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Clothing Ideas for Wheelchair Users

INTRODUCTION

This Information Sheet has been written to give some general guidelines and ideas when choosing clothes and adaptations to clothes.

For up-to-date information on specific products and suppliers in Ireland, visit the ‘Products and Suppliers’ section 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 079 200 during office hours.

GENERAL GUIDELINES

When choosing clothes, you may need to consider:

STYLES

  • Longer neck-to-waist and waist to crotch lengths.
  • Loose fit around the buttocks and tops of thighs.
  • Longer length trousers.
  • Loose fit across the shoulders and upper arms when self-propelling.
  • Slippery linings.
  • Flat soft seams.

COLOUR

  • Lighter, patterned shades worn on the upper half of the body with dark plain-coloured trousers or skirts can help maintain a balanced visual image.
  • Try to avoid horizontal stripes.

FABRICS

It can be useful to know the advantages and disadvantages of different types of fabric.

  • Easy-care fabrics retain a good appearance and need little ironing
  • Stretch fabrics dry quickly, are comfortable to sit in and make dressing easier.
  • Closely-woven fabrics, made from blends of natural and synthetic fibres are strong, keep their shape, and resist creasing.
  • Smooth slippery fabrics are easier to get on/off. However, when worn as garments on the lower half of the body these may encourage someone with limited sitting ability to slide out of the wheelchair.
  • Most man-made fibres are warm but can cause sweating and overheating and be uncomfortable for those with sensitive skin.
  • Natural fibres are more comfortable next to the skin and help to maintain a constant body temperature.

ADAPTATIONS

Ready-made garments can be adapted in various ways, and most alterations are feasible for someone with dressmaking skills, or a local dressmaker or dry cleaner may be able to make alterations. But:

  • Before making any alterations always check the seam allowance is wide enough.
  • At each stage tack and try on the garment before cutting away any fabric.
  • If making several adaptations or adjustments tackle one at a time, completing each one before attempting the next.
  • If appropriate, try propelling your wheelchair to see how your movements affect the garment,

OUTDOOR WEAR

It can be difficult for a seated person to put on a full-length coat.

  • Casual jackets, anoraks or sleeveless body warmers, which finish just below the waist, are easier to put on.
  • Salopettes (padded overalls similar to dungarees) worn with short skiing jackets are very warm and can be easy to put on.
  • Rain capes, fabric capes and coveralls are available from specialist suppliers. Ensure that the size and position of the armholes enables you to push the wheelchair.
  • Quilted zipped bags, which are shaped for wheelchair wear, are also available. These will help keep your lower body warm. They are usually shower-proof and more convenient and warmer than a rug, which can get in the way of wheels.
  • Raglan sleeves or dropped shoulder seams give better armholes. If the jacket has a slippery lining, it is much easier to put on.
  • Quilted and blouson style jackets and body warmers provide warmth without weight.
  • Short capes, shawls and ponchos are useful as they can be slipped on easily.

TAILORED SUITS

Off-the-peg suits may not be practical for an active wheelchair user, as the jacket may be too long and the trousers too short in the crotch. Some of the alterations mentioned later in this Information Sheet may be appropriate.

A few specialist mail order companies will make reasonably priced suits to your measurements. Alternatively, consider having your suits made-to-measure incorporating the suggestions given below into the make of the suit.

JACKETS

Jackets must be sufficiently full across the back of the shoulders. Styles with a double rather than a single rear vent may be more accommodating giving more room in the front.

ADAPTATIONS TO A TAILORED JACKET

For ease of dressing

If a zip is inserted into the centre-back seam this will help a carer to ease the jacket on:

  • Open the centre back seams of both jacket and linings and a short section of the collar seam.
  • Tack the jacket seam back together along the seam line, so that when the zip is inserted, the edges of the seam meet
  • Insert the zip open end down.
  • Hem the turned-back seam allowances of the lining over the zip tapes.

Enlarging the underarm by inserting a gusset makes dressing easier and quicker:

  • Open the seams at the garment armhole, including the lining, approximately 5 inches/13cm each way.
  • Cut the gusset out of a matching piece of fabric on the cross approximately 6 inches/15cm square inclusive of seam allowance.
  • Sew the gusset in to the opening, trimming off the surplus material.
  • Repeat the process for the lining or neaten by sewing the lining to the gusset seams.

