Manual wheelchairs

Introduction

The aim of this Information Sheet is to provide some basic information and suggestions if you are considering getting a manual wheelchair. It looks at:

  • your personal circumstances
  • the various categories of manual wheelchairs
  • the practical and legal requirements when owning a wheelchair
  • a number of accessories that might be useful to you.

If you have very particular requirements you are advised to seek a professional assessment and advice.

The information in this Information Sheet covers manual wheelchairs only. For information on powered wheelchairs, see the Assist Ireland Information Sheet Powered wheelchairs. For information on mobility scooters, see the Assist Ireland Information Sheet Mobility scooters.

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.

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 a suitably qualified therapist who can recommend and prescribe the most appropriate 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

Private hire

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 online, or your local public health nurse or community occupational therapist. A number of private hire firms make daily/weekly/monthly hire charges, which may vary in amount and in the conditions attached.You will also find a list of companies which have an equipment hire service on Assist Ireland.

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 meantime?
  • 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, Blanchardstown Shopping Centre in Dublin 15, Mahon Point Shopping Centre in Cork, Dundrum Town Centre in Dublin 14 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 bank holiday weekend.

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. Contact Revenue's Central Repayments Office to request Form VAT 61a (see Useful Addresses), or you can apply online for a VAT refund using eRepayments in Revenue's myAccount service.

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.

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.

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.

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.

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 maintained, and that you also receive accompanying literature, for example a care manual or assembly and user instructions. You will also need to find a local company able to service your wheelchair and carry out future repairs.

Identifying your needs

For someone who requires a wheelchair all or much of the time, you should access a full seating assessment from an occupational therapist or physiotherapist skilled in this area of work. If you have specialist needs it is vital that you have a professional assessment in order to get the correct chair and seating.

Even if you do not require a professional assessment, it is important to recognise what your requirements are, in order to get the right wheelchair to help you in your circumstances.

There are a number of factors about yourself to consider including:

  • Your mobility – this is your ability to move around. It includes walking, sitting down and standing up, and adjusting or moving your body within the chair. Depending on your level of ability, you will need to consider how you will get in and out of the chair. Are you able to walk short distances? Are you able to stand up and sit down safely? Will you need to transfer, perhaps using a transfer board? Does the chair have removable armrests allowing you to do this? Are you usually hoisted? Will the chair enable your hoist to move close enough to the chair to enable this?
  • Your tolerance – this is the length of time you can tolerate doing something, e.g. standing, walking or sitting.
  • Your balance – this is your ability to remain steady, when standing or seated and especially when moving between the two.
  • Your posture – this is the position in which you hold your body. When using a manual wheelchair, you need to be able to maintain a comfortable, stable, safe and supported seated position. You may need special cushions or support to provide comfort and help you to maintain your position.
  • Your body height and weight – if you are a very tall or large person you will need to look for a wheelchair that is appropriate and safe for you. Measure and record your height and weight accurately and check manufacturers’ details. A tall person will need a chair which can support longer legs, a longer spine and possibly bigger feet. It is important that your limbs and body are fully supported when in the chair. It is important for a large person to have a chair which is designed and made for their body weight and size so as to maintain the correct balance and stability in the chair, to prevent discomfort and pressure areas and to ensure the chair does not break.
  • Your skin condition – is your skin on any potential pressure points intact and healthy? The relevant pressure points might be the bony prominences of your bottom and hips, the base of your spine and the back of your knees. Any areas upon which you lean without relieving the pressure has the potential to develop a pressure ulcer, such as your shoulder blades and elbows or forearms (Stockton and Flynn 2009). If you are going to spend significant time in the chair and if you find it difficult to relieve the pressure on these areas by shifting around, you must have suitable pressure relief cushioning.
  • Your sight, perception, memory and cognitive ability – if you are losing your visual, perceptual, memory or cognitive abilities, it is unlikely that a self-propelling manual wheelchair is appropriate for you.

All of the above can be affected by many things including age, tiredness, a medical or physical condition and medicines.

Consider how all these factors will be affected by, and will affect, your use of the wheelchair.

If you have a condition which is deteriorating, you may wish to take account of your possible future needs at this earlier stage. You also need to take into account the abilities and needs of any person who will be helping you, including possibly lifting the chair and carrying out basic maintenance tasks.

Getting in and out of the chair

As mentioned above, your remaining level of mobility may dictate how you get in and out of the chair and which features you may need as part of the chair. If you can still walk short distances and can stand up and sit down, you will be able to manage getting in and out of the chair without assistance.

