Life on Wheels (52 page)

They have less motivation to lower pricing, especially for parts and accessories.

They provide less personal service.

There are dozens of small companies out there making wheelchairs. Since they don’t have the marketing budgets of the big firms, it’s harder for them to get exposure, so you might not hear about them. However, if you decide a small producer’s chair is the right one for you, your dealer should be perfectly willing to call the manufacturer and ask them to sell you one.

They are generally passionate about their work, concerned with quality, and interested in helping people.

You are likely to get more personal attention.

You might find a chair that more specifically meets your needs, even one that can be more aggressively customized for you.

Since smaller producers don’t have huge production schedules, they may be able to deliver your chair faster than can a large company.

You might be able to find a better price.

Some wheelchairs designed by the smaller companies can look like they were designed by an engineer, whose concerns are more focused on the operation of the chair and the ease of manufacturing it and whose training does not include aesthetics. This is not universally true of small producers, but it is more the rule than the exception. There are, in fact, companies that make image a very high priority, such as Colours. Lasher Sport makes highly artful, beautiful (and extremely expensive), customized chairs.

The period from your initial consultation to the actual ordering of your chair can take as long as two to three months. This includes taking time to try out one or more models. A more complex chair may take longer. If you encounter resistance from your insurer, that could also add time to the process.

Once you have decided on the model of chair that is best for you, the dealer—using information from you and your therapist—will fill out a specification sheet with the exact details for every aspect of your chair. Ask to see a copy of this list. If you have questions or concerns about anything, ask. Make sure the list is complete and correct, checking for something inadvertently omitted (such as clothing guards) or wrong (such as color). Even if the problem can be fixed, you’ll probably have to pay for it. Your therapist will sign off on this list, and it will then go to your physician, who will write a prescription for it.

The prescription and specification list will be sent to your insurance company or funding agency for approval. Once your chair is approved, the dealer will order your chair from the manufacturer. If your chair is not covered by insurance and you are paying for it yourself, a down payment of 50% at the time the order is placed is typical. Your dealer should give you an accurate delivery date so you can plan accordingly.

One of the most dramatic changes that occurred in wheelchair design in the early 1980s is that they became far more adjustable. This has allowed people to fine tune their relationship to the seat and the wheels through actual experience, optimizing their comfort and stability and, for manual chair riders, to exert their strength as efficiently as possible.

With this adjustability comes the other side of the coin: a maladjusted chair is going to be even more uncomfortable and difficult to use. So the real trick in ordering your chair is to ensure that, for the features that are adjustable, there is a sufficient range of dimensions that will meet your needs once you fine tune it from experience.

Adjustability is generally more valuable for first-time chair users. Experienced riders come to know what dimensions meet their needs, so they can graduate to a more customized frame with fixed dimensions for such features as seat height or axle position. That also means fewer moving parts, less maintenance risk, and lighter weight. Ironically, the advent of adjustability in the wheelchair industry led to a next generation of product that is increasingly customized and built to fit.

When your chair arrives at the dealer from the factory, you will need to have the store adjust it specifically to your needs. Plan on taking the time to have them fine tune it for you, and don’t hesitate to ask them to continue to make changes until it is right. Dr. Boninger, of the University of Pittsburgh, finds that factory settings are not particularly optimal overall. For example, he makes this observation about manual chairs:

Axle position is only one of the many details of chair configuration that have a significant impact on the efficient, comfortable, and safe use of your chair. Remember that a wheelchair is really a complex web of interrelationships. Changing the axle position or caster height affects seat and back angles and the relationship of your arms to the wheels. Placement of a joystick affects overall posture. And so on. With wheelchairs being more adjustable than were early models, this process cannot be overlooked.

Some riders learn—by observing and asking questions of a qualified technician—how to expertly adjust their own chairs, but you should not attempt to adjust your chair until you are confident in your knowledge. Be certain that you understand in principle what you’re trying to achieve and have the right tools to protect the chair from scratches or stripping the heads of screws or bolts. It is generally best to make small adjustments and to affect only one thing at a time so you can judge its impact independently from other changes you might make. More than one wheelchair salesperson can tell a story of a customer who called complaining that his chair was wrong or damaged, only to discover that he had made inappropriate adjustments or used the wrong tools.

The first decision to be made when choosing your wheelchair is whether it will be a manual or power chair. Often this decision is obvious or becomes clear after your therapist tests your strength, balance, dexterity, and other abilities. In some cases, though, the choice is not so simple, and, in fact, having one of each type of chair could prove to be the optimal solution.

Two chairs are actually a good idea for everyone—manual and power chair riders alike will want to have a backup manual chair for use in case their main chair is out of commission for a few days. A backup chair doesn’t have to be as complete or as customized as one you purchase for daily use. If you aren’t able to get your own backup chair, find out if your dealer has loaners available for those times when your chair needs servicing.

Manual chairs have a number of advantages over power chairs, and most people prefer to use a manual chair if at all possible. Consider the following list of “pros,” but also be honest with yourself about your strength and energy—you’ll need plenty of both to operate a manual chair, especially if you plan on an active lifestyle: