Learn all about how you can travel smartly with mobility this holiday season.
Traveling has always been an option for people through various modes of transportation, such as trains, planes, cars, buses, and public transit. In order to travel smartly with mobility, we must first understand what are the things that often stand in the way. Let’s talk about some of the common accessibility challenges for individuals with mobility needs when traveling.
Inclusive facilities:
Facilities around the world are required by law to meet local accessibility standards; however, not all the latest standards meet the actual needs of mobility users sufficiently. While some hotels and motels have wheelchair accessible rooms and bathrooms, as well as accessible parking spaces and entrances, other accommodations may be overlooked. Examples include visual cues for texture, depth, inclination, and elevation changes. Some facilities may lack updated accommodation and inclusion standards, such as wheelchair ramps, elevators, universal signage, or alternative methods of communications (Braille, voice commands, etc.). Refer to reviews, ratings, and pictures of the facilities as second opinions when selecting for the most inclusive facilities to visit.
Mobility traveler-friendly traveling methods:
The mode of transportation itself may pose barriers for individuals who use wheelchairs. Airlines may mishandle wheelchairs, leading to damage. Narrow spaces, like tunnels and tubes from the platform to the plane during boarding and vice versa, can be hard to navigate.
Most traditional escalators are not designed for wheelchair drivers to self navigate. Trips and falls on those escalators are be extremely dangerous. Always use the elevator if possible. And be extremely cautious with taking the escalators in wheelchairs. For even when it seems like the escalators are just wide enough for the device to fit, always remember that your device needs enough leeway to move around as it enters a surface in constant motion.
Mobility-friendly Restrooms:
Restrooms on trains and airplanes may require navigating through narrow hallways and have too tight of a space inside for mobility users to move around. Wide-body airplanes tend to be a better option accessibility-wise since they provide more toilet and aisle spaces. Some airlines also have more accommodations than others. Uniform airport designs that lack in accessible signage can also make restroom identification difficult. Navigating crowded areas to reach restrooms can also be challenging.
Mobility device arrangements during travel:
Similar to baggage and luggage, mobility devices need to be stored with care for proper protection when in transit. In fact, scratches and bumps to mobility devices can easily cause more serious function-related damages that can singlehandedly hinder the rest of the trip. Avoiding unwanted surprises, make sure you are aware of the best storage option for your devices in transit as well as the related local regulations ahead of boarding time to make the necessary arrangements for assistance. Consider using tagging technology (e.g. AirTag) to help track your mobility device in the event that it is lost or misplaced in transit.
Emergencies:
Emergency exits and evacuation routes can be hard to find in large busy places like airports and train stations. Individual mobility users can face difficulties accessing oxygen masks and inflatable slides during emergencies. Consider traveling during less crowded hours or days for less hassled environments.
Travel smartly with mobility:
- Plan in advance: Contact the transit companies for more accessibility-related information so you can make more informed choices on which airline/train/bus to book tickets from.
- Label Appropriately: Label mobility devices and associated adaptive devices for careful handling. Use bright colors for attention.
- Track your device: Tracking technology can help with locating lost or misplaced mobility devices.
- Arrive Earlier: Arriving early is always a good choice when traveling. It gives you more time to navigate the check-ins and baggage areas with ease.
- Legislation and Rights: Google local traveling legislation on accessibility and visitor’s rights. Remember to take photos/videos to document the devices’ condition before checking your devices in with third party caretakers during transit.
The above solutions for individual mobility users alone are not sufficient. We firmly believe in the transformative power of collective change. We need to raise awareness of the above challenges faced by mobility travelers nowadays so that everyone can understand the crucial role accessibility plays in making essential transit facilities truly inclusive around the world.
You’ve probably heard the saying “buyer beware” before. It’s that feeling you get when you’re shopping for something, like clothes. You start thinking about the occasion, the weather, and whether it’s the right color for the season. You also wonder how long you can wear it comfortably. But no matter how much you think things through, sometimes things just don’t turn out as expected, and you end up feeling like you made the wrong choice. And this common struggle with sufficient buyer awareness becomes especially relevant and impactful when it comes to the mobility device market. It cannot and should not be the end users’ sole responsibility to try and figure it all out. And Braze is here to help every end user who may feel lost with all the essential information they should look out for when shopping for mobility devices.
Adaptive and assistive technology can really change the game for people who use wheelchairs, making a big difference in their quality of life, independence, and mobility. This blog isn’t about saying, “be careful, you’ll run into problems no matter what.” Instead, it’s shedding light on the often overlooked value with proactive measures that can be taken to boost buyer awareness in order to make informed choices that best serve the buyer’s interest.
And the first step to optimizing buyer awareness is asking the right questions to best understand your options, just in case you face issues with your wheelchair or other assistive devices. When you’re getting a wheelchair, it’s important to ask the right questions to make sure it’s the right fit for your needs and preferences.
Navigating Wheelchair Adaptations and Considerations
Which wheelchair are you using?
If it’s a manual wheelchair, you need to be cautious about adding certain extras because there might not be enough space for them. For instance, you can attach backpacks or oxygen tanks to the wheelchair, but there might not be room for other assistive and adaptive devices. On the other hand, if you have a power wheelchair, there’s generally more space on the base and around it, allowing you to add more adaptive and assistive devices as needed.
How can you adjust your wheelchair?
Some wheelchairs are designed to tilt or stand, while others can lean forward and backward. When you’re looking for assistive and adaptive devices, you have to consider where you can mount them safely without causing any damage due to the wheelchair’s movements.
What’s the weight limit of your wheelchair?
This is crucial for safety. If you only use the wheelchair for your own mobility, it’s pretty straightforward. But if you have oxygen tanks, backpacks, additional medical equipment, or any assistive and adaptive devices, they can quickly add to the weight. This extra weight might affect how easily your wheelchair moves and turns.
Do you have a warranty or insurance?
If you do, it’s essential to know the duration and what it covers. This information is vital in case your wheelchair gets damaged from regular wear and tear or due to the addition of adaptive and assistive devices and medical equipment.
Assessing Wheelchair Technology Compatibility
1. Is your wheelchair tech-friendly?
- Do you know if your wheelchair can work with modern technology, or if it would work better with newer technology? It’s crucial to understand your mobility goals and find user-friendly tech that fits those goals. Think about compatibility for safety and financial reasons. Tech that doesn’t match your wheelchair might be risky, and you wouldn’t want the hassle of returning or replacing it.
2. Is wheelchair tech user-friendly?
- Are you familiar with the tech or need some training? Consider your comfort level. How long will it take to get the hang of using this technology? Is customer support available when you need it? Can you connect with other users to learn from their experiences? These factors play a role in your confidence and safety using the technology.
3. Is wheelchair tech accessible and affordable?
- Do you know if there’s any financial help to get the tech you need? Be aware of alternatives if you can’t get funding. Also, find out if there are upcoming upgrades for the technology. If it’s necessary, you might have to buy it right away. But if you have a temporary solution, waiting for an improved version could be worthwhile.
4. Can you test the tech before buying?
- When picking technology for your mobility device, it’s not just about whether it fits the device; it’s also about whether it fits you. So, find out if you can try the tech before purchasing it. This can help you gauge how you feel about using it – whether it’s safe, easy, or tricky to handle.
