Essential Aids’ Guide to Manual Wheelchairs

For people who believe they may need a wheelchair for essential medical reasons, the first step is to talk to a GP. They will help you access a full seating assessment from an occupational therapist or physiotherapist who specialises in the field.

If you’re not in this position but feel a wheelchair would help you in various situations, there are still factors you need to think about before choosing one. There are also important accessories to consider, like wheelchair cushions and wheelchair ramps.

Self-propelled or attendant-propelled wheelchair?

One of the first questions to answer is whether you need someone to push you, or whether you can propel a wheelchair without help. Self-propelled versions require significant body strength through the core, shoulders, arms and hands.

Most chairs of this kind have two rims, with the second designed for contact with the user’s hands as they push.

Attendant-propelled wheelchairs are pushed from behind by a second person. These models typically don’t have the oversized rear wheels. It’s worth remembering that the person doing the pushing must be strong enough to control the chair and negotiate any obstacles.

Propelling a wheelchair yourself

As mentioned, the standard method of propelling a wheelchair is via two large rear wheels, which have two rims. One mounts the tyres in the conventional way, while a second outside rim is used to grip and push. Most people like to use padded gloves to make this easier on the hands, especially if they’re using the chair outside.

There are, however, wheelchairs with alternative designs which allow a different method of propulsion.

Lever-drive wheelchairs require the user to pump back and forth a front mounted lever. This in turn drives the wheels. To steer this type of chair, the user turns to change the direction of the same lever.

If the person has the use of both hands and arms, a variation of the lever-drive system is available which features two levers. This ‘duel lever’ system requires alternate pushing and pulling of the levers.

A ‘double hand rim’ also allows someone with use of just one hand or arm to self-propel a wheelchair. Here both propelling rims are engineered on one side, with a ‘scissor’ mechanism linking one of the rims to the furthest wheel.

The user pushes both rims simultaneously in order to travel in a straight line. To make a turn, the user must pull or push one of the rims accordingly. This process requires both strength, stamina, dexterity and practice!

Pedal attachments allow you to propel a wheelchair using your feet. The mechanism here deploys handlebards, with the feet turning a crank similar to a bicycle.

Picking the right size

It’s vitally important that you don’t use a wheelchair which is the wrong size for your body. It should transport you in comfort and not restrict your movement when you’re in it.

Ideally it should not compromise your posture and retain alignment for your spine, neck, head, knees, pelvis and hips. It should also avoid creating points of friction which might lead to pain or pressure sores. It’s important to make sure the seat is adequately deep and wide so that you can sit in comfort with space either side of your thighs and posterior.

Seat width

When buying a wheelchair, most models will be available in various seat widths. If you have any doubt as to the correct one for you, make sure you discuss it with a medical professional before going ahead. This is especially true if you have a high bodyweight, have lost a limb or you have another specific physical impairment.

Make sure that the chair does not fit tightly around you. You need enough space to move within the seat, so you should be able to rotate your upper body if required.

If you’re buying a wheelchair online, you need to measure various dimensions of your body. Sit in a chair with your feet flat on the ground with your hips at a 90 degree angle to your torso.

To establish which seat width (remember this is distinct from the overall width of the wheelchair) you require, measure the widest point of your upper legs, whether this be your thighs or hips. To choose the correct seat width, you then need to add on 1cm to 2cm either side.

You should also take into account the seat depth. It should be approximately the distance from the back of your knee to your coccyx, minus 2 or 3cm. It’s important that the seat depth is not too excessive, or it might cut into the back of your legs.

Cushions

Wheelchair cushions of various styles and sizes are available to help with comfort. Essential Aids supplies and extensive range range, available in dimensions to fit all commonly found wheelchair seats.

The materials used in wheelchair cushions varies greatly, with foam-filled, gel-filled and inflatable versions all available.

Armrests

When you’re sitting in a wheelchair, it’s desirable to retain a good posture and the correct height of armrests can help you do so. You shouldn’t be slumped to one side or leaning too far forward. The armrests offer support on either side of the body. Ideally the height of the armrests should be set to allow your elbows to bend at around a 90 degree angle.

