Whether you are obtaining your first electric-powered wheelchair or replacing your old one, the important decision could affect your quality of life for years.
You are the focal point of the proper selection of your power chair, and only you can ultimately determine if your chair will be satisfactory.
Most insurers, including the Department of Veterans Affairs (VA), require a prescription from a licensed physician. It is best to get a detailed one.
Once you have the prescription, try a variety of chairs at a seating and wheelchair clinic or with a knowledgeable therapist. If you have complicated seating needs, visit a specialized clinic, even if you must travel for several hours. If you can’t visit a specialty clinic, work with a therapist who has the Assistive Technology Practitioner (ATP) credential from the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA), and a knowledgeable RESNA-credentialed Assistive Technology Supplier (ATS). (A list is available at resna.org.)
While you undergo assessment for a power chair, the clinical team must consider several factors:
• Anticipated changes in your physical condition over the chair’s lifetime
• Flexibility (e.g., contractures) and anatomical limitations (e.g., deformities, body weight)
• Seating tolerance (e.g., pain or discomfort while sitting) and the likelihood of skin breakdown
• Living environment (e.g., home work, school) and modes of transportation (e.g., van bus)
• Wheelchair-driving ability to include a driving test
When participating in an assessment for a new power chair, try a similar model in your home and in your vehicle.
Specialty seating (e.g., tilt, recline, elevation) often requires additional justification and sometimes must be approved by a second-level reviewer within insurance companies. Your clinical team should act as your advocates and prepare appeals for you when necessary.
When your chair arrives, it should be delivered to a wheelchair and seating clinic or your therapist’s office. It is critical to ensure the chair has all the functions ordered for you. All power chairs require some tuning and adjusting, and the therapist should observe you using it and sign off that it is acceptable. You should also receive training in how to operate the chair and its functions.
It is important to understand that when therapists or physicians work for suppliers or manufacturers, they are not serving in the role of clinician; rather, they are part of the business process. Ask (1) whether the therapist or physician is independent from the supplier or manufacturer and (2) how he/she manages any conflicts of interest.
Make sure the chair passes the static, impact, and fatigue-strength tests, and all tests for the electronic systems.
Ideally, power chairs are provided by a team approach including an ATP, ATS, RET, and physician. As technologies become more complex, it is difficult for people who do not specialize in advanced wheelchairs and seating to offer the highest-quality service. Expert teams are also more likely to be aware of new technologies and to apply the latest research findings to hone their clinical practice.