Selecting with Awareness for the Optimal Mobility Solutions
As you can see, there are many things to be aware of when it comes to buying mobility devices that are the best fit for your specific circumstances. To be an informed buyer, you should ask the manufacturer of your wheelchair, the makers of the adaptive/assistive devices, vendors, assistive technology professionals (ATP), clinicians, and fellow wheelchair users:
1. Who Covers Damages?
- Does the wheelchair manufacturer handle damages to the wheelchair, or is it the adaptive/assistive device manufacturer’s responsibility? Maybe the vendor, ATP, or clinician can help. It’s essential to know who can assist you if you encounter any issues with your wheelchair or technology-related adaptive/assistive device.
2. Which is the Best Fit for Me?
- After you’ve shared your mobility needs, strengths, and goals with these professionals, you can ask them whether a particular wheelchair or technological assistive/adaptive device is a good match for you. If it’s not, find out how you can customize it to better suit your needs.
3. Do the Second Opinions Check Out?
- There are various events and online groups related to mobility where you can get advice and insights. These gatherings may have researchers who can answer questions like how a specific wheelchair or technological assistive/adaptive device was developed, considering factors like the user’s needs, the environment, past and future technologies, and any identified issues that could affect users and society.
The A5 Method Plan
First and foremost, a big congratulations for making it this far. You are already more informed as a buyer! And to celebrate that, here is the A5 Method Plan, designed by Braze just for you, that summarizes the five essential steps to follow for cultivating the necessary buyer awareness around mobility devices and related technological adaptive and assistive products over time:
- Assess – Figure out your mobility needs, strengths, and goals.
- Advocate – Make your needs and goals clear.
- Advice – Seek advice from healthcare professionals, family, accommodation experts, vendors, manufacturers, and fellow mobility device users.
- Analyze – Try out products and make informed choices before buying.
- Approve – Buy with confidence and peace of mind, knowing you’ve followed all the necessary steps!
Whether you’re curious to learn more about buyer awareness in general or eager to get the help necessary to start making informed decisions about your mobility devices right away, enter your email below to get your own handy A5 Checklist!
Let’s work together to ensure your mobility needs, strengths, and goals are met, and you can confidently approve your choices with peace of mind. Your journey begins with us – take the first step and request your A5 Checklist now!
In a world where the power of perception often shapes our understanding of others as well as ourselves, it’s crucial to embark on an exploration of wheelchair safety in solidarity with promoting inclusive mobility that values integrity and wellness beyond physical needs. Debunking prevailing social myths surrounding the capabilities of individual mobility device users, we hope to illuminate a path to break free from the biases that might negatively impact individuals’ self-perception and driving potential.
Emphasizing the functional strengths of individual mobility devices users, we will delve into how various factors – education, interaction, and societal attitudes – can profoundly influence the safe use of mobility devices, whether for the better or worse. In doing so, we hope to shift the focus away from individuals’ diagnoses and/or functional limitations to pay more attention to their current capabilities.
In our previous blogs, we explored surprising technological factors such as seating, programming and configurations, and drive controls: 3 Reasons for Accidents with Wheelchairs that Might Surprise You (Technological Factors) as well as key environmental barriers from accessibility, weather to traffic: Safeguarding Wheelchair Users: Unveiling 3 Key Environmental Barriers that Impact the Safe Use of Wheelchairs that all contributed to the safety of wheelchairs. With this third blog breaking down the significance of education, interaction, and societal attitudes, we invite everyone to perceive the safe use of mobility devices as an opportunity for assistance rather than a problem demanding solutions.
1. Mobility Education and Experience
1.1 Mobility Training Communication
It is essential to shift the conversation surrounding the training for individuals with disabilities from a focus solely on what they cannot do to a recognition and emphasis on what they still can, as this perspective encourages a more positively balanced view on their mobility potential, especially with proper use of mobility devices and adaptive technology. To elaborate, when individuals are learning about overall functionality of their bodies which is essential to their safety with mobility devices, they should be asked questions such as “which body part(s) do you find you use the most and are most helpful?” rather than only questions like “which part of your body do you struggle with the most in your everyday life and routine when you try to use mobility devices?”.
These two seemingly similar questions actually carry contrasting implications. One question emphasizes heavily on the individuals’ needs for the solutions proposed based on their reported limitations. This passive focus, in another word, implies that the individuals must depend on factors outside of their control to make their decisions for them. The other question, on the contrary, leaves the decision-making power within the hands of the individuals by simply highlighting all the functional capabilities they still have, allowing them to understand and recognize the available solutions in a much more dignified manner. The latter one is often more difficult to achieve because it requires not just telling, but also educating the individuals more in depth about their circumstances in order to arrive at the right decisions on their own.
1.2 Self Awareness and Training for Mobility
To build the self awareness needed to fully take control of one’s safety as well as realize one’s mobility potential in the long run, one should familiarize oneself with the diverse spectrum of functional abilities that impact one’s mobility:
Cognitive Ability
Cognitive ability is the way we think. It is all about our ability to focus, memorize, multi-task, and make decisions. It impacts our attention and interpretation of the world around us. If an individual has impacted cognitive ability, it is likely they will need more training and repetition of tasks involving their mobility device in their home and outdoor settings, to ensure they have the ability to safely make decisions about when to go faster, slower, change direction, and/or stop their wheelchair. Additionally, if decision-making is impacted due to cognitive impairment, it is best to steer clear of doing multiple tasks at once while driving the mobility device, as the individual might not be able to focus their attention on safety if they are distracted.
Fine Motor Ability
Fine motor ability is the way we move and use our fingers, hands, feet, and toes to complete tasks. Individuals with impacted fine motor skills may need more therapeutic intervention to maintain or enhance their level of functioning to better use their fingers and hands. In this case, training in alternative drive controls such as sip-n-puff, chin/tongue switch, and head array would be helpful – anything that can be used in place of a joystick that requires finger and hand movement.
Gross Motor Ability
Gross motor ability is the way we move and use our head, neck, shoulders, arms, trunk, hip, and legs to complete tasks and navigate the world around us. Individuals with impacted gross motor skills may be receiving ongoing rehabilitation to maintain or enhance their current functioning and might be able to move their body to a certain degree while using their mobility device.
Visual Ability
Visual ability is the way we see the world around us. It is how clearly we see, how far we can see, how much depth we can recognize, what colors we see, and what textures we can recognize. Spatial ability is how we use all of this information to help us navigate in relation to our environment. Together, these are termed visual-spatial ability. Therapeutic interventions involving eye movements, hand-eye-coordination, and depth perception can help with rehabilitation. Training on adaptive technology and assistive devices that may help to “see” the world around them, past the point of their real visual field, could help in operating mobility devices safely.
1.3 Experience with Mobility Devices
More time spent using a mobility device provides more experiential learning opportunities for individuals to become more aware of their bodies in relation to their surroundings, leading to safer use of mobility devices. Overtime, more experienced individuals learn to understand how to navigate various terrains in various weather conditions. They learn what areas in their homes are harder to navigate and which public spaces are accessible to mobility devices. They also have a better idea of how they can balance, go faster, go slower, or stop entirely while navigating known terrains ( the environment blog in this safety series discusses this in more detail). All in all, individuals who have more experience with their mobility devices can better advocate for improvements that will make their community more accessible and inclusive.