Footrests

To keep your feet supported, wheelchairs are usually fitted with foot-plates. These can be extended to the desired length, allowing you to find a comfortable position for your feet and legs. In most cases, footrests swing or fold out of the way when not in use. Heel straps or guards prevent your feet slipping backwards when they are resting on the plates.

If you have complex seating needs or very long legs, you will need to talk to a professional who has first-hand knowledge of your circumstances.

Backrest

The backrest width of the wheelchairs is usually the same width as the seat. If your back is actually wider than your hips or thighs, you should consider buying a larger chair. It is imperative that you are not squashed into the chair when you sit in it.

Again, it is wise to consult an occupational therapist if you have any doubts about sizing.

Total chair width

If you intend to use the wheelchair around the house, it’s obviously important to consider doorway widths or any obstacles which might impede you. Remember that the turning the chair requires a certain arc, so take this into account when you’re measuring.

Individual differences

In terms of an individual’s suitability for either a self-propelled or attendant-propelled chair, there are several factors involved. Here we’ll run down the most relevant:

Mobility

‘Mobility’ refers to someone’s general capacity for bodily movement. This can include their ability to move from A to B, to get up or sit down and their general physical dexterity.

Balance

Your capacity for remaining steady when seated or standing or when moving from one to the other.

Posture

The ability to hold your body in position when either standing or sitting. For wheelchair use, consider if you can remain sitting upright without the support of cushions.

Tolerance

This relates to the time you can spend comfortably sitting, standing or walking.

Cognitive ability, perception and eyesight

If someone has diminished capability in any of these areas, they may not be suitable for a self-propelled chair.

Other physical attributes

If you are severely overweight or unusually tall, a standard wheelchair may not work for you. It is important that any wheelchair you use if both large enough and offers support for your whole body.

If your skin is damaged or fragile, this may also play a part as you may be susceptible to developing sores.

An occupational therapist would need to undertake a thorough assessment if there are question marks over any of these areas.

Aluminium or steel

For a number of years aluminium has been seen as the material of choice for wheelchair frames. It is lightweight, non corrosive and offers the required rigidity. Steel is also used, but is heavy and prone to rust. Steel wheelchairs do tend to be slightly cheaper than aluminium and are still used as first choice for bariatric chairs which need to be stronger.

Folding or non-folding wheelchairs

The vast majority of wheelchairs collapse down for easy transportation or storage. If you think it might be tight for the boot of your car or any storage location you have in mind, make sure you assess the chair’s dimensions when it’s in its collapsed state.

Tyres

There are two types of wheelchair tyres available - pneumatic and solid. They play a part in manoeuvrability and ride comfort.

Pneumatic tyres - which require inflation - offer a more comfortable ride, with the air inside cushioning impacts. They are however liable to puncture if they contact sharp objects, making maintenance costs generally higher.

A more popular option for most modern wheelchairs are solid PU wheelchair tyres. Generally made from a plastic compound or rubber, they’re not vulnerable to punctures but do not absorb bumps in the road surface quite as well as inflatable tyres.

While they do increase the overall weight of the chair, they involve lower maintenance costs and much greater reliability.

Wheelchair ramps

Whether it’s improving access around the home to climb low steps or to cater for raised door thresholds, wheelchair ramps are important pieces of equipment. Essential Aids supplies a wide range of high quality ramps.

Some are of fixed length and designed to stay in place, while others fold down, are lightweight and portable, so they can easily be transported with your wheelchair in the boot of a car.

Modern wheelchair ramps are usually made of aluminium, keeping their weight to a minimum.

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Foot Care Tips For Older Adults You Should Not Avoid

Getting injury on your feet, heels, or ankles can be painful as it may take some time to heal. That is why taking proper treatment from the very first moment is important. Especially elderly people, they might require some extra care for proper healing. Hence, the following are some of the basic foot care tips that may prevent further injuries, fungus, or infections.

Clean and Moisturize

A routine foot cleaning session is important for hygiene. As this routine is important to stop any fungal, viral, and bacterial infections, you might need to have this session outside of the bath and shower. You can have this wipe down session with warm water, soap, and a washcloth. With cleanliness and hygiene, it might relax and calm you down. After that, moisturize to prevent open foot sores, especially for older adults whose skin is drier. Afterwards, you can cover feet with a breathable cotton sock aid for comfort and warmth. 