To insert a zip or zips in underarm seams:

  • Open underarm sleeve seam and lining from armholes to elbow and side seam from armhole to waist.
  • Insert zips to open at the armholes - if the seams meet at the armhole, fit a single zip to open in either direction.
  • Open lining seams in the same way, and hem the turned back seam allowances to the zip tapes.

To shorten a back (to prevent the discomfort of sitting on the lower hem and bunching over the waist and hips):

  • Open side seams from waist to hem, cut the back of the jacket and lining to the required length allowing just enough extra for hem.
  • Hem the lining down along the opened side hems of jacket front to neaten appearance. Reinforce the stitching at the top of side seam openings.
  • Hem at the new level.

To create a vent that will prevent the front of the jacket dragging and creasing:

  • Open the side seam from waist to hem.
  • Hem the lining down along the opened side seams of the jacket front to neaten the appearance. Reinforce the stitching at the top of side seam openings.

TROUSERS

Features to look for include:

  • Deep trouser body to avoid gaping between trousers and tops.
  • A long fly opening to make dressing easier.
  • Accessible front pockets, avoid pockets at the back or side.
  • Styles with soft pleats in the front or that have elasticated waists are loose and can be comfortable. Avoid trousers which are plain cut with a rigid waistband.
  • Elasticated/half elasticated waistbands or side-panels will give comfort and fit and grip tucked in shirts and blouses.
  • The crotch seam should not be too tight.
  • Avoid trousers with wick/hard seams.
  • Jeans, although hardwearing, are not very suitable for wheelchair users; choose softer pliable jeans when possible, try to avoid crotch seams, pockets or riveted studs.

Ranges of trousers incorporating many of the above features are available from specialist suppliers.

If you buy trousers from high street stores, alterations may enable them to fit better.

ADAPTATIONS TO TROUSERS

To lengthen the waist at the back:

  • Tie cord around natural waist and measure the gap between string and trouser waistband.
  • Unpick the waistband from the back of the trousers.
  • Cut a piece of fabric to fit the gap. The shape should taper towards side seams. Allow additional 1.5cm for seams.
  • Sew lower edge of fabric piece to top edge of trouser back.
  • Finally replace waistband.

To shorten the waist at the front:

  • Unpick the front of the trouser waistband.
  • Remove any zip.
  • Pull up the front of the trousers and tie cord around the natural waist over the trousers. Use the string to mark the line on the fabric.
  • Cut excess fabric, allowing for 1.5cm seam.
  • Lengthen the fly opening using spare fabric to extend facing and replace the zip fastener.
  • Replace the waistband; make darts in any spare fabric at the front of the trousers towards the side seam.

To dart behind the knee:

  • Mark the position of the knee dart when the wearer is sitting. Pin to remove the excess material taking care that the trouser bottoms are level.
  • Sew along dart tapering towards each end.
  • Open the dart and press flat for increased comfort.

SKIRTS

  • A-line skirts can give the appearance of a straight skirt without the fabric pulling across the hips.
  • Styles that gather over the stomach may not look attractive.
  • Fabrics such as soft jersey, which drape or hang well.
  • Semi-elasticated or fully elasticated waist styles allow some 'give', yet will grip a blouse or shirt firmly.
  • Long skirts should not be so long or full that they catch in chair wheels.
  • Culottes/divided skirts have many of the practical advantages of trousers while giving the appearance of a skirt.
  • Button-front or wrap-around skirts can be laid on the wheelchair before sitting on it. This may make dressing easier and the skirt can be unfastened and left on the chair when transferring to/from the toilet.
  • A skirt that over-wraps at the back can be put on while seated, then separated and tucked out of the way or easily removed before transferring onto the toilet.

DRESSES

  • Belts and fitted waists can be uncomfortable.
  • Dresses with elasticated waists or softly gathered styles are more comfortable.
  • Styles, which have front or no fastenings, are easiest to put on.