Individuals can learn to use their assistive devices and adaptive devices better, through use of these alongside their mobility device. Additionally, their ability to solve problems and later, build confidence in mobility device use increases as well. For example, the individual is not only aware of their own strengths, but the features of their assistive and adaptive technology, and the combination of both helps the individuals learn to be a safer mobility device user. Our technology blog in this safety series explores this further. Overall, their quality of life and self efficacy increase through experience of terrain and learning of technology.
Solution:
It is important to provide training on cognition, fine motor skills, gross motor skills, and visual-spatial skills to clinicians, vendors, families, and anyone else who works with individuals who use mobility devices. This knowledge can help stakeholders understand the goals and strengths of individuals who use mobility devices, so recommendations and opportunities can be made to fit well with these individuals. They can also learn more about the strengths-based approach and person- and family-centered care. This would help view needs as goals and view functioning as strengths. Experience working with mobility devices over time will assist with understanding accessibility more as well.
2. Societal Attitude
It is important to understand what societal attitudes, perceptions, and acceptance is when it comes to mobility devices and individuals who use them. Although accessibility and disability may seem like universal concepts, the level of acceptance society displays varies.
Can societal attitudes of independence have an impact on how society views users of mobility devices and ultimately, how users of mobility devices view themselves? Can cultures where independence is highly valued view disability as more devastating perhaps, when compared to cultures where interdependence is supported? Is it possible that individuals who use mobility devices from independence-valuing cultures view themselves as being more in need of accessibility than individuals who use mobility devices from interdependence-valuing cultures?
A journal article published in the Scandinavian Journal of Occupational Therapy suggests that societal attitudes of disability impact whether individuals who use power mobility devices either feel included or excluded in society. The issue is not just societal attitudes, it runs deeper. The way society feels about individuals who use mobility devices can impact the way that individuals who use mobility devices view themselves.
We have to be mindful to make sure that our attitudes of disability, mobility devices, and accessibility are equitable and fair so we can create a more inclusive society for everyone. Explicitly, negative bias may look like individuals saying insensitive things about disabilities. Implicitly, this bias may play out in the way that spaces are designed, policies are created, and health related evidence-based practices are researched. Some individuals may not be familiar with the challenges faced by wheelchair users and may lack awareness or understanding of their needs. This can result in barriers that make it harder for wheelchair users to move around comfortably and safely.
Solution:
Providing more advocacy related campaigns, social media posts, and education can help people understand whether society is being inclusive of individuals who use mobility devices or if there is more work that needs to be done to enhance accessibility of society by changing attitudes towards disability and accessibility.
3. Interaction
Individuals using a mobility device have either used these as a child or they come into contact with using a mobility device in their adult life. Skills like navigation, learning a skill, using our senses, identifying problems, and using creativity to solve these problems develop not just through our training in mobility devices and the experience we have with mobility devices. Rather, it goes beyond that – the training and experience works through the element of interaction. Interaction is when the individual can make changes to their mobility device, environment, and/or themselves in response to their experience with the mobility device and associated technology, their own goals and strengths, and their environment.
For example, when an individual uses their mobility device and their adaptive devices and technology in their daily routine, they may realize they need to alter their mobility device (such as adjust their seating), their routine (perhaps to low-traffic times), the devices and technology on the mobility device (perhaps adding backup cameras or blind spot sensors), and/or their own training (perhaps needing more information or training on certain aspects). Check out our blog on The Prevention of Wheelchair Collisions to understand more about the value of experience, training, and your role in how to use mobility devices safely.
Solution:
The three blogs in the safety series highlight the importance of the technological, environmental, and personal aspects of safe mobility. We must understand the individual and their needs not in isolation, but view the goals and strengths of the individual in relation to their current mobility device, environment, training, experience, technology, and support available through relevant stakeholders (such as clinicians, vendors, and family).
In summary, the goal of this entire blog series was to shed light on the factors beyond the individual’s diagnosis and functioning, and to increase opportunities for independent mobility. The purpose of this blog series therefore, is to take the strengths-based approach to improving quality of life. Just as one must not just speak of health in the presence of illness, one must not speak of accessibility only in the presence of disability, otherwise we will only work to make this society more accessible if and when there is a disability.
References
Mortenson, W. B., Miller, W. C., & Hardy, T. (2009). Ready to roll? Wheelchair use in residential care. . Disability Health Research network: UBC Okanagan. http://www.dhrn.ca/page.php?pageID=181
Widehammar, C., Lidström Holmqvist, K., Pettersson, I., & Hermansson, L. N. (2020). Attitudes is the most important environmental factor for use of powered mobility devices – users’ perspectives. Scandinavian journal of occupational therapy, 27(4), 298–308. https://doi.org/10.1080/11038128.2019.1573918
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In this blog, you will learn how wheelchairs can enrich quality of life as you discover the three most common yet impactful environmental obstacles as well as ways to overcome them. From accessibility options, weather conditions, to population density, we break these factors down thoroughly in relation to mobility safety. Our goal of the Wheelchair Safety Series is to introduce a holistic perspective on how environments influence safety on wheels. This second article in the blog series sheds light on how the following environmental factors may interfere with the safe use of wheelchairs:
- Accessibility
- Weather
- Traffic
Raising awareness about environmental hazards to wheelchair safety helps increase not just the safety of wheelchair users, but also the chance for the public to get involved. We hope that everyone can be a part of a more accessible and mindful shared environment.
Accessibility
The presence of accessibility-related environmental hazards can limit a wheelchair user’s ability to navigate their surroundings safely and independently, hindering their mobility and quality of life. Accessibility of public and private spaces is one major issue. Individual wheelchair users frequent public spaces such as parks, libraries, malls, theaters, healthcare facilities, and grocery stores. If a building has no ramps, elevators, appropriate clearance and size of doorways, and/or visible signs, it prevents wheelchair users from entering as well as impairs their ability to maneuver safely once inside.
Commonly seen challenges of navigating public spaces include and are not limited to maneuvering narrow aisles, backing up and into spaces with lots of traffic and/or fragile items, elevation changes between flooring, and having belongings (such as backpacks, oxygen tanks, or wiring from your adaptive and assistive technological devices) getting caught while maneuvering.
Lack of Awareness Leads to Lack of Accessibility
Additionally, cracked or uneven paths, gravel surfaces, and rugged terrains can easily get the wheels stuck, leading to wheelchair accidents. At times, especially in busy cities, we constantly see parked cars or groups of people blocking sidewalk entrances and exits, forcing wheelchair users to take alternative routes that are potentially dangerous. Navigating on the sidewalk is especially a safety concern when curbs are involved. A common fear of wheelchair users is accidentally going over a curb and into oncoming traffic, as this could lead to catastrophic injuries.
