable if their knees are also at an angle of approximately 90°.

The footrests on the wheelchair should be set so that they support the legs and feet at a height where the undersides of the thighs are evenly supported along the length of the seat. If the footrests are too high or the seat too low, the knees of the user will be higher than the hips so that pressure under the buttocks is increased.

Arrows showing the length of the user's lower legs for appropriate footrest adjustment

If the footrests are too low, or the seat too high, the knees of the user will be lower than the hips and pressure will build up under the thighs and behind the knees.

Footrest angle

For users with long legs, some wheelchairs have footrests that are set out at a wider angle in front, so that the leg length can be accommodated without hindering activities such as kerb climbing. Some active user wheelchairs have a choice of two or three footrests, each of which is set at a different angle.

Footplate angle

The angle of some footplates (ie the flat plate at the end of the footrest on which the feet are placed) can be adjusted on some chairs. Feet, which can be very strong stimulators of muscle contractions of the whole body, may cause extension patterns or tremor spasms in the legs. This is a common problem experienced by users with MS (multiple sclerosis). By setting the footrest/footplate angle at less than 90° the feet of the user can be prevented from slipping forwards and down off the footplates. This also stretches the calf muscles and may inhibit extension patterns and spasms.

Backrest height

Arrows showing the length of the upper lumbar region for appropriate backrest support

Most people only need a backrest that supports them to about half way up their back in order for them to be stable. Although not as supportive as one that extends to just below shoulder height, it enables the user to propel without restriction. This is a compromise that many active users find most comfortable.

The only disadvantage of a wheelchair with a lower backrest is that the pushing handles are often too low if an attendant needs to push the chair. Some active user chairs have adjustable-height or tall, removable push handles to overcome this problem.

Backrest shape and angle

Most users will benefit from a backrest with an appropriately shaped lumbar area. Many chairs have tension adjustable straps which can be loosened or tightened appropriately to make necessary adjustments. This, combined with a suitable backrest angle, provides support and balance for the upper body.

Many active user chairs are provided with backrest angle plates that make it possible for the backrest to be angled forwards by a few degrees to provide maximum support. These plates are useful, as the sitting posture of a wheelchair user will often change over a period of time.

Arm support

In theory, if a person has a stable seating base then he/she should not need armrests.

Armrests should not be used to help someone stay in the chair - if this is the case, the seating base of the user should be reassessed. A more sophisticated seating system may be necessary.

However, armrests provide useful rest and stabilising positions for users who tire rapidly and/or those who have weak upper limb and neck muscles.

Armrest height

Arros showing the appropriate distance between elbow and knee for appropriate positioning of armrests

When armrests are properly adjusted, they should support the forearms of the user comfortably with the elbows at 90°. If they are too high, the shoulders of the user will be hunched; if they are too low, users will tend to slump to one side.

Armrests also provide an appropriate surface to push down on for users who stand up directly from their wheelchairs. However, they do make approaching tables and work surfaces difficult and often have to be removed for assisted transfers out of the chair.

Users whose wheelchairs do not have armrests should consider clothes guards made of stiffened material, which protect clothes from some of the dirt from the wheels and may also provide a degree if stability for the user.

A stable seating position will not only benefit users physically, but also psychologically because, if they are sitting straight, their clothes will hang correctly so that they will look and feel better.

Having sorted out the seating base on the wheelchair, the next thing to consider is the type and set-up of the wheelbase as this affects how much energy is needed to move the chair. It is often thought that the weight and the material from which the wheelchair frame is made are the main factors, which affect the manoeuvrability of the chair. In fact, it is the size and position of the wheels. These affect the weight distribution, the rolling resistance and, therefore, the manoeuvrability and the amount energy needed to propel the wheelchair.

A chair that is easy to manoeuvre

Man manoeuvering in a wheelchair

The ability to back-wheel balance has an important effect on manoeuvrability. To do this, the user balances the chair on the large rear wheels so that the front castors are lifted clear off the ground. This makes it easier for him/her to negotiate kerbs or avoid small obstacles such as an uneven surface or grids.

