Time for a New Ride: Wheelchair Buying Guideby Rachel Zohn Health Writer
A wheelchair opens up your world, explains Dave Bexfield, who has been living with MS since 2006 and runs the organization ActiveMSers. Since being diagnosed, Bexfield has used several mobility devices, including wheelchairs and motorized scooters. “[They’ve] given me the flexibility to travel all over the world,” says Bexfield. “My legs don’t work for long distances and my wheelchair has gotten me through a lot of really challenging situations.” If you’re dealing with frequent symptoms from multiple sclerosis that limit your mobility, or fatigue and balance problems make walking difficult or unsafe, it may be time to consider if a wheelchair or motorized scooter is right for you.
You'll Know You're Ready When…
If it’s way easier to sit than to stand then it’s time. Wheelchairs can be a great way for someone with MS to regain mobility when symptoms make it hard to be on your feet, explains Kathy Zackowski, Ph.D., an occupational therapists and scientist who serves as senior director of Patient Management, Care and Rehabilitation Research for the National MS Society. Depending on how your MS progresses, you may need to use a wheelchair full-time, or only occasionally. But a wheelchair is a big decision with a few factors to consider before pulling out your wallet.
Will It Be Covered?
Yes! Most insurance companies cover some or all the cost for wheelchairs. Be specific about what you should clear with your insurance company and how much you can expect them to pay for. For instance, they may not spring for the super-deluxe solar-powered scooter, but you can expect them to cover a standard power chair. In general, health insurance companies will cover purchasing one new wheelchair, every five years. Zackowski recommends having a conversation with your neurologist and looking at how your MS has progressed in the last five years and how your doctor sees your MS progressing over the next five years.
There are a variety of wheelchair styles to consider, each with various pros and cons (click through to see them all). These include:
Manual (average standard $250; average custom $3,500) - You propel yourself by rotating your hands on the rims of the wheels.
Scooters (average $2,000) - This is an easy-to-operate option if you’re able to sit down and standup without help.
Pushrim-activated power-assist wheelchair (PAPAW) (average $3,000) - A battery motor assists you up hills or through difficult terrain.
Power wheelchair (average $7,000) - This is propelled by an electric motor and doesn’t require any manual power.
Manual wheelchairs come in a folding-frame style and a rigid, non-folding style. You can also get wheelchairs with solid-core tires or inflatable tires, Bexfield explains. Inflatable tires are generally more shock-absorbing and offer good traction, but they can also be punctured and require more maintenance. Solid core tires are puncture-proof (the inner core is filled with a material like foam or rubber), but they can be heavier and slip easier on wet surfaces.
A Manual Wheelchair is a Good Pick If…
You have good arm strength to turn and maneuver the wheels. You want a chair that you can put in your trunk.
Pros: The benefit of a foldable wheelchair is that it’s more portable and easier to get into a trunk of a car, says Bexfield. “When I travel, I take my foldable wheelchair, which has been beat up by airlines,” Bexfield says. “I use my rigid wheelchair at home, because it’s easier to snug up to countertops. I prefer that one for day-to-day life.”
Cons: Foldable wheelchairs tend to be heavier and the footplates tend to stick out more, which can make it harder to get around your house in, Bexfield explains.
Scooters are clutch for when you need to traverse longer distances or difficult terrain, such as a day outing to a park or area with paved paths. “I could get around by myself without someone needing to push me,” says Bexfield. He also notes that as his MS has progressed, it’s more difficult to get on-and-off the scooter.
A Scooter is a Good Pick If…
Standing and sitting are no big deal.
You plan on being out and about for several hours at a time.
You want to carry things with you.
Pros: Travel scooters are great for an outing, but they aren’t designed for everyday comfort.
Cons: On the flip-side, sturdier scooters “are too heavy to lift--you can’t just pop it into the truck--so you would need a lift on your car,” Bexfield says.
Pushrim-Activated Power-Assist Wheelchair (PAPAW)
PAPAWs were developed to help people who have difficulty propelling a manual wheelchair on inclines such as hills and ramps, or over some surfaces, such as carpets, grass or gravel. These wheelchairs have specialized wheels with a battery-operated motor. You may be able to add a power-assist system to your manual wheelchair.
A PAPAW is a Good Pick If…
You want to go up hills or over uneven terrain easily.
You want to go long distances solo.
You want to conserve energy for other activities like physical therapy or workouts.
Pros: “These are a great option for someone who wants to use a manual wheelchair but sometimes needs a little extra help,” says Zackowski.
Cons: The motor on one of these bad boys does add extra weight, which makes it harder to lift or stow in a vehicle. They can also be expensive, with some add-on systems costing thousands of dollars.
Power wheelchairs, which are mostly operated with a joystick control, are propelled completely by a battery motor and can accommodate a wide range of needs. Because you don’t need to use any physical effort to get moving, you can travel longer distances and go over difficult surfaces.
A Power Wheelchair is a Good Pick If…
You’re unable to push a manual chair.
You like options, as power chairs are very customizable with mid-wheel drive, off-road capabilities, and more.
Pros: Some have a power seat that allows you to recline, tilt or elevate your legs or raise you to a standing position. Some power wheelchair options can be very specialized, which can be great if you need specialized seating positions or you can’t propel a wheelchair on your own, noted Bexfield.
Cons: Power wheelchairs can be expensive and require service repairs and special maintenance. Be aware that there is a wide range in maneuverability, adjustability and portability with various models.
If you’re an outdoorsy type, you’ll want an all-terrain wheelchair that is designed to handle the rigors of exploring Mother Nature. Some models are even able to ride over sand or into water (!!). On his website, ActiveMSers.org, Bexfield has reviewed two off-road manual wheelchairs, Mountain Trike and the GRIT Freedom Chair, which he compares to mountain bikes in their ability to handle rugged countryside.
An All-terrain Wheelchair is a Good Pick If…
You spend more time outdoors than you do indoors.
Your current wheelchair can’t stand up to the rigors you put it through.
Pros: These wheelchairs offer innovative ways to stay active and explore areas that would otherwise inaccessible.
Cons: “They really don’t go backwards very easily and they’re [too] long and big for indoor use,” says Bexfield.
Now Go Get Fitted!
Once you have an idea of what might be a good type, make an appointment with your occupational therapist. OTs can do an evaluation and take your measurements to determine which wheelchair is best suited for you. You can also visit a “wheelchair seating clinic” that specializes in detailed evaluations and measurements to help you decide what options are right for you. Many seating clinics also have different chairs there that you can try out and see what you like, Zackowski explains. Most major medical centers will have a wheelchair seating clinic, she notes.