Saturday, May 22, 2010

Choosing The Right Medical Mobility Equipment

The Renaissance Fair was something Annie looked forward to every year but this year she would have to skip it.  There was just too much walking and her medical problems had progressed as expected, limiting her endurance.  Maybe it was time for her to accept her limitations and put that aspect of her life behind her, OR maybe not.

I recently had a discussion with a neighbor who is a Physical Therapist.  She has a blanket rule that she never recommends handicapped scooters.  Her thinking is that a walker with a seat provides the same support and helps keep the user active.  I would contend that her approach is a "one size fits all" way of thinking.  Coming from a position of a person who actually has a disability, I think this approach limits the opportunities available to physically challenged people.  For me, because of fatigue due to multiple sclerosis, I had very limited endurance.  My scooter helped me live a more active and independent life.   If I paced myself, it was amazing what I could accomplish.  The independence that it allowed me did wonders for my self image.

I used a full sized scooter with a lift to get my scooter in and out of my van in one piece.  With the lift, I only had to be able to walk to the back of the car and push the lift buttons to remove or insert my ride.  Not having these aids would have severely compromised my independence.  I was able to do my own grocery shopping, which is something I would never have accomplished if I was required to walk up and down all those aisles.  This aid allowed me to take a plane trip alone and brave a five hour solo trip by car.  In order to continue exercising my legs, I did not use the scooter in the house.  My scooter helped me to expand my world and allowed me to continue activities outside my home.  I am not saying don't push yourself to be as active as you can be, but when you have come to a wall, don't automatically discourage aids that will help you overcome obstacles.  (Because my needs have changed, I now use a power wheelchair. delete: hence the past tense on the scooter.)

Consider the source of advice when purchasing mobility aids.  The motivation for that advice could be self-serving.  As an example, I present the following actual occurrence.  I met a man walking with a cane who was waiting for his new power wheelchair to be delivered.  He wanted mobility assistance when any distance was involved.   The store selling the mobility equipment advised him to get a power wheelchair saying he might eventually need it and his insurance could possibly not cover a chair and scooter.   I doubt a power wheelchair met his needs.  It would be too difficult to transport and not available when he really needed it away from home.  I believe this recommendation was based on the store's motivation to maximize profit by selling a $5,000+ wheelchair instead of a $3,000+ scooter or even a lightweight scooter for less than $1,000.

With this incident in mind, I want to provide information that will help you determine what is right for you.

MOBILITY EQUIPMENT TO CONSIDER:

  • Manual Wheelchair - This is easier to transport than any of the power equipment.   Power equipment is so heavy that you may be limited in your access to some buildings.  If there is no access ramp, a manual wheelchair can be rolled backwards up a few steps.  An additional consideration is that a manual wheelchair takes upper body strength and will help you maintain that strength.  But if upper body strength is a problem, maybe a power wheelchair is the correct option.

  • Power Wheelchair - If you can't move a manual wheelchair independently, consider a power wheelchair.  The pros are that a power chair can easily maneuver around furniture and will turn on a dime with the simple movement of a joystick.  Cons are that if you stop trying to use your muscles with everyday living, these muscles will get weaker and atrophy.  Also, a power wheelchair is very heavy and may limit your accessibility to some areas.    If someone has limited body strength, and with poor ability to improve that strength, this may be an option that gives them a fuller life.

  • Transport Wheelchair - This wheelchair does not have the heavy side wheels.  It is good for getting from point A to point B if you have a helper to do the pushing. Without the side wheels the chair is easier to transport but also cannot be self-propelled.  Several models of manual chairs have side wheels that can be removed to make them easier to transport

  • Rollator - This is a walker with a seat to use as needed for rests.  Many models have a basket or saddlebag to help carry things.  With this equipment, many people can obtain the mobility support needed but still exercise muscles to prevent wasting.  Of course, it would be much easier to transport then power equipment

  • Full-sized Scooter - A full size Scooter has its advantages over a lightweight one.  With a car lift, the scooter can be put into your vehicle in one piece.  No assembly or disassembly is required.   Quick stops are easy, adding to independence.  The extra expense of a car lift is a disadvantage and the fact that these lifts are permanently installed, presents a problem when not using your own car.   These scooters come in 3 or 4 wheel models.  The 4 wheel models are not supposed to tip as easily.  Unless you are very heavy, tipping should not be a problem.  The three wheel models have a smaller turning radius.

  • Lightweight Scooter - These scooters disassemble into 4 or 5 lightweight pieces and can be reassembled within minutes.  Because they are so easy to transport, you have more flexibility when using a friend's car, taxis, or when traveling.   If you will be alone and making frequent stops, a full-sized scooter and lift may be preferable.  Lightweight scooter cost less than $1,000 and may be covered by your insurance.  I helped my nephew obtain one through his insurance, but be prepared that that may take time and persistence.


When choosing the right mobility aid you need to take into consideration:
1.     Your current ability
2.     Expectation for future ability
3.     Whether or not you will be using this alone or with assistance
4.     Cost and insurance benefits
5.     Degree of independence you hope to achieve

Choosing the right mobility equipment is an important consideration.  I am not suggesting you give in and choose the equipment that makes mobility so easy that the muscles you have go to mush.  On the other hand, used wisely, these aids can help you live a more independent, full life.