Trim the toenails

This may prevent fungus, or bacterial infections, several foot injuries, inward nail growth, and help you maintain your overall hygiene. However, due to flexibility issues, it may be a bit of struggle to reach toes for many elderly people. In this case, taking external help can be helpful. If anything looks wrong then you can get them trimmed by a qualified podiatrist rather than at a nail salon. 

Pro Tip: Trim nails no shorter than the tips of the toes.

Ensure good circulation

You can include several things in your routine for better movement of your feet. Having occasional massage sessions may improve the overall blood circulation for better mobility. During the massage, keeping your feet propped up on the couch or a footstool may reduce the likelihood of swelling. In cases of sitting for a significant period of time, wiggling the toes, moving feet around can help the blood pass through the feet and toes. Including stretching in your daily routine may also boost the blood flow.

Prevent fungal infections

Constant moisture around the feet may invite fungal infections. Hence, it is important to change socks or stocks as often as necessary. You can search online bed socks for elderly to find the suitable one for your use. To prevent the foot moisture, using a good foot powder may also help in drying that up. In the cases of constant itching or burning, schedule a meeting with a podiatrist to have it checked before some infection develops.

Buy quality footwear

Equipping yourself with quality and good fittings shoes, socks are important. With loose footwear, you may develop blisters that can worsen because of shoes sliding around your feet as you move. And wearing tight shoes can cause circulation problems. In cases of mobility issues, investing in a sock aid may come of great help. That compensates for Limited Range of Motion. Patients having arthritis experience difficulty bending and reaching their feet and a sock aid can allow them to independently put on their socks.

It is a flexible or semi-flexible material attached with two long handles. You can buy bed socks for elderly online and attach the sock on it and then place your foot inside the slope of the aid. Then you can pull it with the rope to wear your sock.

Avoid Bare Feet

For elderly people, it is preferable to wear shoes even when indoors to prevent cuts, scrapes, or some heavy object falling on the feet. Especially when using the toilet, there is always the risk of bacterial and fungal infections. Slippers would act as a protective barrier against nasty foot infections such as toenail fungus and athlete's foot.

Visit your Podiatrist Regularly

Even if your feet are perfectly fine, visiting your doctor once a year will make sure that nothing severe is developing. This can be a preventive step to prevent all kinds of early-stage foot issues. Being a little active will make sure that warts, hammertoes, bunions, bone spurs, and neuromas, never get the chance to blow up into major problems that may require serious treatment.

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8 Tell-tale Signs You Might Need a Walking Stick

A walking stick is one of the most important disability aids that helps a person gain independence and enhance the quality of life. However, people may have difficulty deciding whether they require a walking cane/stick or not.

Though circumstances may vary from person to person, people generally require a walking stick to enhance body balance and stability. As a rule of thumb, your body starts indicating the need for some type of walking aid through various signs.

Let's understand in detail the most general scenarios where you may need this valuable walking aid.

• Doctor's Recommendation

If a doctor recommends using a walking aid, you should start using it without any delay. This is because only a professional is qualified enough to assess your condition thoroughly and advise you rightly.

Even if you feel you need a walking aid, it is recommendable to avoid going on a hunch. You should always seek medical advice first before picking a walking aid.

• Pain in Joints

If you experience unbearable pain in your knees or ankles while walking, a walking cane may help alleviate your pain. In some cases, a walking cane alone may suffice. In some other cases, you may need a combination of two or more disability aids like a wheelchair, over bed table, etc.

• Back Pain

People generally don't consider using a walking aid as long as they don't start facing issues with walking. However, severe back pain may also lead to poor posture and hunching problems. So, if you experience back pain while walking or later, you should go consult a physiotherapist to find out whether you need a walking cane or any other mobility aid.

• Leg Injury/Accident

A leg injury (like a minor sprain, cramp or fracture) may present problems in walking. If you try to walk without any aid, you may strain on the affected part further. A walking cane may come in handy to ease pressure on the affected part and prevent the situation from worsening.

You should seek advice from a physiotherapist to find out the right type that would fit your requirements the best.