On the other side of the curbs, there are additional factors of risk such as changes in elevation and surface type (e.g., grass, mud, gravel). Tipping or falling into grassy patches can lead to the wheels getting stuck. An injury prevention journal presented a study highlighting wheelchair-related injuries by age. It suggested that over 100,000 injuries lead to ER visits one year. In which 65–80% of injuries related to tips and falls. As you can see, barriers above all deter wheelchair users from accessing and enjoying outdoor spaces, negatively impacting their safety, independence, confidence in their ability to maneuver a wheelchair, and quality of life.
Solutions:
- Downloading apps that show accessibility rates of a particular location.
- Additions to wheelchairs mentioned by Sunrise Medical, such as encoders, can help with safe steering of the wheelchair to ensure it stays on the path and direction it was intended to be on, regardless of the environmental hazards that come in the way.
- If going to a new public place and you need more information about its accessibility, perhaps calling ahead or visiting their ‘contact us’ and/or ‘about us’ section on their website might help plan ahead for your visit. Look for signage that might prepare you about the accessibility of a place ahead of time, for example, parking lots.
Weather
In most regions where seasons changing is a yearly ritual, not many are aware of the various challenges that come with each of the four seasons. From summer, fall, winter, to spring, wheelchair users face plenty of seasonal challenges within their indoor and outdoor environments that demand more awareness and attention from the community.
To name a few, there are unclean pathways covered by fall leaves and/or snow. There may cracked terrain with water piled up inside. There are leaves, snow, and water that can hinder the driver’s view and/or depth perception, making it difficult to predict what they are driving themselves into and increasing the likelihood of a bad accident. During winter times, wheelchair users can bump into snow banks. They can easily scrape parts of their wheelchair, and even tip and fall, crashing into snow banks.
Weather changes may impact accessibility of public transportation for individuals using wheelchairs. Uncleared sidewalks near bus stops prevent wheelchair users from boarding the buses. This adds unnecessary cost and stress to wheelchair users just to get around. In places where weather conditions change often, timely maintenance of pathways is a challenge. Failure to do so forces wheelchair users to allocate more funds for alternative transportation such as uber and taxis just to avoid social isolation and carry out routine errands (read more on this topic at inaccessibility of public transportation).
Solutions:
- Having access to cost-effective accessible taxi services such as Uber and Lyft. Torontonians can check out our blog on what to look out for when trying to book a ride on Accessible Transit in Toronto.
- Looking for visible signage (‘an icy slope’ or ‘road curves ahead’ or ‘bridge ices over in winter’) to prepare you for safe navigation of your wheelchair can be helpful.
- Keep up-to-date with wheelchair maintenance. Make sure you complete maintenance of all your assistive devices and your wheelchair ahead of weather changes. This way, your wheelchair, technology, and you, are all ready for safe wheelchair navigation and maneuverability.
Traffic
Using a wheelchair in a busy environment with lots of cars and people can get hazardous for wheelchair users. Public spaces are generally louder during high traffic hours such as the beginning and end of the day. During those times especially, there are a lot of larger vehicles that tend to reduce visibility and accessibility for everyone, not just individuals who use wheelchairs. Examples include large transportation trucks, large school buses, large public transport buses, and emergency vehicles.
Awareness of surrounding areas is important not just for individuals who use wheelchairs, but the general public as well. Wheelchair users are more vulnerable to accidents in high traffic areas. Automobile drivers may not be paying attention to the road, especially in high traffic areas. This may lead to collisions with wheelchairs.
Let’s talk about what is beyond the typical traffic.
When we say traffic, we often think of cars, buses, and bikes. What we don’t realize is that traffic on the road is not the only concern. Foot traffic on sidewalks can be of concern as well. When there are a lot of people accessing public walkways, maneuvering a wheelchair gets challenging as the user has lot more things they must try to avoid bumping into. To add to that, others sharing public sidewalks need to be mindful of how much space they leave to wheelchair users when using devices such as scooters, strollers, and walkers.
On top of everything mentioned above, the less talked about concept of “sensory traffic” needs to addressed. Intensive vehicular and pedestrian traffic often come with overwhelming sounds and lights as well. Not only must wheelchair users navigate through weather and accessibility related environment factors, they must also do all this under the constant influences of surrounding sensory stimulations and distractions. A sudden sensory input can lead the individual to act abruptly braking out of panic or accelerating in a rush. The individual has to divide their attention between all three traffic types then, vehicular, pedestrian, and sensory: this attention required for long periods of time and to make decisions, makes it even more difficult for individuals using wheelchairs to be socially active.
Solutions:
- You can increase your visibility to others by wearing bright colours, adding LEDs to your wheelchair and parts, hanging bright bags on your wheelchair if you use bags. Check out our blog on Wheelchair Safety Tips for more ideas.
- Adding sensors, cameras, and mirrors to your wheelchair could warn you when there is a change in your immediate environment. For example, a sensor could notify you if someone drives, runs, or walks past you suddenly. Check out our blog on the Pros and Cons of Visual Aids.
- Using a white cane could help improve depth perception during changes in elevation so you can prepare ahead of time when maneuvering your wheelchair.
At the end of this blog, we invite you to envision the potential opportunities out there for us to create a more inclusive and supportive environment! Do check out our previous blog in this Safety Series that talks about the 3 technology-related factors impacting the safe use of wheelchairs: seating, programming and configurations, and drive controls.
References/Citations:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2563507/https://brazemobility.com/3-reasons-for-accidents-with-wheelchairs-that-might-surprise-you/https://brazemobility.com/life-is-a-journey-not-a-destination/https://brazemobility.com/wheelchair-safety-tips-for-driving-on-roads/https://brazemobility.com/visual-aids-for-people-who-use-wheelchairs/https://brazemobility.com/accessible-transit-the-what-where-how-of-wheel-trans/https://www.sunrisemedical.ca/education-in-motion/clinical-corner/december-2016/steer-correction-for-power-mobility Mortenson, W. B., Miller, W. C., & Hardy, T. (2009). Ready to roll? Wheelchair use in residential care. . Disability Health Research network: UBC Okanagan. http://www.dhrn.ca/page.php?pageID=181 Xiang, H., Chany, A. M., & Smith, G. A. (2006). Wheelchair related injuries treated in US emergency departments. Injury prevention : journal of the International Society for Child and Adolescent Injury Prevention, 12(1), 8–11. Retrieved from https://doi.org/10.1136/ip.2005.010033
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Safety is a prevalent issue related to wheelchair use, with one study highlighting that 55% of wheelchair users reported experiencing at least one collision, and 17% reported experiencing two or more collisions within a three year period. You can read our earlier blog article on the prevalence of wheelchair collisions for additional statistics. Here is a quick view of the consequences of wheelchair collisions and accidents.
So why is it that individuals who have demonstrated their abilities sufficiently enough to be prescribed a wheelchair experience these challenges? At the other end, is it really the case that individuals who are currently being excluded from powered (motorized/electric) mobility device use are too “unsafe” to drive? As a researcher mainly working with individuals with cognitive impairment, I knew there was little research that offered insights into the skills required to use a powered wheelchair. There is even less research to support the misconception that those with cognitive impairment cannot use or learn how to use a powered wheelchair. Despite this, individuals, specifically with cognitive impairment, are given few opportunities to trial and learn how to use a powered wheelchair.
How can we be sure that we are giving everyone a fair chance at independent mobility? In addition, are we viewing mobility as not just a way to get from point A to point B, but also as a necessary tool for learning and development in general.
7 years ago, when I had just started my company Braze Mobility, I walked into the home of a potential client, Wade Watts, and was taken aback by the amount of damage in his home. While I had seen safety often being the reason cited for long-term care residents being denied access to powered wheelchairs, I was not aware of the prevalence of accidents in the community. Despite the fact that Wade is skilled enough to be able to navigate even the most challenging environments, I noticed baseboards had been ripped off many of his walls. He even had to remove a couple of doors because of the damage to his doorways.
In fact the more wheelchair users I spoke to, the more I realized how commonplace property and wheelchair damage are. One of my clients, Herman Witlox, is another wheelchair user who is extremely skilled at using his device, and explains “I can turn [my wheelchair] through a few millimeters of clearance…I can [drive] up two 2 by 4s into the side of the vehicle – that’s a pretty narrow path to keep on course”. Despite this, he shared that
“2 or 3 dents in the wall a day [was] normal. I just [learned] to live with it”.
By Herman Witlox
Through my decade-plus-long research in the mobility space and more than 7 years of providing mobility solutions, I have witnessed a plethora of barriers in accessing and maintaining safe and independent mobility. Exploring these barriers in depth for each individual user can ensure that we identify solutions that address their specific needs.
When I get an inquiry from a therapist or a caregiver about a client who is “driving into things” and I ask the question “why?”, the reasons are often unclear or unknown. I have heard the phrase “they are just a terrible wheelchair driver”, many times from frustrated spouses or other family members who have had to pay for all the damage. However, in my experience, this reason is rarely true.
Most non-wheelchair users, including some therapists that prescribe the technology, don’t realize that operating a wheelchair, especially a powered one, can be extremely difficult. In this blog series, we break down the challenges in 3 areas: technology, environment, and client. By examining each of these individual areas, we aim to provide a more holistic view of safety-related pain points and barriers in wheelchair use. In this first article in the blog series, we highlight factors that are technology-specific.
Seating
Seating is of utmost importance in allowing the user to navigate effectively and comfortably. An individual can experience pain with wheelchair use, independent of their current diagnosis and functioning. When a comfortable, dynamic (movable) seating option is available and positioned correctly for the user, it can reduce the user’s pain by avoiding sliding, slipping, and sudden movements that can all cause injury. In addition, seating adjustments can improve safe and efficient operation of the wheelchair by ensuring that the drive control (the mechanism used to operate a powered wheelchair) is visible and within reach. A RESNA position paper provides insight on the seating-related challenges faced by wheelchair users and associated recommendations. Permobil provides a helpful seating and positioning guide. Additionally, Michelle Lange provides insight into some factors that come into play when considering seating in this Decision Making Tree.
Even when an optimal seating configuration is selected, the backrest of the wheelchair typically creates a massive “blind spot”. If you have never used a wheelchair and don’t believe me, try sitting in a regular office chair and try to look at the floor behind you (without turning the chair or the seat if you’re in a swivel chair). This is challenging if not impossible for just about anyone, regardless of your upper body mobility. So, it is not surprising that most wheelchair users cannot easily see what’s behind them.
Braze Blind Spot Sensors can be used as a tool to enhance spatial awareness in these blind spots around the wheelchair, and have helped clients like Wade, Herman and hundreds of other wheelchair users. In a recently published 3rd-party peer-reviewed study where existing powered wheelchair users were asked to detect objects in the rear using their standard methods (such as shoulder-checking), the participants detected low stationary (static) obstacles with only 44% accuracy. When participants used the Braze Blind Spot Sensors, their accuracy in detecting these obstacles increased significantly to 96% and they were able to do so in significantly less time. The sensors significantly increased the users’ accuracy in other scenarios as well including detection of higher and moving (dynamic) obstacles in the rear.
Power Wheelchairs Programming and Configurations
Powered wheelchairs can reach relatively high speeds, and if users are not familiar with their speed and acceleration capabilities, they may lose control, leading to collisions or tipping over. Rapid acceleration or sudden stops can catch users off guard and result in accidents, as the user’s entire body or parts of their body can make a jerk-like movement because of this change in speed. Appropriate adjustments can be programmed by a wheelchair provider or manufacturer rep in collaboration with the therapist to ensure user needs are met. The wheelchairjunkie provides information on various programming aspects such as speed of acceleration, deceleration, and turning, and how they impact the powered wheelchair driving experience.
In addition, certain wheelchair configurations can compromise the user’s rear, peripheral, and even front visibility. For example, a user who needs to be in a tilted position while driving will typically have an altered field-of-view that limits their ability to see objects that are lower to the ground. Accessories like oxygen tanks, backpacks, custom leg and footrests, and communication devices that increase the space taken up by the wheelchair can also block the user’s view of obstacles in their environment, making them more likely to have accidents. Bariatric wheelchairs (engineered with a heavier weight capacity and broader seats than standard wheelchairs) can pose additional challenges due to wider wheelchair dimensions, making navigation in tight spaces particularly challenging. Wheel drive configurations (front-, mid- and rear-wheel) can also have an impact on maneuverability, as explained in this article by Permobil. For example, certain types of wheel drive configurations are better for textured pathways while others are better in navigating tighter spaces.
Braze Blind Spot Sensors have helped clients in all of the above scenarios by providing feedback regarding the location and proximity of objects in the environment, thereby increasing spatial awareness in areas that are not directly visible to the client. They can also help new wheelchair users learn the extremities of their wheelchair as they figure out how to maneuver in various spaces with their wheel drive configuration.
Drive Controls
Powered wheelchairs are typically driven using a joystick. However, some users might be unable to operate a wheelchair with a joystick and require the use of “alternative drive/access controls” or “specialty control interfaces”. Alternative drive controls allow a user to control and drive the wheelchair without a joystick, using other parts of the body such as the chin, tongue, mouth, for example. Numotion provides some details of these alternative drive controls. It might be necessary to trial various drive controls in order to find the best fit for the client that allows them to operate a powered wheelchair safely. Michelle Lange provides decision-making trees for joystick and non-joystick driving methods. Here is another resource from mo-vis that sheds light on how to find a good fit between the user and drive controls.
While alternative drive controls provide increased opportunities for independent mobility, devices such as head arrays, sip and puffs, and eye gaze require the user to face forward while driving, potentially limiting their spatial awareness. I once saw a client who is a skilled head array user, but certain environments required her to navigate doorways backwards. As she would try to back up through the door and shoulder-check to make sure she was centered, she would inadvertently activate her head array (which detected her head movements as designed) and zig zag through the doorway hitting the sides multiple times.
Braze Blind Spot Sensors can be used in conjunction with alternative drive controls to enhance spatial awareness of obstacles around the wheelchair. In addition, the multi-modal alerts (visual, audio, and vibration) can be used by clients to help center themselves in tight spaces like doorways and elevators to improve their navigation skills, even when moving backwards. This feature can greatly improve powered wheelchair usability, considering 40% of powered wheelchair users in a study reported difficulty with steering tasks, especially while navigating through doorways and elevators.
