How to Use a Manual Wheelchair Safely Guide
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A wheelchair is supposed to be a life-enhancing device that improves your ability to get around, but if it isn’t used properly, it can quickly become a danger and a threat to your safety, and it could cause a wheelchair fall.
When operating your standard wheelchair, there are some important guidelines that you should follow, which we will cover in this guide.
General Manual Wheelchair Operation
Before you can start safely using your manual wheelchair, it is important to familiarize yourself with its general operation. Getting to know how your wheelchair works will give you the best chance of success.
Opening a Standard Wheelchair
How you open your manual wheelchair will depend on the type of chair you are using. However, in most cases, this can be done quickly and easily.
- Be careful not to make the mistake of sliding your fingers down the sides of the chair where they may become jammed.
- Use the wheelchair handles to open the device enough so that you can push down on the seat to flatten it completely.
- If you are using a solid backrest then you will need to fit this by lining up the catches. It may require you to wiggle the wheelchair frame a little to get them to fit into place, but always be gentle when doing this.
- Be sure to secure the locking mechanism.
- If you use a cushion, it is important to put it onto the seat the right way around to make the most out of the pressure relief. To figure this out, find the diagonal corners; these go at the back of the seat.
- Next, you will need to mount the footplate onto the wheelchair frame. When it is in the correct position, you should hear it lock into place.
Closing a Standard Wheelchair
Closing your wheelchair can be as simple as opening it, provided that you follow the basic steps. If you are using a soft back and seat wheelchair then the following applies:
- Begin by locking the brakes.
- If there are any safety restraints or supports in place, you should unfasten these now.
- Next, fold up the foot plates.
- Now take hold of the center of the upholstered seat and lift; the wheelchair will fold in on itself.
For those people that are using a solid backrest wheelchair, the following applies:
- Use the quick release locking mechanisms on the rear of the backrest, as you release these, the backrest should come away easily.
- If you find that the mechanisms are tight or the backrest won’t come loose, it is vital not to try to force them as you run the risk of bending them.
- If your headrest is a separate component, this should be removed. Some are attached to the backrest and will come away with it.
- You can now remove the foot plates if this is possible. Otherwise, you can simply fold them up.
- If there is a cushion present, this should be removed and the wheelchair can be pulled from the center causing it to fold.
There are also solid seat wheelchairs which can be closed as follows:
- In most cases, wheelchairs that have solid seats will have the option to slide the seat out before folding; do this first.
- You can now fold the wheelchair ready for transportation or storage.
Tips for Wheelchair Transfers
You aren’t going to be spending all of your time sitting in your wheelchair but moving from here to other places such as a chair, bed, or into the bath can be incredibly dangerous when it is not done correctly.
Getting Into Your Wheelchair Independently
- Before you attempt to get into your wheelchair, always ensure that the brakes are locked.
- You will need to move the footplates which typically swing to one side, to allow yourself sufficient room to get in without knocking your legs or feet.
- Face away from the wheelchair and hold onto the armrests to keep yourself steady.
- Carefully lower yourself down into the wheelchair.
- Move the footplates back into position.
Getting Out of Your Wheelchair Independently
Similarly to getting into your wheelchair by yourself, getting out again requires careful attention.
- Always make sure that the brakes are locked before trying to get out of the wheelchair.
- Swing or fold the footplates out of the way.
- Take hold of the armrests and use these to push yourself upwards and out of the wheelchair.
- It is important to make sure that any walking aids are located within reach to help you move safely away.
Wheelchair to Bed Transfers
How the patient is moved from the wheelchair to the bed may differ depending on the environment and the specific needs of the user. One effective technique is called the stand pivot transfer, but you should discuss the best method with your physical therapist.
- Begin by placing the wheelchair next to the bed at a slight angle.
- Ensure that the brakes are in the locked position and the foot plates are swung away.
- The wheelchair user should now stand out of the chair and use small steps to make a pivoting movement until the back of the knees touch the bed.
- The person can then lower themselves back onto the bed. This may be done with the assistance of a caregiver or independently.
- Moving back into the wheelchair will require the patient to be moved into a sitting position. If they are able, they can reverse the previous actions to get back into the chair.
- For patients that are unable to do this, a caregiver can wrap their arms around the wheelchair user whilst using their leg to support the leg furthest from the chair.
- The caregiver must now shift their weight and lift the patient who can use the pivoting movement to turn towards the wheelchair.
- Now, the wheelchair user can bend their knees as the caregiver lowers them into the chair.