• Assistance in Walking

If you have recently undergone surgery in your lower extremity parts like legs or thighs, you may feel (shaky/wobbly) when walking without support. If you can't walk independently and require to grab nearby objects like furniture, door knobs, you may need a walking cane.

• Balance Issues

If you suffer from a neurological disorder like:

• Acoustic neuroma
• Vertigo
• Cochlear hydrops
• Meniere's disease, etc.,

that causes balance problems then you may require a walking cane to maintain stability.

• Tiredness

Even if you don't suffer from any balance or mobility issues, you may need a walking aid if you are too tired to walk. This may be due to a condition like asthma when you run out of your breath after walking for long distances. Canes and sticks can provide you with great support during long distances and help you regain your breath.

• Old Age Issues

Though old age blesses you with wisdom, maturity and empathy; it deprives you of strength and energy. Further, several age-related issues like osteoarthritis, Parkinson's disease, spondylitis, etc. increase the risk of fall injuries.

A walking aid won't only help prevent fall injuries but also provide great support and balance for walking. It also alleviates the pain you experience due to ageing-related conditions.

Therefore, if you feel symptoms of an age-related issues, go see your doctor. Find out what exactly is the cause of those symptoms. After that, you can figure out the right mobility/disability aid(s) for you by consulting a physiotherapist.

A wrong choice of a walking stick may be of no use for you. So, you should always keep two things in mind while choosing the right model for yourself - height and weight-bearing capacity.

First, it should be strong enough to distribute and support your weight properly without breaking. Second, its height should be optimal. A very short stick or cane will force you to bend over too much putting extra pressure on your arms leading to muscle spasms. Similarly, a very long stick may fail to support your body weight properly.

The best way would be to take help from a certified physiotherapist to get this walking aid of optimal dimensions.

In a Nutshell

A walking stick is one of the disability aids that helps a person with leg injuries, short-term or chronic mobility issues. At times, deciding when to start using aids like sticks or canes may be tricky at times. 

However, you can always combine some tell-tale signs and a professional therapist's consultation to decide when to start using a walking aid.

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Choosing The Right Shower Seat

Bath aids are of great help to patients or the elderly with mobility limitations. They help them use the bathroom independently and efficiently. Out of the several bath aids available in the market, a shower seat holds great importance.

Several types of shower seats are available in the market for you to choose from. However, you need to pick the right type to ensure that it serves your purpose.

So, let's discuss in detail the several factors you need to consider for the right selection of this important bath aid.

• Weight Bearing Capacity

The weight-bearing capacity plays a crucial role in the selection of the right variant. The model you choose should be strong enough to support your weight.

The standard model is ideal for people with normal body weight. However, for people with slightly higher body weight than normal, a bariatric model may be a better choice.

While a shower stool can bear a weight of up to 100 kg, it is generally light and is an ideal fit for those who need to sit down only when feeling tired during showering. If you don't feel dizzy or require support when lifting yourself up, you can go for a shower stool.

If you need more support for sitting or lifting yourself up, a shower chair may be a more suitable choice.

Again, a shower seat is of different types like folding, non-folding, or wall-mounted.

A folding or wall-mounted variant may be ideal for little spaces. It folds down easily when not in use and hence doesn't require much storage space.

Further, a wall-mounted variant may be useful for people who have balance issues (like those rehabilitating from a stroke or half-paralysis). So, even if people tend to lean too much on one side than the other, the chair doesn't topple because of its permanent position. This can prevent possible fall-injuries.

• Design

Design is also a crucial factor to consider while selecting the right variant. While some variants have non-tilt (or upright) back supports, the other variants have tilting back supports. As a rule of thumb, the 'fixed or non-tilt back' variant may be ideal for those who don't require much assistance in showering and can hold their back in an upright position for long.

If a person needs assistance in showering or bathing, a tilt-back variant may be more suitable. Such tilt-back variants generally are more suited to places like hospitals and care centres.

• Purpose

Your purpose also determines your choice. If you want a bath aid that can help you assist you in the toilet as well, a dual-purpose shower commode chair may be an ideal choice. The additional feature of the commode chair eliminates the need for transferring individuals with mobility limitations to a commode chair separately.

If you don't require the additional commode functionality, you may go for the standard shower chair.