Take-Aways
Challenges related to seating, programming/configurations, and drive controls can be addressed in various ways, including some of the suggestions in the references provided. It can be helpful to discuss these with the wheelchair provider and therapist when getting a new wheelchair in order to facilitate a better fit between these factors and the user. Some useful considerations when purchasing a new powered wheelchair can be found in our earlier blog article.
Braze Blind Spot Sensors are helpful smart wheelchair technology to help mitigate some of the challenges related to spatial awareness that are often exacerbated by seating, wheelchair configurations/accessories and drive controls.
This blog is related to challenges in wheelchair operation that relate specifically to the wheelchair user’s technology. There are also factors related to the environment and the user that can present safety issues, but I will go over these in the next articles.
References/Citations:
Nilsson, L., & Kenyon, L. (2022). Assessment and Intervention for Tool-Use in Learning Powered Mobility Intervention: A Focus on Tyro Learners. Disabilities, 2(2), 304–316. MDPI AG. Retrieved from http://dx.doi.org/10.3390/disabilities2020022
https://0201.nccdn.net/1_2/000/000/184/61f/Dynamic-Seating-decision-making-tree.pdf
Lange, M. L., Crane, B., Diamond, F. J., Eason, S., Presperin Pedersen, J., & Peek, G. (2021). RESNA position on the application of dynamic seating. Assistive technology : the official journal of RESNA, 1–11. Advance online publication. https://doi.org/10.1080/10400435.2021.1979383
Pellichero, A., Best, K. L., Routhier, F., Viswanathan, P., Wang, R. H., & Miller, W. C. (2021). Blind spot sensor systems for power wheelchairs: obstacle detection accuracy, cognitive task load, and perceived usefulness among older adults. Disability and rehabilitation. Assistive technology, 1–9. Advance online publication. https://doi.org/10.1080/17483107.2021.1983654
Mortenson, W. B., Miller, W. C., & Hardy, T. (2009). Ready to roll? Wheelchair use in residential care. . Disability Health Research network: UBC Okanagan. http://www.dhrn.ca/page.php?pageID=181
https://0201.nccdn.net/4_2/000/000/076/de9/joystick-decision-trees.pdf
Fehr, L., Langbein, W. E., & Skaar, S. B. (2000). Adequacy of power wheelchairs
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I recently received a physical copy of “Knowledge, Innovation, and Impact: A Guide for the Engaged Health Researcher”, co-edited by my co-founder Dr. Alex Mihailidis and featuring two book chapters that I had the privilege of authoring. Writing these chapters was a fairly unique, challenging, and fun experience as compared to others that were a lot more academic in nature. They really allowed me to reflect on my own experience in translating research that I worked on for more than a decade into a product that I eventually commercialized at Braze Mobility.
The first chapter (Chapter 42) was “Commercializing Research Innovations: An Introduction for Researchers”, which I co-authored with Lupin Battersby. In this chapter, Lupin and I present some food for thought to researchers who are thinking about or beginning the path of commercializing their research. Key concepts we outline are:
- Licensing vs. launching (which path is right for you?).
- Identifying your market, customers, and value proposition (who benefits?).
- Types of innovation and Intellectual property (discussed further in Chapter 45 by my friends and mentors Richard McAloney and Emanuel Istrate).
- Value chain and key stakeholders (how to get to market?).
- Funding (how to raise money, especially non-dilutive?).
- Creating a business model canvas (how do you put all the pieces together?).
- Sources of support within academia (who do you get help from?).
I hope the guidelines and suggestions above help you along your journey to creating real-world impact.
The next chapter (Chapter 43) was particularly exciting to write: “Case Study 1: Blind Spot Sensors for Wheelchairs – Increasing Access to Independent Mobility”. In this chapter, I describe various aspects of my entrepreneurial journey.
- The challenge: Safety is an issue while navigating in powered mobility devices, which can result in exclusion from the use of these devices. The objective was to find a solution that would enable independent mobility while increasing safety.
- Technology push vs. market pull: What the engineer believes to be the solution is not always what the customer needs and wants – how to avoid this?
- Separating academic and commercial activities (to keep clean records of intellectual property).
- The start-up “pivot”: After more than a decade of developing semi-autonomous systems for wheelchairs (e.g., automatic collision avoidance), I pivoted to creating warning/alert systems instead. Why? Read the chapter to find out!
- Outcomes and impact: a success story of a long-term care resident who nearly lost access to his powered wheelchair, but continues to remain independent and mobile today.
Also, my journey would not have been possible without the support of AGE-WELL NCE, Impact Centre, Semaphore Lab, Assistive Technology Clinic, and March of Dimes Canada.
You can order a copy of this book from Amazon.com and Amazon.ca.
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It was the summer of 2006 and I had just joined the Intelligent Assistive Technology and Systems Lab (IATSL) at the University of Toronto run by Dr. Alex Mihailidis. I still remember a lab meeting where Drs. Geoff Fernie and Rosalie Wang were introducing one of their projects, an anti-collision wheelchair. As a lab that primarily focused on technologies for older adults, the issue they were trying to solve was that of exclusion of older adults with dementia from the use of powered mobility. I got to see this problem myself when I visited a long-term facility for the first time along with my supervisor (Dr. Alex Mihailidis, who would become a RESNA President and Fellow, and my co-founder at Braze Mobility Inc. several years later). Many residents at the facility did not have the strength to self-propel their manual wheelchairs, and powered mobility use was prohibited due to safety concerns. Statistics showed that 60-80% of residents have dementia, and there was not a lot of research evidence at the time (still isn’t!) to provide guidance on who might and might not be able to operate a powered wheelchair safely.
Several solutions had already been implemented and tested with the intended users – one of the things that attracted me to this lab, as it was often the case that assistive technologies were tested with able-bodied individuals, or just in simulation experiments with no users at all.
One of these solutions included a bumper skirt, a bunch of panels installed around the powered wheelchair that would automatically stop the wheelchair when they made contact with an obstacle. The contact force required was small (1N from the time of first contact to the full stopping distance of the powered wheelchair).
Another interesting solution was a haptic joystick – a joystick that used a bunch of motors to prevent the user from pushing the joystick in the direction of an obstacle, as part of a multi-modal feedback system that provided user feedback to indicate which direction had the most free space around the obstacle (through arrows and audio cues). One study employed a “Wizard of OZ” paradigm. The simplest way I describe this is “fake it till you make it”. The obstacle detection part of the problem was solved by a human, the “wizard”, who was following closely behind the user and would activate the feedback module whenever the user approached an obstacle. The “wizard” is typically hidden so that the user believes he/she is interacting with a system that actually offers all the functionality being simulated.
This paradigm is fairly popular in the field of human computer interaction, especially in the early stages of research where complex technologies can be mocked or simulated by a human to understand their impact on the intended user. This approach can save a lot of resources that would otherwise be spent on building the technology, and can instead help quickly identify usability issues even before the technology is built. Wizard of OZ would eventually play a big role in my post-doctoral research, helping me to accelerate my own research and development efforts. Fun fact: the Wizard of OZ phrase and its use in human computer interaction was coined by Dr. Jeff Kelley. He was a usability expert who was inspired by the scene in the movie “The Wizard of Oz”, where Toto reveals that the wizard is just a man behind the curtain flipping switches and pulling levers.
At the time I joined the lab, non-contact sensors were being explored (i.e., sensors that could, unlike the bumper skirt technology, identify obstacles without needing physical contact with them). Drs. Alex Mihailidis and Jesse Hoey had just won a competition for a project that used an infrared sensor to automatically detect obstacles and stop the wheelchair in the case of an imminent collision. While the results seemed promising, an issue with infrared sensors is that they work by transmitting and receiving infrared waves, which are also found in direct sunlight. So, these sensors can fail in direct sunlight, unless more advanced techniques are used (such as using specific patterns or pulses that could be used to identify whether the infrared wave entering the receiver is similar to ones being transmitted by the sensor).
Interestingly, Alex’s research group had recently struck a collaboration with the University of British Columbia. This was particularly relevant to me as I had already been offered acceptance into UBC’s Computer Science program for Graduate Studies and would be starting there in Fall 2006. Researchers there had been doing interesting work with stereo-vision sensors. The advantage of these types of sensors over those being used previously was that, much like the human eyes, not only could stereo-vision sensors figure out how far away an obstacle is (proximity), but could also be used to automatically create maps from visual landmarks. The application of computer vision to smart wheelchair research had just begun, and I was excited to be part of this pioneering work.
Photo Credit: Martin Dee, University Photographer, Public Affairs, UBC
Over the next 6 years, I would go on to learn not only about computer vision, but also artificial intelligence, robotics, machine learning, and human computer interaction, finally bringing all these fields together in a highly trans-disciplinary PhD dissertation. Join me in my next blog posts as I share my learnings.
References:
Marcantonio ER. Dementia. In: Beers MH, Jones TV, Berkwits M, Kaplan JL, Porter R, eds. Merck Manual of Geriatrics. 3rd ed. Whitehouse Station, NJ: Merck & Co., Inc.; 2000:357-371.
Wang, R.H., Gorski, S.M., Holliday, P.J., and Fernie, G.R. (2011). Evaluation of a contact sensor skirt for an anti-collision power wheelchair for older adult nursing home residents with dementia: Safety and mobility. Assistive Technology, 23(3): 117-134.
Wang, R.H., Mihailidis, A., Dutta, T., and Fernie, G.R. (2011). Usability testing of multimodal feedback interface and simulated collision-avoidance power wheelchair for long-term-care home residents with cognitive impairments. Journal of Rehabilitation Research and Development, 48(6): 801-822.
John F. (“Jeff”) Kelley. 2018. Wizard of Oz (WoZ): a yellow brick journey. J. Usability Studies 13, 3 (May 2018), 119–124.
Viswanathan, P., Wang, R. H. and Mihailidis, A. (2013). Wizard-of-Oz and Mixed-Methods Studies to Inform Intelligent Wheelchair Design for Older Adults with Dementia. 12th European AAATE Conference, 19-22 Sept, Vilamoura, Portugal.
Mihailidis A, Elinas P, Boger J, Hoey J. An intelligent powered wheelchair to enable mobility of cognitively impaired older adults: an anticollision system. IEEE Trans Neural Syst Rehabil Eng. 2007 Mar;15(1):136-43. doi: 10.1109/TNSRE.2007.891385. PMID: 17436886.
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I took my first Wheel-Trans trip this past weekend, and had the chance to discuss the pros and cons of the system with someone who has much experience with it than I do. I will share some of those thoughts with you, and hope to hear your opinion as well! Have you used Wheel-Trans or a similar service? Leave a comment below about your experience and let’s start a conversation about what is working well and how we can improve accessible subway transit.
What Is Wheel-Trans?
Wheel-Trans provides door-to-door transit service in Toronto for people who have a disability that prevents them from using the wider TTC (Toronto Transit Commission) transit system. This includes both temporary and permanent disabilities. If you are unable to use any conventional TTC transit, or are unable to access certain services offered by the TTC, you may be eligible for Wheel-Trans services. For example, if you are able to use the subway but the location you need to go is close to an inaccessible subway station, you may be eligible for Wheel-Trans for all or part of that trip.
The service is available 24 hours a day, 7 days a week and costs the same as a standard TTC fare.
Where Is Wheel-Trans?
Anywhere the TTC goes, Wheel-Trans offers a door-to-door service.
How Can I Book A Wheel-Trans Service?
In order to book Wheel-Trans service, contact TTC at via phone (416-393-4222), book online, or use their automated phone booking service (416-397-8000). Bookings can be made 7 days in advance, but must be made at least 4 hours prior to departure (between 5AM and 11PM). The driver will pick you up from your home, and will drop you off at the designated location. The driver will help you to enter and exit the vehicle and safely strap your mobility device in. If you require additional support during your trip, bring a support person free of charge with a Support Person Assistance Card.
What TTC is Killin’ it on!
- Wheel-Trans is growing! The government announced a $41 million investment in the service. This will provide 120 new accessible busses, create 18 new access hubs, as well as improving the digital presence of Wheel-Trans, and making booking easier!
- In 2017, Wheel-Trans provided 4.1 Million rides.
- You might be traveling on a Wheel-Trans bus, or a contracted accessible taxi, all for the price of a standard TTC fare! Typically the system is fairly direct from origin to destination.
- Travel between Toronto and other transit regions is made easier by agreements made with Durham, York and Peel Region
Areas of Improvement
- Booking can be difficult over the phone. This is recognized as an issue by TTC, and they have begun to offer alternative services, such as an automated booking line and online booking. Phone services could still be improved though.
- The booking system is not good at determining optimized routes for the busses. Often, people traveling from the same location get sent separate busses, which adds unnecessary strain on wheel trans resources.
- When busses are running late, and or trips have been cancelled, the Wheel-Trans staff often call last minute, causing stress for the person relying on the ride.
Contact TTC and Wheel-Trans
- Booking (416-393-4222)
- Priority line (416-393-4111)
- TTC customer service (416-393-3030)
- Eligibility (WTEligibility@ttc.ca)
- Customer Service (wtcs@ttc.ca)
All advice in this blog should not replace medical advice. Be sure to follow updates from the WHO and CDC/Health Canada for the most updated advice on COVID-19 management.
As the COVID-19 pandemic evolves, the ability to go to stores, restaurants and other public places has been a welcome relief to many after months of isolation. Here in Ontario Canada, the opening of businesses has come with the requirement of all customers to wear a face mask or covering while inside the business (unless seated and eating). These laws are designed to keep everyone safe, while allowing a return to the lives that we have all been missing.
The Accessibility Challenges Of Using Face Masks
But, how do people with disabilities fit into these laws? The use of face masks may be a challenge for many people. According to the Americans with Disabilities Act (ADA), the people who may be limited in their ability to use a face mask includes:
- Someone who has low fine motor skills or spasticity in their upper body may find putting on or taking a mask off difficult
- Someone who relies on lip reading for communication may find it difficult to understand others while they are wearing a mask.
- Someone who uses a mouth-control for their wheelchair such as a sip-and-puff alternative joystick control would not be able to wear a mask while operating their chair.
- Someone who has speech impairment may not be understood while wearing a mask.