Tippiness is the term sometimes used to describe the ease with which the chair can be made to achieve this balance point.

The position of the rear wheels affects the ease with which a chair can be tipped. The wheels on standard wheelchairs tend to be set quite far back so that more leverage, and therefore more energy/effort, is needed to lift the castors off the ground.

To find the balance point of a standard manual chair, the castors have to be lifted quite a long way off the ground so that the chair is leaning backwards at quite a dramatic angle!

Active user chairs wheelchairs have a multi-adjustable axle plate which allows the wheels to be set further forward under the body of the user.

This not only affects the leverage, making it easier to lift the castors off the ground, but also the distribution of weight over the wheels, which, in turn, affects the tippiness of the chair. The higher the percentage of weight placed over the back wheels, the easier it is to lift the front castors off the ground. Standard wheelchairs have a weight distribution of 40:60 front to back wheel ratio, high performance wheelchairs have a 30:70 ratio.

This weight distribution also affects the rolling resistance, ie how much energy is lost during pushing. This can be calculated by dividing the weight of the wheelchair by the area of the wheel that is in contact with the ground. To achieve the minimum rolling resistance, as much weight as possible needs to be placed over the larger back wheels without compromising stability. A chair that is too 'tippy' will be dangerous. Always seek professional advice when setting up an active user chair.

The average active user wheelchair weighs 12kg and the weight is distributed 30:70 front to back wheel. Calculated in the way described above, this type of wheelchair has a rolling resistance of 1.5.

If a standard, self-propelled wheelchair weighs 18kg, the weight is distributed 40:60 front to back so that the rolling resistance of this type of wheelchair is 2.5.

To achieve the minimum rolling resistance, therefore, as much weight as possible needs to be placed over the larger back wheels without compromising stability.

An energy-conserving chair

Most standard self-propelled wheelchairs have a 20in-22in (51cm-56cm) rear wheel. Active user chairs usually have 24in (61cm) wheels but can have ones of 26in (66cm). Therefore, using the above calculation without taking into account any other factors, active user wheels are shown to have less rolling resistance since a larger area of the wheels is in contact with the ground so that the chair is easier to propel.

As the distance between the front and rear wheels is decreased, the turning circle is also shortened. The result is that less energy is needed to turn the chair, and it is more manoeuvrable in confined spaces.

The position of the rear wheels also affects the amount of energy needed for self-propelling. If the wheels are set with their axles in a vertical line with the shoulders of the user, maximum push with minimum effort can be achieved. This reduces the amount of wear and tear on the shoulder joints of the user.

A chair that is easy to steer

If the rear wheels of a chair can be cambered (ie angled towards the chair at the top), this will reduce dramatically the effort required to propel a wheelchair across a slope in a straight line. Anyone who regularly pushes outdoors and has to tackle pavements will therefore benefit from cambered wheels.

Less effort is needed to keep the wheelchair in a straight line if its wheels are cambered, and the ease with which the user is able to turn the wheelchair is also increased. For everyday use, camber up to 5° is acceptable. Beyond this, the chair often becomes too wide so that going through narrow spaces, eg doorways and small bathrooms, becomes difficult.

Wheelchair with standard wheels

Wheelchair with cambered wheels

People who use a wheelchair for sport may camber the wheels at more than 5° so that they can guide the chair with greater ease and accuracy.

A chair that is easy to transport

Wheelchairs can be cumbersome and heavy to lift into a car. High performance chairs with a cross-bracing mechanism underneath can be folded flat and made lighter if the leg rests and armrests and quick release wheels can be removed. Rigid-framed chairs can also be dismantled if the quick release wheels and armrests are removed and the backrest, etc are folded down. These 'stripped down' can be independently loaded into a car by the user lifting it across his/her body and storing it on the passenger seat or passenger footwell whilst driving.