• Sitting Surface

The sitting surface of the variant you choose should be ideally slip-resistant, water-resistant, and durable. Moreover, you may be well off with a padded and easy-to-clean sitting surface. Many variants come with drainage holes in the sitting surface to facilitate faster drying by preventing the build-up of water.

If an individual is suffering from skin issues and is prone to pressure ulcers, it is recommendable to use a variant with a padded sitting surface. In other cases, a non-padded or contoured sitting surface may also work.

Tips to Take Care of a Shower Seat

Purchasing the right variant may not suffice alone. To make sure that your investment doesn't go waste and your seat lasts long, you can follow several care tips such as:

• Avoid using harsh detergents to clean your chair.
• Wipe off the residues from beneath the chair after every use to keep it clean.
• Let your chair dry between two uses.
• Follow the maintenance instructions in the user manual that comes with your chair properly.
• If you find any signs of damage or rusting in any part, replace that part immediately. Generally, all shower seats come with a stainless material; but there is no harm in checking once for reassurance.
   

In a Nutshell

Though a shower chair is one of the important bath aids, its wrong choice may fall flat. Therefore, ensuring that you choose the right variant is highly recommendable.

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Factors to Consider When Buying a Pressure Relief Cushion

A pressure relief cushion is of great help to those with mobility restrictions. They help prevent development of pressure sores and maintain skin integrity in bed-bound or wheelchair-bound people. Sometimes, finding a suitable pressure cushion may be tricky just like in the case of other mobility aids.

Though a professional's recommendation is always the first thing to seek for, considering some basic factors while selecting the pressure cushion may simplify your process a little.

So, let's walk you through what all points to bear in mind while selecting a pressure cushion.

• Pelvic Stability
  

Pelvic stability is an important factor to consider while selecting a pressure cushion. The pressure relief cushion you choose should provide you with sufficient pelvic stability.

This means that your pelvis should be in a 'neutral' position. It shouldn't rotate forwards or backwards. A proper coordination between your lower trunk and proximal posterior muscles helps attain stability in your spine. A stable spine helps the trunk extend properly keeping your body straight. Thus, not only your posture stays straight but also your abdomen and chest don't feel unnecessary pressure that facilitates proper breathing and digestion. Further, a stable pelvis and spine may facilitate using your arms without losing your upper body control.

To achieve pelvic stability, matching the contours of the cushion surface with those of your posterior may be a good idea.

• Immersion

Bottoming out is the condition when the pressure relief cushion doesn't provide adequate support resulting in the transfer of the person's weight to the bed base. If this happens, the pressure cushion may induce pain. Even worse, a person may develop Ischial Tuberosity or Ischial bursitis (severe inflammation of the bursa, a fluid-filled sac between tendons and muscles in Ischia, the bones in the base of pelvis) overtime.

Therefore, ensuring that your cushion supports 'immersion' is advisable. A cushion that is not too soft or easily compressible but still lets your body to sink without bottoming out may be a good choice.

• Off-Loading

Off-loading is removing the pressure from a small surface area (Ischial Tuberosities, lower pelvic bones) and distributing it to a greater surface area (to femur and thigh bones). This helps even distribution of pressure that provides more stability and skin-protection.

• Envelopment

Apart from immersion, envelopment is also a crucial factor. Immersion and envelopment are often inter-linked.

After ensuring you sink well into the cushion without bottoming out, you should also ensure that your cushion provides envelopment. This means that it envelops your bony areas and distributes pressure across the entire surface area.

This reduces pressure on bony areas preventing their inflammation.

• Heat

The increase in heat may lead to the development of ulcers. So, choosing a pressure cushion that keeps your body temperature optimal is recommendable. If you tend to perspire more, a gel cushion may help slow down the rise in body temperature and keep your body cool.

On the contrary, if you tend to feel colder, a standard foam cushion can give you extra insulation.

• Waterproofing

If you suffer from incontinence issues, a simple cushion may not suffice for you. A cushion provides adequate water-proofing may work well. Such a cushion won't only keep you dry but also prevent damage to your skin from continuous moisture.

• Fire Retardancy

Ensure that your pressure cushion is fire-proof and complies with the British Standards Institute (BSI) for pressure cushions, especially if you smoke often or need support getting up from your wheelchair or bed in an emergency.