BLOUSES, SHIRTS AND JUMPERS

  • It is important that blouses, shirts and jumpers have large armholes and have sufficient fullness across the back and shoulders to ensure that they are easy to put on and that a wheelchair can be propelled unimpeded.
  • Tops made from jersey fabrics are stretchy and give when you move.
  • Those with gathers, pleats or tucks in the back yoke, and dropped or raglan shoulder seams allow for active movement when propelling a wheelchair.
  • Longer length or layered T-shirts, blouses and jumpers worn over trousers or skirts, make it less likely that garments will separate at the waist.
  • Long sleeves can become very dirty and worn if they are caught in chair wheels. Cuffed sleeves which are not too full minimise the chance that this will happen; sleeves which are particularly vulnerable can be covered with a removable protective cuff. Short or elbow length sleeves avoid the problem.

ADAPTATIONS TO BLOUSES, SHIRTS, AND JUMPERS

To make an inverted pleat in the back of the garment:

  • This can only be carried out if the garment has a centre back seam.
  • Measure the centre back seam, open it and enough of the yoke or collar seams to allow for insertion of the pleat.
  • Cut a piece of matching or contrasting fabric-length - the centre back measurement plus hem and seam allowance is suggested.
  • Sew fabric insert to seams of garment.
  • Bring seams together and fold insert sides-to-middle to make the inverted pleat, tack across the top. Sew up the collar/yoke seam to include the pleat.

To strengthen seams:

  • Machine-sew along the line of the seam. Use an elastic straight stitch if possible.
  • Alternatively, use seam binding and double stitch it over the seams.
  • Re-sew through seam binding, this is particularly effective if the seams are curved.
  • Seams in stretch fabrics are best reinforced with a small zigzag stitch.

UNDERWEAR

Pants should always fit comfortably - avoid tightness at the waist and groin. Loose styles are a wise choice if you have a catheter as they will not cause back-pressure in the catheter tube. Loose rather than close fitting styles are also easier to pull up and down. Cotton and natural fibres may be the most comfortable to wear.

Women

  • For women who struggle to pull up/down their underwear, wide leg French knickers may be broad enough to enable them to pull the crotch to one side for self-catherisation.
  • Cami-knickers are another option; those that fasten at the front of the crotch are easiest to manage. Fastenings can be replaced with Velcro. Always ensure the hooked surface faces away from the body.
  • Tanga pants with thin elastic at each side may be easier to pull up and down.
  • If you transfer onto the toilet by hoist, open-crotch knickers or drop-front pants amy be helpful

Men

  • For men who use a hoist, drop-down underwear complete with trousers may be the most appropriate option.
  • For additional information, see the Assist Ireland Information Sheet ‘Clothing for Continence and Incontinence’.

VESTS

A shorter vest can be taken off and put on easily and will not get in the way when using the toilet.

BRAS

Reaching behind to fasten a bra whilst seated in a wheelchair can be difficult.

  • A front fastening bra should be easier to fasten.
  • A back-fastening bra can be put on at waist level and fastened at the front, then moved round and pulled up into the conventional position.
  • If shoulder straps slip, they can be anchored to the shoulder seams of the dress or top using a safety pin or a small stud-fastened loop. Alternatively, T-back or racer style backs may be more appropriate or a bra accessory can be bought to link the shoulder straps across the back.

CORSETRY

Women who wish to wear a foundation garment should seek expert advice. But, by clever choice of clothing, you can avoid the need for corsets. For example, stockings can be fastened by suspenders to cami-knickers, a liberty bodice or simple suspender belt rather than wearing a corset. Open crothch corsets can be worn with pants over the top, so that the corset does not need to be removed when using the toilet.

PETTICOATS

Petticoats made from slippery material can make dressing easier, assisting the top garments to slip on as well as easing transfers. Half petticoats and camisole tops are easier to get on when seated.

If you wear a fully lined skirt, you may not need to wear a petticoat.

NIGHTWEAR

  • Nightwear made of cotton is the coolest and most absorbent.
  • Elasticated, waisted pyjama trousers are easier to get on and off than button or cord fastening styles.
  • If you find it hard to turn over in bed, satin or silk may facilitate this movement.

DRESSING GOWNS

Many dressing gowns are difficult to get on and off.