Remember - however you transfer, you must ensure that you put the wheelchair brakes on before you get in or out of the chair. Most chairs have removable armrests which may be useful to you if you slide transfer - perhaps when moving to or from a car or the bed.

Every chair will have footplates which either swivel or flip-up out of the way. It is important that you take the time to move the footplates out of the way before you get in or out of the chair. If not, they become a trip hazard or you run the risk of tipping the chair should you put your whole weight upon them.

If you require a hoist to be transferred in and out of the chair, you need to ensure that your hoist and the chair that you choose will work together. The base of the hoist will need to span the overall width of the chair, or be able to move underneath it, getting close enough to correctly position you into the seat.

Choosing a wheelchair for your body shape and size

A wheelchair should add to your freedom and independence; it should enable your comfort and well-being, not limit your body movement or cause pain or pressure sores.

If your body shape allows, you want to preserve and support good posture by:

  • keeping your head, neck and spine aligned
  • keeping your pelvis, hips and knees aligned
  • choosing suitable support cushioning.

Avoid creating pressure points or limiting your movement within the chair by:

  • ensuring that the chair seat, back and shoulder rests are the right size for you
  • allowing for some space either side of your bottom and thighs
  • avoiding the use of lumpy cushions or wearing any bulky clothes which create pressure points when you are seated in the chair
  • choosing an appropriate pressure relieving cushion.

A wheelchair is a bulky object and can be longer than it is wide. It is designed to be as safe and balanced as possible, especially when moving over uneven or sloped surfaces.

It may also be designed to accommodate a person’s individual body size, shape or requirements - e.g. when a person loses a lower limb, their centre of balance changes, even when seated. The balance of the chair has to be adjusted moving the rear wheels of the chair backwards to prevent it tipping. If you are a fit, active user the rear wheels can be moved forward to enable more efficient propelling and turning, but it can potentially be less stable.

If you have significant personal requirements in terms of your body size, shape or mobility you are advised to seek professional assessment and advice.

Measuring for your chair

You should not be ‘squeezed’ into the chair, but have enough space to move within the seat, to rotate your upper body if possible and move your arms. Yet you also need to be supported, especially if you find maintaining your posture tiring and difficult.

You will need help to gain accurate measurements of yourself. Make sure you are seated comfortably and well-supported, with your back as straight as possible and with your hips at 90 degrees (a right angle) and your feet flat on the floor. Wear your normal clothing and shoes. If you have complex seating needs, you may have to adapt these measurements, but you are then advised to seek professional advice.

Measure and record these distances (in centimetres). You may not use all of them, depending on the level of support you require from your chair:

(a) Seat width (not the overall width of the chair) – the distance between the widest part of your hips or thighs, plus 2cm either side. The seat/backrest width should give you enough room for winter-weight clothing, but not be so big that it causes you to lean sideways to find support. This is particularly important if you have poor upper body strength and control. So if, when seated, the widest part of your bottom or hips measured 42cm across, you should be looking for a chair seat with a width of approximately 46cm (18”).

(b) Seat depth - the distance between the back of your bottom to the back of your knee, minus 2cm. If you have a discrepancy in your leg length, take the measurement from the shorter leg. So if, when seated, the distance between the back of your bottom and the back of your knee is 46cm, you should be looking for a chair seat with a depth of 44cm at most (17.5”). If you choose a larger depth it will cut into the back of your knee.

(c) Arm rest height – the distance between the seat and your elbow when bent at an approximate right angle (as if resting on the chair arm). Make sure you are not leaning to one side.

(d) Lower leg length and seat height - the vertical distance between the back of the knee to the heel of the shoe. This gives the distance from the wheelchair seat to the footplates. Add 4cm to give the total seat height from floor to seat.

(e) Back width - the widest distance across the back, just below the armpit. If your back is very much broader than your hips/thighs and you need back support at a higher level, you may have to consider having a wider chair, or a more specialist back rest.

(f) Back rest height – this will depend on how much support is required. For people with good body strength, a shorter back rest will be necessary. Take the following measurement according to the level of support you require:

  • The vertical distance between the seat surface to bottom of the scapula (shoulder blade), if you are able to sit comfortably with minimal back support.
  • The vertical distance between the seat surface and the top of the shoulder, if you need support all the way up your spine.
  • The vertical distance between the seat surface to the bump on the back of the head, if you require head support also.