A chair that is versatile/adaptable

A person's body shape and size of a person do not always remain static. As changes occur, wheelchair requirements may also change. Chairs which have interchangeable or adjustable component make them more versatile and adaptable.

A chair that meets the needs of carers

Many users of self-propelled wheelchairs are independent, and can get themselves in and out of cars and buildings. However, others may rely on someone else to load the wheelchair in and out of the car, or maybe to push them round in it, at least for part of the time.

If the person who is pushing the wheelchair is also the carer, it is especially important once the needs of the user have been met that as many as possible of the needs of the carer are also taken into account. By reducing energy expenditure and increasing the manoeuvrability and transportability of a chair, life will be made easier and the risk of back injury minimised. In addition, the right wheelchair will enable the carer to take the wheelchair user to a great many places that had previously seemed either difficult to get to, or even inaccessible.

A chair that makes the user look good and feel confident

A chair that is energy efficient and looks aesthetically pleasing will inspire confidence in the user.

ACTIVE USER WHEELCHAIRS

WHAT FEATURES SHOULD YOU CONSIDER WHEN CHOOSING A NEW WHEELCHAIR?

FRAME

Materials

Steel - strong, cheap but heavier than other materials. Easy to repair but may corrode if finish is damaged.

Aluminium magnesium alloy - lighter and not too expensive. An anodised finish helps to prevent corrosion and scratching.

Titanium and carbon fibre - extremely strong and lightweight but expensive. Does not corrode but may be difficult to repair.

Rigid frame

Tends to be lighter and stronger than a folding frame, and, as it has no moving parts, it usually requires less maintenance. It will be easier to propel as less energy is lost through the movement of the frame, However, unless it has suspension built in, it will provide a rougher ride as there is no shock absorbency in the movement of the frame. Rigid frames do not fold compactly for transporting - only the backrest folds down although the wheels and armrests can usually be removed. This type of frame is essential if the user is likely to take part in sports, as they will not fold if hit from the side.

Folding frame

Enables wheelchair to be folded flat for easier storage and transportation. However, because there are several moving parts and joints, it tends to be heavier that a rigid frame chair, and may require more maintenance. Requires more energy to propel as energy is lost in the frame movement, but provides more shock absorption. Not recommended for sports use. Historically, folding frames did not have the same degrees of adjustment to modify for individual adjustment, however, as technology moves on, this is becoming less apparent.

Semi-rigid frame

Similar properties to rigid chairs (ie less energy is lost because of frame movement) because the frame locks into place when open, but they incorporate some kind of folding mechanism to make them easier to store and transport.

Anti-tip device

Anti-tip devices

Useful to give confidence to users starting to use a wheelchair, and for those learning to back-wheel balance. However, they may inhibit users who use back-wheel balancing to get up kerbs. Check whether the anti-tips can be removed when the user feels confident enough.

Tipping levers

Enable another person to assist with kerb climbing - not usually needed as wheelchairs with a variable axle can be adjusted so that they tip back more easily.

TYRES

Castors

These are the small front wheels that steer and manoeuvre the wheelchair. There are many different sizes and types of castor available on the market - some are very functional, other are purely for aesthetic looks. Large castors provide more rolling resistance and therefore make propulsion more difficult. However, they roll more efficiently over uneven or rough ground and are more manoeuvrable over thresholds etc. Small castors provide a small turning circle and better foot clearance.

Pneumatic - These are air-filled and therefore usually offer better shock absorption than solid ones and provide a more comfortable ride. May puncture and also require regular maintenance and inflation.

Solid - Hard-wearing but provide little shock absorption and therefore a rougher ride.

Sports castors - These are very small and solid castors, great for sport but difficult for use outdoors over uneven ground.

Puncture-proof - filled with a jelly-like substance; need less maintenance.

Coloured castors - Available as a design feature as are those with flashing lights.

Adjustable position castors - By adjusting the position of the castors, the wheelbase can be shortened so that the wheelchair becomes more manoeuvrable.

Main tyres

There are many different types of tyres available to be used with active user chairs.

Pneumatic - These are air-filled and therefore usually offer better shock absorption than solid ones and provide a more comfortable ride. They may puncture but some have a special protective inner layer to reduce the likelihood of this happening. They are available with a strong profile grip which provides good traction, or a 'slick' profile which creates a low rolling resistance. They require regular maintenance and inflation. Some pneumatic tyres require a higher tyre pressure which are easier to propel on solid surfaces, but tend to be more expensive and wear out quicker.

Sports - These high pressure tyres have very little tread on their surface. They therefore provide less traction and rolling resistance, and so less energy is needed to propel the chair. Used mainly on sports wheelchairs, their features also make them useful for weak, independent users who tire too quickly when using ordinary tyres. However, they may prove an expensive option as they wear out quickly.

Solid/puncture proof - Hard-wearing but provide little shock absorption and therefore a rougher ride. They are heavier than pneumatic tyres. Available with strong and low profile grips.

Other types of tyre include those with a smooth sidewall which reduces the chaffing to the user's hands, 'off road' mountain bike type tyres, a folding tyre for carrying easily as a spare, extra wide tyres for a high profile or extreme outdoor conditions such as snow.

DRIVE WHEELS

Multi-adjustable axle plate

Multi-adjustable axle plate

This plate enables the rear drive wheels to be positioned so that a compromise can be reached between manoeuvrability and stability. The chair will be most stable when the wheel is set in the bottom back position, and least stable when set in the top front position.

Quick release wheels

Useful to reduce the weight/size of the wheelchair when storing and transporting.

For those users who have restricted finger movements, a quad release mechanism can be obtained which makes the wheel easier to remove.

Materials

The wheel rim can be made of a variety of materials which will effect the weight and strength of the wheel.

Aluminium - strong, light and rustproof.

Titanium/carbon fibre - very light in weight but expensive.

Plastic - strong, the whole wheel has to be moulded in plastic - the rim, spoks and hub - a 'mag' wheel.

Spoked wheels

Usually made from aluminium or stainless steel, they make for a smooth ride as their flexibility allows shock absorption. The more spokes on a wheel, the better the shock absorption. Although the spokes can be fairly easily bent or damaged, individual ones can be replaced. Most spoked wheels require regular maintenance, but makes such as 'Spinergy' wheels are lightweight and maintenance free.

Composite (or mag) wheels

Composite (or mag) wheels

Moulded rim, hub and wide spokes (usually about six) give the chair a sporty appearance and are easily cleaned. Although they are more robust and require less maintenance than spokes, if one does get broken it cannot be replaced indiviually. They provide much less shock absorption and therefore a bumpier ride. They are heavier than spoked wheels. They are sometimes used with spoke guard as fingers can easily be trapped in the gaps betweent the spokes as the wheel spins round. However, the advantage to these large gaps is to allow easy access under the chair.

Handrims

May vary in shape and finish. High friction finishes are available but may damage the hands if the wheelchair is stopped at high speeds. Capstan hand rims (with projections at oblique or right angles) may help a user who needs to propel with the palm of the hand.

Camber

Ability to camber the rear wheels reduces the effort needed to propel a wheelchair across a slope in a straight line. Very important for anyone who pushes outside and therefore needs to tackle pavements.

Diameter

Drive wheels range in size from 18-26in (51-66cm). In general, the larger the wheels the less effort is needed to propel, but check whether they would hinder transferring especially on a short wheelbase.

BRAKES

High-mounted brakes

May cause obstruction when the user is transferring sideways. Also, fingers tend to catch in them when propelling. If the latter is a problem, look for brakes that retract when in the 'off' position.

Low-mounted brakes

User needs good balance to be able to reach down and operate them, but do not impede transfers.

Hill brakes

Allow forward propulsion but prevent rolling backwards on a hill.

Extension handles

Available for users unable to reach the operating lever, but may impede transfers.

FOOTRESTS

One-piece tubular

One-piece footrest

Because there are no moving parts, this type of footplate adds rigidity to the frame. The taper provides a sleek look and more support around the user's legs, helping to keep the feet in position and making manoeuvring through tight spaces easier. However, it may make transfers more difficult.

Flip-up

Flip-up footrests

Enable user to stand within the frame when getting up from the wheelchair. They may be flip-ups alone on a rigid chair, or combined with swing-away fittings on a folding chair.

Swing-away (out or under)

Can be moved out of the way for transferring. Usually detachable as well. Some semi-rigid wheelchairs have one-piece footrests which swing back under the seat to ease transfer.

Swing-away footrests

Detachable

Reduce the size/weight of the wheelchair for storing and transporting.

Elevating

For users who need to have their legs raised for long periods, or who need to keep them straight.

  • Some models have the option of different, fixed angle footrests, which can accommodate fixed deformities, tone reduction and extreme height while still enabling the footplates to clear the ground.

ARMRESTS

Active users with a stable seating base may not want armrests that can restrict arm movement and so make propelling the chairs more difficult. A clothes guard may help to protect clothes from dirt and damage. They would need to be dropped down for transferring.

Desk-style

Desk-style armrest

Allow access to work surfaces but do not provide support for people who need to push down on the armrest to stand up.

Tubular

Offer minimal support, look sporty and usually swing out of the way.

Adjustable-height

Can be adjusted to provide maximum support.

Fold-up/fold-down/swing-away

May be more convenient for sideways transfers than detachable ones that can be mislaid.

Detachable

Reduce size/weight of wheelchair for storing and transportation. However, care should be taken not to mislay during removal.

BACKREST

Dimensions

Angle and height of backrest affect posture.

Folds backwards/forwards

Useful when storing and transporting.

PUSHING HANDLES

Many are an integral part of the backrest frame - others are an optional extra.

Adjustable height

A good idea if a person is assisting as they can help reduce backache during prolonged pushing.

Adjustable angle

Many rigid frame active user chairs are provided with backrest angle plates which make it possible for the backrest to be angled forwards by a few degrees to provide maximum support. These plates are useful as the sitting posture of a wheelchair user will often change over a period of time.

SEAT

Dimensions

It is vital that the user is accurately assessed for the correct seat size, as this will determine posture and comfort.

Weight

A lighter wheelchair is usually an advantage for both an active user and for someone who is assisting.

PROVISION OF EQUIPMENT

Medical Card Holders

Equipment for people with disabilities, sometimes referred to as aids and appliances, is usually supplied free of charge to medical card holders. The card holder must first be assessed by the relevant therapist who can recommend and prescribe the most suitable equipment.

Long Term Illness Card Holders

People who have one of the conditions listed as qualifying under the Department of Health’s Long Term Illness Scheme may be eligible to receive items of equipment, essential for the primary condition, free of charge. Assessment by the relevant professional is required.

Hospital Treatment

People in hospital may have aids and appliances provided free of charge when they are prescribed as part of in-hospital treatment in a public hospital.

Health Insurance Schemes

The main companies offering private health insurance in Ireland are:

  • Voluntary Health Insurance (VHI)
  • Irish Life Health
  • Laya Healthcare
  • GloHealth

Some policies provide members with cover for a limited number of aids and appliances under their out-patient schemes. A list of approved appliances is available on request. A claim for the reimbursement (part or full) will be subject to a member’s out-patient excess. Medical certification is usually necessary. Contact your health insurance company’s Customer Services to check if a particular appliance is covered by your policy.

Some employers have their own special health insurance schemes which provide cover for their employees. The employee’s family is also often covered. Check with the employer to see what, if any, equipment is covered under the scheme.

ASSESSMENT

Depending on the type of equipment required, a qualified therapist will assess the individual and make a recommendation to the body responsible for the provision of the equipment or to the person or agency who has requested the assessment. Generally the following applies, but the assessment process and provision may vary in different parts of the country.

  • Occupational therapists will assess for aids to daily living – these include wheelchairs, mobility aids, specialised chairs, bath, shower and toilet aids, stairlifts, hoists etc
  • Physiotherapists will assess for movement, strength and balance training equipment, walking aids and exercise devices
  • Speech and language therapists will assess for communication, speech therapy, and training aids
  • Other relevant therapists and specialists may also be involved in carrying out assessments, depending on the equipment or appliance required.

All the different therapists described above are based in hospitals, community care areas, and with various voluntary agencies. For more information, contact the Community Care section of your Health Services Executive area or the relevant hospital department as appropriate.

SHORT TERM LOAN/HIRE OF WHEELCHAIRS

Quite a variety of equipment, including wheelchairs, hospital beds, hoists and a variety of walking aids, can be hired for daily, weekly or monthly periods. Many of the companies and voluntary organisations that provide this service can be found in the Golden Pages under ‘Disabled Persons Products & Services’, or by contacting your local public health nurse or community occupational therapist.

Before you choose to hire, consider the following:

  • Does the company provide a delivery and/or collection service and, if so, are there any additional charges?
  • Does the company ask for a deposit and is it refundable?
  • If hiring long term, is the vehicle subject to a six-monthly service and, if so, will a replacement wheelchair be supplied in the mean time?
  • Who is responsible for maintenance if you have a puncture, for example?
  • If you are hiring for holiday use, are you permitted to take the vehicle overseas? Are there additional charges, and/or an increase in the deposit needed?
  • Are you obliged to take out insurance? Is this included in the price, and what does the insurance cover?
  • When hiring a wheelchair, make sure you understand how to operate it and feel confident using it; and make sure you receive instructions on how to charge the batteries (if required) and carry out other simple maintenance.

Shopmobility

A Shopmobility scheme operates in Liffey Valley Shopping Centre in Clondalkin, Mahon Point Shopping Centre in Cork, Dundrum Town Centre in Dublin, Blanchardstown Shopping Centre in Dublin 15, and Whitewater Shopping Centre in Newbridge, Co Kildare. This scheme enables anyone to get the loan of a manual wheelchair, a powered wheelchair or a powered scooter while shopping. This is a free service and helpful for anyone who finds shopping a tiring experience. To avail of this service, you must have two pieces of identification with you including photo ID. It is advisable to ring beforehand, particularly coming up to a holiday period or a bank holiday weekend (see Useful Addresses).

Some other shopping centres also have manual wheelchairs that they loan out to customers. Contact Customer Services of the shopping centre to check on the availability of this service.

PURCHASE OF EQUIPMENT

Private Purchase of Equipment

Private purchase may be necessary if the user is not eligible to obtain the necessary equipment from the local area health services. Some people may also choose to buy privately because they want the wider choice of equipment available on the private market.

The purchaser has the option of:

  • personally funding the cost of the equipment
  • applying to charities/benevolent funds etc for funding
  • buying second-hand
  • checking with your health insurance company, if a member, to see if, or what, reimbursement is available.

Private Purchase – Applying for a VAT Refund

VAT paid on certain equipment which is privately purchased for use by a person with a disability can be reclaimed from Revenue. The relief applies to VAT on the purchase of goods which are aids and appliances designed to assist a disabled person to overcome a disability in the performance of their daily functions. Most aids to daily living and communication aids are included. Goods designed for leisure purposes are not. An invoice clearly stating the VAT content of the total amount paid must be included with the application. Form VAT 61a is available from Revenue or can be downloaded from their website (see Useful Addresses).

Funding from charitable sources

If you have little or no disposable income, but do not have a medical card, you could consider applying to a local charity, benevolent fund or occupational fund for financial assistance. Some such organisations have budgets for exceptional cases or needs and requests will be dealt with in confidence.

Private Occupational Therapists

Occupational therapists in private practice can carry out assessments in the home or workplace, and if home modifications are being considered, provide a report detailing the recommendations. It is important to ensure the therapist is experienced in relation to your particular needs. Make sure to discuss fees before engaging anyone’s services, and also check what the assessment fee includes (or does not include). The profession’s representative body, the Association of Occupational Therapists in Ireland (AOTI), keeps a list of contact details of member occupational therapists working in private practice in Ireland. This list is available from the AOTI (see Useful Addresses).

Private Physiotherapists

Physiotherapists can assess for movement, strength and balance training equipment, walking aids and exercise devices and recommend accordingly. If you wish to consult a physiotherapist you can go directly to your local chartered physiotherapist or ask your GP to refer you. It is important to ensure the therapist you consult is experienced in relation to your particular needs. Chartered physiotherapists work in hospitals and in the community where treatment is covered under the public health service. They also work in private practice and can be contacted through the profession’s representative body, the Irish Society of Chartered Physiotherapists (see Useful Addresses), or through the Golden Pages.

Second-hand equipment

Buying second-hand can be a cheaper way of finding a solution to your mobility difficulties but, since choice is more limited, you must make sure that you do not compromise on your essential requirements. Also check that what you are buying is in good working order. You do have certain consumer rights when buying second-hand; for example, the seller must accurately describe the product he/she is selling; and you should be made fully aware of any faults that need attention. If possible, obtain a written description of the product from the seller before you buy so that, should you find any faults, you can get your money back more easily.

There are basically two sources of second-hand equipment: equipment retailers and private individuals.

Some commercial suppliers also buy unwanted or little used equipment, recondition them, and then offer them for sale with a short guarantee of, for example, three months. Buying second-hand from a retailer is generally more expensive than buying from a private individual, but the equipment is likely to have been serviced and should be in reasonable working order.

Buying from a mobility equipment retailer

Some commercial suppliers of wheelchairs also buy unwanted vehicles, recondition them, and then offer them for sale with a short guarantee of, for example, three months. Buying second-hand from a retailer is generally more expensive than buying from a private individual, but the wheelchair is likely to have been serviced and should be in reasonable working order.

Buying from a private individual

Some mainstream magazines and several disability organisations publish journals that contain advertisements for second-hand equipment. If you are buying second-hand from a private individual, you must make sure that the wheelchair has been regularly maintained, that you also receive accompanying literature, for example a care manual; and that you receive instructions on how to control and steer the wheelchair. You will also need to find the local company able to service your wheelchair and carry out future repairs.

TRY BEFORE YOU BUY

Wheelchairs are expensive so it is essential that you do not rush into buying a vehicle that you later find is not entirely suitable. If the wheelchair is being provided by the health services, the occupational therapist and wheelchair service provider will be able to assist you in selecting the most suitable wheelchair for you.

Before buying privately, it is strongly recommended that you seek the advice of an occupational therapist on the suitability of the wheelchair to your condition or situation. It is also recommended that you try out and compare a range of different wheelchairs if possible.

You can arrange to visit a supplier’s showroom (if they have one). Contact details of suppliers can be found under ‘Disabled Persons Products & Services’ in the Golden Pages and some may have a website with details of their products and services which you can view online.

Sometimes suppliers organise exhibitions of different types of equipment in various locations around the country allowing people to see and try equipment. These exhibitions are often advertised in the local paper or on local radio. You can also request to be put on a supplier’s mailing list so you will be notified if there is an event being held in your area.

Some companies will give equipment for a try-out period before purchase. Enquiries should also be made about maintenance (if it will be required), maintenance contracts (if relevant) and whether a user manual is provided with the equipment (essential).

When purchasing from any supplier, it is important to remember that it is their business to sell. There may be several suppliers of that particular piece of equipment or different manufacturers of the same type of equipment, so always shop around.

