Responsible Wheelchair Provision
August 31, 2011
Most people think that providing a wheelchair is a simple matter of buying one and giving it away. But in order to avoid harm to the user and give the user the greatest degree of independence and mobility, wheelchair provision needs to include a whole series of steps starting with an initial screening and assessment and ending with a proper fitting and adjustment. In many cases, follow up soon after provision is also necessary.
Proper provision is important to Whirlwind because it significantly increases the benefit to wheelchair riders, our reason for existence. We do our best to see to it that our chairs are provided in accordance with the World Health Organization’s Guidelines On The Provision Of Manual Wheelchairs In Less-Resourced Settings.
Although thousands of wheelchair riders the world over love our RoughRider® model, there are many people for whom it is not the best option. In fact, no wheelchair is good for every rider. A variety of wheelchair products is important. Every recipient of a wheelchair first needs to be assessed to determine what type and model of wheelchair is appropriate considering their disability, lifestyle, and environment.
A properly fit wheelchair is as important, usually more important, than a properly fit pair of shoes. For example, shoes that are too big are hard to walk in; shoes that are too small or too narrow can hurt and cause blisters. If you want a pair of sneakers but get lumberjack boots instead, it could be hard to play sports. A wheelchair that is too wide can make it impossible for the user to get through narrow doorways, be difficult to push, and in short order can cause shoulder injuries from the user having to push in an awkward position. A chair that is too narrow can tip over sideways on a side slope. A chair with too tall a back can impede the rider’s ability to push the hand rims. A chair with too short a back can provide insufficient support, be uncomfortable, and lead to long term scoliosis (curvature of the spine). And a wheelchair without a proper cushion can cause a pressure sore in a paralyzed rider’s buttocks that can easily lead to life threatening infection.
The outcome of a wheelchair project is most likely to be successful if people experienced in wheelchair service are involved. There is no substitute for partnering with skilled therapists and seating specialists, and highly experienced users. At the same time, Whirlwind recognizes that in some cases wheelchairs are purchased for riders by organizations that do not have access to clinicians or seating specialists or highly experienced users in the remote locations where the RoughRiders will be distributed. In that case, we offer educational resources designed to inform wheelchair providers with an introduction to the basic concepts. With basic training, providers can serve many riders. Wheelchair users who have limited sensation due to spinal cord injuries and other more complex disabilities require special services and training on pressure management. All RoughRider® users should have no severe contractures, good head control and the ability to maintain a sitting position. For more complex seating situations, we recommend that you contact Whirlwind for a referral to a local organization with expertise in wheelchair fitting for complex seating needs. It is our goal that by working with skilled providers, each wheelchair rider can receive a wheelchair that is appropriate for his or her needs as well as the education needed to use the wheelchair safely and optimally.