Image of wheelchair measurements

Image of wheelchair measurements

Manual wheelchairs

Manual wheelchairs can be either self-propelled or attendant-propelled.

Self-propelled chairs require the user to use their upper limb, body and grip strength to move the wheelchair, usually by grasping the wheel rims and moving the wheel, and thereby the chair, in the chosen direction. There are alternative ways of propelling a chair which are described below.

Attendant-propelled chairs require another person to push the chair from behind, using handles at the rear of the back support. If you are obtaining an attendant-propelled chair, ensure your carer is fit and strong enough to push the chair and manage obstacles such as kerbs.

Self-propelled chairs have large rear wheels for the user to grasp and push. Attendant-propelled chairs have much smaller rear wheels. This means that the self-propelled chairs tend to give a smoother ride as the large rear wheels better span lumps and bumps in the road/floor surface. If you are privately buying or renting a chair, you may wish to consider this, irrespective of who will propel the chair.

Propelling the chair

Double hand rim
This is designed for people who only have the use of one arm/hand. It has both hand rims on the same side of the wheelchair, but controls the rear wheels on both sides. The inner hand rim is connected to the far wheel by way of a bar or scissor mechanism between the hand rim and the wheel.

When propelling the wheelchair in a straight line, the user grips both hand rims in one hand equally and pushes or pulls the hand rims in the direction they wish to travel. To turn the wheelchair, the user will push or pull on one rim more than the other. Double hand rim controls require good grip, hand strength and dexterity.

Lever drive systems
This has a lever attached at the front of the chair, with linkages to the rear wheel. The user ‘pumps’ the lever back and forward to drive the chair. - this is attached to the forward, neutral and reverse settings. To steer, the user turns the lever in the direction that they wish to travel.

The user requires grip and the physical stamina to pump the lever, along with the ability to consider steering and pumping at the same time.

A single lever can be used by someone with the use of only one arm/hand. A dual level drive system is available. The user pushes and pulls each side alternately. It requires significant strength and stamina.

Using your foot to propel the chair
Some people choose to propel themselves in the chair by using their feet, or one foot, to scoot across the floor surface, whilst using the wheel rims to assist with steering. This can work for those who have good leg and foot strength and perhaps have less pushing strength in their upper limbs.

If you choose to self-propel with your feet, you will require a chair with a lower seat so that you feet fully reach the floor. You may also benefit from a lap strap or harness to keep you safely in the chair.

Pedal attachment
Attachments are available which in effect turn the wheelchair into an adult tricycle. The pedal mechanism can be used by the feet or hands, depending on your ability. The chair is steered via the handlebars, just like a bicycle. Most users will require assistance fitting these attachments. Once attached, transfers in and out of the wheelchair are only possible by very able users.

Pedal attachments are also available with power-packs.

Converting a manual chair to a powered chair

Converting a manual chair to a powered chairIt is possible to obtain a powerpack which attaches to a manual chair, in effect adding a motor. They are fitted very easily and offer a full conversion to a powered chair with a joystick; or giving a level of assistance, which takes some of the strain out of manually driving a chair, or for the carer pushing.

You can still choose to manually drive your chair for periods, even when they are fitted.

Most manual chairs can be fitted with a powerpack. Depending on the drive mechanism, some units require particular wheels to be fitted to your chair and some require an anti-tipping mechanism to be added.

Training and safety

Most people can instinctively manoeuvre a manual wheelchair in a simple way, but some people can find it difficult. It is worth practicing propelling and turning techniques, getting over obstacles, tackling kerbs and thresholds etc in a safe environment before venturing outside.

Reclining and tilt-in-space wheelchairs

Image of a reclining wheelchairWheelchairs are available which have the ability to recline or tilt in space. These would help someone who has weak upper body strength or experiences back and/or hip pain and needs to rest.

These are two separate movement mechanisms. The reclining chairs have a back which reclines, but the seat remains static. Elevating leg rests may be required to make this a comfortable option. Tilt in space chairs tilt the back and seat backwards as one unit, keeping the same angle at the hips, knees and ankles.

When either of these mechanisms is used, the chair becomes very long and not very manoeuvrable. Consider what space will be required when used inside. Look to see how these mechanisms are operated - can they be used by the person in the wheelchair, or will help be required? Can they be operated when the user is in the chair?