  • A short style with raglan sleeves is best.
  • A towelling poncho could be an alternative, these are available from special suppliers or can be made by sewing two towels together lengthwise leaving a central opening for your head.
  • Specialist mail order suppliers sell dressing gowns for wheelchair users.

SOCKS

Socks should fit well and not cause any pressure on the feet, particularly if you have reduced sensation in your feet.

  • Wear styles with little or no elastic, as elastic restricts the blood from circulating and may cause your feet and ankles to swell.
  • If you have cold feet, you will find wool or wool mixtures warmer than cotton socks.

TIGHTS AND STOCKINGS

  • Avoid tights or stockings which are too small or too tight as they restrict the blood circulation.
  • Open crotch tights do not need to be pulled up and down when using the toilet or for self-catherisation.

SHOES

Shoes should fit well and give sufficient support to keep your feet in a good position. For more information, see the Assist Ireland Information Sheet ‘Finding Suitable Footwear’.

GLOVES

Gloves are needed for hand protection when self-propelling as well as providing warmth.

  • Wearing fine thermal or silk gloves under a heavier pair helps keep your hands warmer.
  • Leather gloves worn by golfers and cyclists with reinforced palms and incomplete fingers are widely available.
  • Some specially designed wheelchair mitts open out flat and fasten with Velcro.

STORAGE

Easy access to clothes storage is important to enable you to hang your clothes properly and choose outfits easily.

  • To be accessible the base of the wardrobe should be level with the floor. Sliding or fold-away doors are easier than hinged doors to open from a wheelchair.
  • Hanging rails should be at convenient heights. A sliding rail which can be pulled out towards you gives better access than a fixed rail.
  • A long rod attached to the centre of each coat hanger may enable the wheelchair user to lift them down from a high rail.
  • Some specialist suppliers sell wardrobes with pull-down hanging rails.
  • Transparent or wire baskets which can be slid out and removed, makes it easier to see the contents.

SHOPPING

If you know exactly what you want, you may save a fruitless journey by telephoning the shop and checking on availability. Some shops have internet sites where you can look at the styles/sizes available before leaving home. Before going shopping it may be advisable to phone to check: stock and facilities:

  • Ask about the access to a shop and within it.
  • Ask about the changing rooms - whether it is communal or if there are separate cubicles, and if a bigger cubicle is available to give better access for you in your wheelchair, or if you need help from a shopping companion.
  • Ask if shop assistants will help by carrying purchases or fetching garments.
  • Check the refund and exchange policy of the store.

Mail order shopping is a useful alternative. Goods can be ordered at leisure and tried on at home. They can be returned if unsatisfactory and any money paid will be refunded.

USEFUL PUBLICATIONS

  • The Access Directory
    A directory of assistive technology, aids and appliances suppliers and services published annually. Available from:
    Access and Mobility Ltd
    6 Ticknock Dale
    Sandyford
    Dublin 18
    Tel: 01-206 3387
    Email: accessandmobility@gmail.com
    Website: www.accessandmobility.ie

USEFUL ADDRESSES

  • Association of Occupational Therapists of Ireland (AOTI)*
    Ground Floor Office
    Bow Bridge House
    Bow Lane
    Kilmainham
    Dublin 8
    Tel: 01-633 7222
    Email: aoti@eircom.net
    Website: www.aoti.ie

*It should be noted there is currently no statutory system of registration to either an independent chartered institute or representative professional body for allied health professionals eg occupational therapists, chartered physiotherapists and speech and language therapists in Ireland. This is likely to change soon as the Health and Social Care Professional Bill published in October 2004 sets out a system of legal registration for health and social care professionals irrespective of whether they work in the public or private sector or are self-employed.

  • 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)
    380-384 Harrow Road
    London
    W9 2HU
    England
    Tel: 0044 207 289 6111
    Email: dlfinfo@dlf.org.uk
    Website: www.dlf.org.uk

  • Ricability(independent research body in UK which produces guides for older and disabled consumers based on professional research)
    30 Angel Gate
    326 City Road
    London
    EC1V 2PT
    England
    Tel: 0044 207 427 2460
    Fax: 0044 207 427 2468
    Email: mail@ricability.org.uk
    Website: www.ricability.org.uk