- Someone with autism may experience sensory overload when having a mask covering their face
- Someone with PTSD or claustrophobia may experience severe fear when wearing a mask
- Someone with COPD or other breathing difficulty
For all of these reasons and many more, people with disabilities may not be able to wear face masks in public. There is a requirement by the ADA to modify the rules around mask wearing to accommodate people with a disability. Some suggestions include:
- Allowing prompt curbside pickup from a safe social distance, using both telephone and internet orders
- Allowing loose-fitting face coverings when entering buildings, including face shields
- Allowing people to wait in vehicles for appointments, and calling them in when ready
- Providing phone or video appointments as an option
Overcoming Accessibility Challenges of Face Mask Wearing
All of these options are useful, however many of them do not reduce the isolation, or help return life to normal. People with disabilities have been greatly impacted by social isolation, and enabling a return to normal everyday life should be a priority. Some ideas for helping people with disabilities overcome the challenges of wearing masks include:
- Face masks with transparent windows have been made by accessibility-focused groups such as the Como Foundation to help those who are hard of hearing access masks that enable communication through lip-reading
- Face Shields are another more loose-fitting option. Although the CDC does not currently recommend using face shields in place of a mask, they recommend that a mask that wraps around the face, and descends past the chin may be used when a mask is not a viable option.
- Help educate others about the importance of wearing a mask. If you are unable to wear a mask, help others protect you by encouraging proper mask wearing and hand cleaning & surface sanitizing.
We would love to hear your ideas for staying healthy and returning to activities of daily living in the face of COVID-19. Leave a comment below!
Resources
COVID-19: Considerations for Wearing Masks. (2020, August 7). Retrieved August 08, 2020, from https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover-guidance.html Williamson, P. R., Morder, M. J., & Whaley, B. A. (2020) The ADA and Face Mask Policies [Fact sheet]. Retrieved from https://www.adasoutheast.org/ada/publications/legal/ada-and-face-mask-policies.php
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If you have recently been prescribed a power wheelchair, there are quite a few things to consider. There are many different options when ordering a power wheelchair and ensuring that you are provided with a chair that is right for you is important. The following blog post offers some ideas about options that you have when choosing a wheelchair. Speak to your Occupational or Physical Therapist and your wheelchair vendor if you have any questions regarding your wheelchair order. The following post contains some ideas of things to consider, but is not meant to be an exhaustive list of all options available.
The optimal location for the drive wheels on your chair will depend on a few things. Often, once someone gets used to a certain location of drive wheels, any other location might feel weird. Each type of chair has different pros and cons, so there is no one best location. The Queensland Spinal Cord Injuries Service provides a full comparison of the wheelchair drive trains.
Rear Wheel Drive
Pros of Rear Wheel Drive
These chairs usually have the highest top speeds, and are very stable navigating rugged terrain.
Cons of Rear Wheel Drive
The turning radius is higher in rear-wheel drive chairs, making navigation in tight spaces more difficult. Additionally, the concentration of mass at the back of the chair makes tipping on uphills more likely.
Front Wheel Drive
Pros of Front of Wheel Drive
You will be able to turn your front end very quickly, making rounding tight corners easier! These chairs are also very stable, because they distribute the overall mass of the chair the most evenly. Additionally, you will be able to get close to workspaces or tables easily.
Cons of Front Wheel Drive
Going uphill these chairs have a higher chance of losing traction, as if the mass is concentrated on the rear of the chair the front wheels will have less ability to grip. When turning corners in a front wheel drive chair it may be difficult to maintain awareness of the rear of the chair. This could result in hitting more things with the back of the chair if you aren’t careful! At top speeds, these chairs have also been known to be difficult to maintain control.
Mid Wheel Drive
Pros of Mid Wheel Drive
These chairs are the most maneuverable of any chairs! You do not require any extra space to turn than that which you already have. They are also the most stable on a slope, because the mass is centered in the middle! Often, people find mid wheel drive chairs the easiest to drive.
Cons of Mid Wheel Drive
They can get stuck in uneven terrain if the front and rear castors suspend the middle wheels.
You can operate your chair using a few different methods depending on your abilities and preferences.
The Most Common Control Types
- The most common control used is a hand-held joystick controller. These are controlled by using your hand to move the control arm in the direction you wish to go. Operation of these requires motor control of your hand and arm.
- Chin control uses a chin instead of a hand to control the joystick. The controller will be mounted near your face, and you will use your chin to move the control arm.
- A head array is a control that you can trigger with your head. Pushing your head towards the sensors on either side will turn the chair, and pushing your head backwards will make it move forwards. To reverse, a switch is activated and then you can push your head back on the head array.
- Sip and puff users control their wheelchairs via air blown into or sucked out of a straw-like controller. For example a hard puff may mean forwards, and a hard sip backwards. Soft sip and soft puff may correlate to a left or right turn. This control method requires practice to drive smoothly, as the output is not intuitive.
- Touchpads do not require much force, but do require steady control of the hand and arm. Sliding your hand along a controller panel will move the chair in that direction.
Lights can be added to wheelchairs when ordering, however this option is typically quite expensive and often not covered by public insurance. Lights are important to ensure safety when driving, especially in traffic. This blog post discusses the importance of visibility in a wheelchair to prevent injury.
Affordable, DIY Solutions For Wheelchair Lights
If you do not want to spend hundreds of dollars on lights from the wheelchair manufacturer, many people create DIY solutions, including attaching battery powered lights to the chair. If you aren’t able to create a solution yourself, organisations like the Tetra Society may be able to help you make a custom light solution.
Many power wheelchairs are able to tilt, recline, and seat elevate electronically. These features can be especially useful for people who are unable to adjust themselves in their seats. Being able to tilt back is an easy way for care attendants to help someone adjust back in their seat. Being able to recline is important if you are going to spend a lot of time in your chair as it will allow you to stretch your back out. Elevation will allow you to rise up to eye level with people who are standing, and is useful to reach high cabinets, and to reach counters at cashiers, coffee shops, etc. These features may be funded depending on the need for them. Without funding, electric tilt, recline and elevate can cost thousands of dollars. Speak to your therapist about whether or not these features are right for you.
There are many different things that you can buy as odd-ons upon ordering a power wheelchair. Our Mobility Blog discusses add-ons, including those that increase safety, rear visibility, or have cool features. One feature that you can add on that fits into all three of these categories is the Braze Sentina, which is a blind spot sensor system designed for use with wheelchairs.
Bringing Your Wheelchair Home
When you first bring your wheelchair home, you may find it difficult to know what the footprint of the chair is, and as a result there is a high chance that you will bump some walls and doorways in your home. This can be avoided using various visual aids, such as blind spot sensors to monitor the environment behind your wheelchair. Braze Mobility Inc. makes blind spot sensors that can be added to any wheelchair, and provide the user with 180 degrees of rear view blind spot coverage.
I hope this blog post has given you an idea of some of the options available to you in ordering a power wheelchair. Your OT and/or PT and wheelchair vendor are there to answer all of your questions and support you in your selection. Make sure that you advocate for yourself, and know your options in order to ensure that the chair you get is right for you. Please comment below if there are any other features you think should be included!
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