High-performance chairs

These are the lightest and most manoeuvrable chairs available. They are designed to require less effort to propel or push, so are often used for sport. High-performance chairs are low-backed and tend to give minimal side support. The rear wheels are larger and may be angled to assist with propelling. They are often very adjustable to meet individual needs and preferences.

Practical considerations

Storage

Your wheelchair will need to be stored in a secure, dry place. You also need to ensure that it is not a trip hazard or a fire hazard (by blocking escape routes) for yourself or anyone else whilst it is stored.

If you live in a communal property, such as council or housing association flats, sheltered housing or a care home, you must seek advice and permission from the landlord or organisation in relation to storing your chair. There are usually strict rules preventing the storage of chairs in communal areas. They are not usually allowed to be stored in corridors or stairwells as they could cause an obstruction or be a trip hazard.

You may have space for a chair in your personal flat or room, or there may be an allocated room or space for storage. In any situation check that it is not a hazard to yourself or any other person.

Servicing and maintaining your wheelchair

There are a number of things that you can do to maintain your chair:

  • Manual wheelchair tyres are very similar to bicycle tyres. Punctures are not uncommon. Check they are kept at optimal pressure (look at the manufacturers advice) and check the tyres for wear and tear
  • Check the brakes. The chair needs to be securely held by the brakes as you get in and out of it. Ensure that when the brakes are applied, the wheels do not move
  • Keep the wheelchair clean and regularly oil the axles and pivot points
  • Regularly check any nuts and bolts to ensure that they are secure
  • Periodically check the frame for damage or cracks, especially if the chair gets heavy usage.

A regular service will ensure that your wheelchair is safe. Check the manufacturer’s or supplier’s instructions.

Getting your chair into a car

Most manual wheelchairs are able to fit into a car, enabling you to take it with you when you travel. Your chair may have a folding frame, with a fold down backrest, removable footrests etc, or it may have a rigid frame, but with removable wheels.

The chairs are heavy to lift, so there are a range of options for getting them into a vehicle, including ramps, lifts and hoists.

RIDC (Research Institute for Disabled Consumers - formerly known as RICA) have produced some information on getting a wheelchair into a car. They also have a search facility to identify the best cars for wheelchair users.

Footrests

The footrests on a chair should be used at all times when sitting in the chair, but should be moved out of the way when transferring in and out of the chair.

Footplates usually swivel to the side and flip up out of the way. Your feet should not ‘dangle’ but be supported by the footplates, preventing all the weight of your legs being carried on the back of your thighs. They should be at least 4cm clear of the ground.

There are usually heel straps attached to the footrests which cup your heels and prevent your feet slipping backwards. These can be removed if you find them inconvenient. This may occur if you have particularly big feet.

Elevating leg rests

Elevating leg rests support the lower leg in a raised position. The leg rest is supplied in place of a footrest. Care should be taken when mobilising or pushing a wheelchair with the user’s legs raised, as it can make the legs and feet quite vulnerable to being knocked.

Armrests

Most wheelchairs can accommodate a choice of arm rest designs. They can be full length or desk style (shorter). They may be height adjustable. Some are detachable, fold up and/or down or swing away.

If you have good torso strength and stability, you may prefer to have less support and use shorter armrests. This can give more freedom of movement in the upper body and arms. It also means you can move the wheelchair closer in to tables and desks. If you have less upper body stability, you are better off getting good support from the armrests.

The armrests should support your forearms without the need for you to hunch your shoulders or lean to the side. They should be padded, so not to cause pressure points along your forearms.

Consider how you will be getting in and out of the chair. Will you need a full-length armrest to support yourself as you sit into the chair or up from the chair? Do you need removable or movable armrests if you transfer sideways in and out of the chair?

Look at the manufacturer’s website, or ask the supplier for information on what options are available.

Cushioning and support when seated

Most standard wheelchairs will come with a padded seat or a basic seat cushion. If you are using your chair much of the day, this may not offer enough pressure relief, even for someone who has good skin condition. You are advised to consider obtaining a cushion which offers an element of pressure relief. Look at the manufacturer’s information or ask your supplier.

When you are seated in the chair, aim to keep your body as aligned as possible and not leaning to one side.

Moulded cushions can help to maintain the hips and pelvis in good alignment. You can obtain chair inserts and cushioning which offer support at particular points if required.

If you struggle to maintain an upright posture, you may benefit from support around your torso. Look for a backrest or cushion which is shaped, curving around your back and slightly under your arms at the back.