• Portability

If you travel frequently and need to transport your cushion from one place to another, the weight of the pressure cushion also matters. A foam or gel cushion may not be as easily transportable as an air cushion due to it being heavier.

Hence, an air cushion may be an ideal choice for easy and frequent transportation.

In a Nutshell

A pressure relieving cushion is one of the essential mobility aids for the individuals bound to spend hours in sitting/seated or supine position. However, it is important to bear in mind that all mobility aids are useful only when you choose them wisely. Hence, if you consider the factors mentioned above while selecting a pressure cushion, it may help you arrive at the right decision easily.

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Tips on Buying The Right Raised Toilet Seat And Commode Chair

Toilet aids are highly useful for people with mobility restrictions. Two essential aids to make toilets accessible are a raised toilet seat and a commode chair.

A toilet seat is for those who have difficulties standing up or sitting down but can still manage to walk short distances like going to the toilet.

On the contrary, a commode is an independent toilet seat that doesn't require any plumbing system. This toilet aid has an opening with a basin that can collect urine and faeces. It can be suitable for those with severe mobility restrictions that can't walk even short distances.

However, there are some factors you should consider for selection of both these toilet aids. Let's understand them one by one.

Points to Consider when Buying a Raised Toilet Seat

Support Arms

While some variants of this toilet aid come with support arms, others don't. If you suffer from balance issues besides mobility issues, a variant with armrests may suit you more than a variant without them. Further, you can leverage the armrests to transfer yourself from your seat to bed easily.

If you don't have major balance issues and need only a little support when lowering down or getting up, a variant without armrests may also suffice.

Ease of Transportation

Several variants of toilet seats have a clamping mechanism. If you need to transport or change the location of your seat on and off, a variant with clamps may be more suitable. This is because these clamps facilitate easy installation and removal of a toilet seat.

So, even if you are away from your home, you can carry your toilet seat along. It ensures that you have a safe and easy-to-use toilet aid wherever you go.

Padding

A padded variant may be more useful if you suffer from a skin condition or are at risk of developing pressure ulcers.

If you are suffering from age-related issues that make it difficult for you to get up or sit down but you still have mobility sufficient enough to walk a little, a standard toilet seat may suffice.

If you are suffering from posterior injuries or recuperating from posterior surgery, you may require more comfort and skin protection. A padded variant may be a better choice in this scenario.

Points to Consider when Buying a Commode Chair

Versatility

Versatility is a crucial factor to consider when buying a commode. While a standard variant helps you with defecation only, a 2-in-1 variant helps you with both showering and defecation. The latter variant may be of great help to the elderly or disabled who have difficulties frequently transferring from one disability aid to the other.

Weight-bearing Capacity

The weight-bearing capacity also plays a role in the choice of a commode.

The weight-bearing capacity of the standard commode is generally around 200 pounds. If you are larger in size, a standard commode variant may present problems. For instance, you may face risks of arm support failure, buckling of commode legs, or slippage.

A heavy-duty variant may come in handy in this scenario. With strong metal handles, larger seating surface and weight-bearing capacity of up to 300 kg, this variant can accommodate heavy patients.

Height Adjustability

Whether to buy a height-adjustable variant or not depends on your requirements. If you need to use your commode in multiple locations, a height-adjustable variant may serve your purpose better. On the other hand, if you don't need to shift your commode chair to multiple locations, a non-adjustable height variant may be enough.

Storage Space

The storage space a commode requires may also determine its choice at times. If you have enough space to accommodate the commode when not in use, a non-folding variant may fit your purpose. However, a folding commode may fit in better in case you have storage space restrictions. This is because you can easily fold it when not in use and use that space for other purposes.

Price Considerations

The more enhancements you want, the higher the price of your commode goes. For instance, a folding variant may be costlier than a non-folding one. Similarly, a wheeled variant may be slightly costlier than a non-wheeled variant. Therefore, combining both your requirements and purchasing power is highly recommendable to arrive at the right decision.

Summing Up

The choice of the two essential toilet aids - raised toilet seat and commode depends on a number of factors. Always ensure that you combine the above-mentioned factors with a professional's advice. Only then will your final choice be an ideal choice.

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