Before you commit to buying, check the following:

  • What is the delivery time?
  • Will the wheelchair arrive readily assembled?
  • What guarantee is available?
  • What after-care service is offered?
  • How much is the call out charge?
  • Will spare parts be brought to the home?
  • If the chair has to be taken away for repairs will a 'loan chair' be offered?
  • Does the manufacturer offer insurance schemes?

USEFUL PUBLICATIONS

  • Building for Everyone
    Publication which examines buildings and the external environment to achieve equality and inclusiveness for everyone. Available from:
    National Disability Authority
    25 Clyde Road
    Dublin 4
    Tel: 01-608 0400
    Fax: 01-660 9935
    Email: nda@nda.ie
    Website: www.nda.ie

USEFUL ADDRESSES

  • Association of Occupational Therapists of Ireland (AOTI)
    Office 1 & 2
    1st Floor
    Haymarket House
    Smithfield
    Dublin 7
    Tel: 01-874 8136
    Email: info@aoti.ie
    Website: www.aoti.ie

  • Irish Society of Chartered Physiotherapists (ISCP)
    Royal College of Surgeons
    St Stephen's Green
    Dublin 2
    Tel: 01-402 2148
    Fax: 01-402 2160
    Email: info@iscp.ie
    Website: www.iscp.ie

  • VAT (Unregistered) Repayments Section
    Revenue Commissioners
    FREEPOST
    Central Repayments Office
    M: TEK II Building
    Armagh Road
    Monaghan
    Tel: 047 621 000
    LoCall: 1890 60 60 61
    Email: cromon@revenue.ie
    Website: www.revenue.ie

  • Shopmobility (a free service offering manual wheelchairs, powered wheelchairs and scooters to members of the public with limited mobility for periods of up to a day)
    Liffey Valley Shopping Centre
    Quarryvale
    Clondalkin
    Dublin 22
    Tel: 01-620 8731

  • Shopmobility(a free service offering manual wheelchairs, powered wheelchairs and scooters
    to members of the public with limited mobility for periods of up to a day)

    Blanchardstown Shopping Centre
    Red Car Park - Marks and Spencers Entrance
    Blanchardstown
    Dublin 15
    Tel: 01-821 1911

  • Shopmobility (a free service offering manual wheelchairs, powered wheelchairs and scooters to members of the public with limited mobility for periods of up to a day)
    Mahon Point Shopping Centre
    Mahon
    Cork
    Tel: 021-431 3033

  • Shopmobility (a free service offering manual wheelchairs, powered wheelchairs and scooters to members of the public with limited mobility for periods of up to a day)
    Red Car Park (Level 2M)
    Dundrum Town Centre
    Dundrum
    Dublin 14
    Tel: 01-298 7982

  • Shopmobility (a free service offering manual wheelchairs, powered wheelchairs and scooters to members of the public with limited mobility for periods of up to a day)
    Green Car Park
    Whitewater Shopping Centre
    Cutlery Road
    Newbridge
    Co Kildare
    Tel: 045-450736

  • Irish Wheelchair Association (IWA)
    Áras Chúchulainn
    Blackheath Drive
    Clontarf
    Dublin 3
    Tel: 01-818 6400
    Fax: 01-833 3873
    Email: info@iwa.ie
    Website: www.iwa.ie

  • Disabled Living Foundation (DLF)(UK charity providing advice and information and a comprehensive up-to-date database of disability equipment available in the UK)
    Ground Floor
    Landmark House
    Hammersmith Bridge Road
    London W6 9EJ
    England
    Tel: 0044 207 289 6111
    Email: info@dlf.org.uk
    Website: www.dlf.org.uk

  • Rica(independent research body in UK which produces guides for older and disabled consumers based on professional research)
    G03, The Wenlock
    50-52 Wharf Road
    London
    N1 7EU
    England
    Tel: 0044 207 427 2460
    Fax: 0044 207 427 2468
    Email: mail@rica.org.uk
    Website: www.rica.org.uk