There are a range of cushions, backrests and mouldable supports that fit into a wheelchair leaving the existing seat and backrest in place. If you need active support, look for an insert that is more rigid (although it will need a soft outer covering). If you just want comfort, look for a soft padded insert or cushion.

It may help you to maintain an upright posture if you have a belt or harness, which also adds an element of safety. You can have a lap strap or hip belt, as you would wear in an aeroplane, or a higher strap across your tummy. These can be padded for extra comfort. More support can be given by a chest harness which secures you around your torso and over your shoulders. You can also add a crotch strap. You are advised to seek professional advice before you use a full harness, as they can create pressure points and distort a person’s posture if poorly fitted.

It is important to remember that straps and harnesses should not be used for the sole purpose of restricting a person’s freedom when they lack capacity to understand or make choices.

If you have complex positioning needs, seek the advice of a seating specialist.

Portable ramps

Image of a portable rampYou may need ramps to be able to enter or leave your home when on your wheelchair.

You can choose whether to create a permanent ramp or to use portable ones.

Ensure that the ramps can bridge the change in levels adequately, without creating too steep a slope and check the weight capacity of the ramps. Check that the ramps can accommodate the width of your wheelchair and the combined weight of the wheelchair and your body.

As a general rule most ramp manufacturers recommend a gradient no steeper than 1:12 for independent use and 1:10 for assisted use. A simple calculation for finding out the right ramp length is to multiply the height by the ratio - i.e. if working on a 1:12 ratio multiply the height of step by 12 to give you the minimum length of ramp, e.g. 6 inch step x 12 = 72 inches (6ft ramp).

Accessories

Walking stick or crutch holders
Clips are widely available to hold walking sticks, crutches etc.

Most combine a clip with a cup to hold the base of the stick or crutch. They attach to wheelchairs with a variety of fastenings including screw clamps or hook and loop Velcro. Some are fitted behind the chair, others to the side.

Consider the most appropriate fitting for your chair and your ability to reach to guide your choice. Ensure that the clip element of the holder is big enough for your stick or crutch.

Drinks holder
There are a range of cup, bottle and drink holders available. These attach on to the frame of the wheelchair and allow you to carry a drink around with you.

Wheelchair umbrella
A wheelchair umbrella clamps to the wheelchair frame and has a flexible handle to enable positioning. Clamps are also available into which a standard umbrella can be fixed.

Bags
There are a range of bags available specifically designed to attach to a wheelchair. Most attach to the back of the chair, but others fit to one side, as pannier bags, or under the seat.

Consider the design of your chair and your ability to reach the bag when seated in the chair.

A number of other specific bags and holders are also available, such as ones for carrying mobile phones, wallets or oxygen cylinders.

Wheelchair outdoor clothing
Wraps, capes, ponchos and macs - when you are sat in a wheelchair, it is easier to put on or take off and wear an outer layer which is loose fitting. Wraps, capes and ponchos are easy to slip around or over your head.

The looser fit across the shoulders and upper arms is more comfortable as you self-propel your chair. Large capes and ponchos are available in waterproof fabric, acting like a mac in wet weather. They can be large enough to cover both you and the chair.

Leg cosy - A leg cosy or zipped sitting bag keeps your legs warm and protected from wet or windy weather. These are designed to be used instead of having a blanket over your legs, as blankets can get caught up in the wheels of your wheelchair.

Tables, trays and stands
Image of a wheelchair table height=Wheelchair tables and trays come in a variety of sizes and designs. Some fit across the whole lap space, attaching to both sides of the chair, others are a half-lap size, fitted to one side, which flip over to be used or stored at the side.

Most people would need assistance in fitting a full width wheelchair tray once in the chair. A half-lap size can usually stay in situ, flipped over and stored down the side of the chair.

Most trays have a smooth wipe-clean surface with a raised edge. Some are moulded or have a cut-out circle to accommodate a cup or mug. An increasing number are made of see-through polycarbonate, which enables the user to see what’s in front at floor level. Padded trays are also available.

Small stands are available which clamp to one side of the wheelchair frame. With a flexible arm, these can hold books or a tablet.

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)
    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)
    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)
    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
    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)
    England
    Tel: 0044 207 289 6111
    Email: info@dlf.org.uk
    Website: www.dlf.org.uk

  • Research Institute for Disabled Consumers (RIDC) (independent research body in UK which produces guides for older and disabled consumers based on professional research - formerly known as RICA)
    England
    Tel: 0044 207 427 2460
    Email: info@ridc.org.uk
    Website: www.ridc.org.uk