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Adapting to using a wheelchair

12:00am | & Lifestyle

There may come a point in your life when you need to use a wheelchair, either temporarily while recovering from an accident, illness or medical procedure, or on a more permanent basis.

Whatever the reason, and for however long you need it, there will inevitably be a period of adjustment and adapting to life using a wheelchair. It will be different for everyone, depending on their individual circumstances, the type of wheelchair they need and how long they need it for.

For example, some people will be able to move themselves along in a ‘manual self-propelled wheelchair’, using their hands on the push-rims on the rear wheels. Others will need a ‘manual attendant-propelled wheelchair’, which must be pushed by a carer or attendant using the handles at the back. It’s easy to tell the difference, as a self-propelled wheelchair has larger rear wheels, with push-rims attached to them.

Some people might need, or choose, a powered wheelchair, which uses rechargeable batteries in the base and is moved and steered using a small joystick on one of the armrests.

The type of wheelchair needed will dictate some of the lifestyle adjustments which accompany it. For example, with an attendant-propelled chair, it’s not just the user who will need to adjust, but also the regular attendant – the person pushing the wheelchair. Also, some people might be able to stand (possibly with help) and walk a short distance or transfer to another chair or bed, while others might be unable to stand or walk at all.

Whatever type of wheelchair you need, and whatever way you need to use it, you should receive valuable advice from an ‘occupational therapist’ – the person in the medical team treating you who will introduce you to a wheelchair and how to use it. If you only need a wheelchair for a short recovery period, it will probably be loaned to you by the medical facility treating you.

Listen very carefully to what the occupational therapist tells you – they are experts who routinely deal with hundreds of wheelchair users. Take notes or record their advice, and don’t be afraid to ask questions, either at the time or if they occur to you later. However, there are some general tips on adjusting to using a wheelchair which will benefit most people (or their carers):

  • If you’re going to be in a wheelchair longer-term, get the best one you can. Having a correctly fitted wheelchair which meets all your needs will not only make it more comfortable and easier to use, but also benefit your long-term health. Think how much time you’ll spend in the wheelchair and then invest in the best you can afford. Depending on your circumstances, you might be eligible for a ‘Personal Wheelchair Budget’ from the NHS, to help you buy a chair. Ask your doctor or occupational therapist about this, or click here to find out more about Personal Wheelchair Budgets.
  • In choosing a wheelchair, key measurements to consider are the width, depth and height of the seat, the length of the footrest, height of the arm rests, and the back height. Ideally you should be fitted for your chair by a professional, like getting a made-to-measure suit from a master tailor. Many ‘off-the-peg’ chairs are available in different width options and adjustable in other key areas. Heavier users might need a more robust wheelchair, sometimes called a ‘heavy duty’ or ‘bariatric’ wheelchair.
  • Various cushions or seat pads are available to guard against pressure sores from spending long periods sitting in a wheelchair. Again, seek professional advice on this, but getting the right type will help prevent potentially serious problems developing.
  • You’ll need to get used to seeing the world from a different height. For many people using a wheelchair for the first time, one of the biggest adjustments is seeing other people at torso level rather than face-to-face. Some users report neck and shoulder pain from constantly looking up to interact with others. It can also be a problem in particularly crowded settings.
  • If you are pushing your own wheelchair, you will ache! It will take time to build up the muscles in your arms and shoulders needed to propel and steer your wheels using the push-rims. Don’t overdo it, but build up steadily and expect to have aches and pains until your body adjusts. You should also buy gloves specially designed for wheelchair users, to protect the palms of your hands.
  • It’s not just you who will need to adapt – your home will have to change to. Standard houses are not designed for wheelchair users. If you’re going to be in a wheelchair long-term, you may need to move to a new home designed for a wheelchair user, with wider doorways, corridors, ramps, lower work surfaces, accessible storage and so on. If not, your existing home might need significant modification. You might need to rearrange your accommodation to live on the ground floor, or install some kind of wheelchair-accessible lift.
  • You (or your attendant) will need to become expert at judging the road ahead. Things we take for granted when walking can present obstacles or hazards for wheelchair users, such as high kerbs, steps or uneven surfaces. Pavements should have ‘dropped kerbs’ at road junctions, but thoughtless drivers often park across them. Cracks, holes or inclines in the road or sidewalk can also trap or unexpectedly divert the wheels of a wheelchair. By law, most public places (including shops) should be accessible to wheelchair users, but not all are.
  • Be prepared for breakdowns. You should carry a small kit of essential tools on your wheelchair for minor running repairs that could stop you getting stranded. Punctures are a common problem with pneumatic (inflatable) tyres. Some wheelchairs have solid or ‘puncture-proof’ tyres, but these typically give a harder ride, even when combined with a suspension system. Some wheelchairs have tyres designed to ‘run flat’ for short periods, until they can be repaired.
  • Talk to other wheelchair users! The very best resource for anyone new to using a wheelchair is other people who have been doing it for a while. They will be a mine of tips, advice and information on how to get the best out of your wheelchair and avoid common pitfalls.
  • Be ready for an impact on your mental health and be open to counselling. It’s not just your body which will need to adapt to using a wheelchair; potentially the biggest adjustment will be a psychological one. Many users report depression, frustration, loss of self-confidence and self-esteem, mood swings, anger or resentment when they start using a wheelchair. Be prepared to talk openly about these feelings, preferably with a trained and experienced counsellor – it really will help. Many long-term wheelchair users report a gradual transition from initially seeing their wheelchair as something which restricts them, to something which enables them to live life to its fullest.

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