Wheelchair to Car Transfers
- When transferring from a wheelchair to a car, the best seat to choose is the passenger seat at the front of the vehicle.
- Your caregiver will first need to move the front seat back as far as it will go, allowing for optimal space.
- The wheelchair should be placed at an angle to the car.
- Ensure that the brakes are on and that the foot plates are moved out of the way.
- Here, the patient can use the stand pivot technique we discussed earlier to position themselves so that the backs of the legs are against the car.
- The user can then lower down onto the seat, but it may be necessary for your caregiver to offer support due to the low seat design. If you require balance support, the caregiver can create a fist for you to grab onto as you lower down. They can also ensure that you do not bump your head when getting in.
- The legs can now be moved into position, and you can shuffle to make yourself comfortable.
- Your caregiver can offer any assistance in doing this as well as helping with the seatbelt, if needed.
- To transfer back out of the vehicle, the reverse process can be followed.
Wheelchair Maneuvering
Whether you are moving a wheelchair independently or whether you are propelling someone else in the chair, it is important to become familiar with the easiest and safest methods of wheelchair maneuvering.
Propelling the Patient
- Before moving away, ensure that the wheelchair user’s clothes are not in the way of the wheels and that the elbows are tucked away.
- You will first need to disengage the brakes.
- Be alert for hazards.
- Wheelchairs may tip when used on uneven or soft surfaces, so try to avoid these.
- You should not hang bags on the handles of the wheelchair as this will affect its balance.
- When pushing the user, always be sure to communicate with them what you are doing. For example, if you are going to turn or tilt the chair.
Self-Propelling
- Before you get moving, you must make sure that the brakes are not applied.
- It is important to avoid uneven surfaces.
- If the surface is wet, slippery, or icy then extra care should be taken.
- When you want to move forwards, you should take hold of the hand rims which are located on the rear wheels, and push yourself forwards.
- When you want to move backwards, you will need to pull back while holding onto the handrims.
- Turning the wheelchair will require you to keep one handrim still while pushing on the other one to move in the direction you wish to travel. For example, if you want to move left, you should keep the right-hand rim still while pushing on the left. To move right, hold the left handrim still while pushing on the right.
- When you come to a stop, always make sure to apply the brakes.
General Tips for Operating Your Manual Wheelchair
Navigating the world in a wheelchair is vastly different from navigating the world on foot. It may take a little time to get used to this, but these tips should help you to get there a little more confidently and quickly.
Curbs
- It is recommended to go down a curb backwards as there is less chance of the wheelchair tipping over. Moreover, the maneuver is considered easier.
- Doing this can be done alone or with the help of a caregiver, in any case, extreme care should be taken.
- Begin by moving the wheelchair to the curb.
- Now tilt the wheelchair slightly so that the back wheels remain on the floor. Move down the curb until the front wheels are at the edge.
- Some wheelchairs are fitted with anti-tipping levers which should be kept at a clearance of 2″ between them and the ground.
- The caregiver can now pull the wheelchair down the curb fully.
- Moving up a curb is better done forwards, and the wheelchair should be moved to the curb to the point that the footplates are in line with it.
- The caregiver can then tilt the chair so that the front wheels can clear the curb.
- The handles can then be used to lift the wheelchair up onto the curb.
Inclines/Ramps
- Ensure that anti-tippers are used when going up or down an incline.
- When going up a slope, you should lean forwards to avoid the wheelchair tipping over.
- Your movement on the hand rims needs to be consistent and quick so that your wheelchair doesn’t lose momentum.
- As you descend an incline, you should lean back in the wheelchair.
- Allow the wheels to move themselves but keep your hands on the hand rims to allow yourself to control the speed of the descent.
Elevators
- When using an elevator, you should always enter so that you are facing the door on the way out.
- Do this by reversing into the elevator doors.
- If you are being propelled by a caregiver, they will need to pull you into the elevator in reverse.
Steps
- It is not recommended to attempt to descend stairs alone. We would always advise using an elevator. However, if one is not available, then you will need two able-bodied and sufficiently strong assistants.
- Before beginning, the wheelchair user should be strapped in with a seatbelt, if required and the feet placed on the foot plates. Hands should be on the lap.
- One caregiver will need to stand at either side of the wheelchair and grip it firmly.
- Tackling one step at a time, the assistants should gradually guide the wheelchair down.
- To ascend the steps, a caregiver will need to hold the handles and use the tipper to tilt the wheelchair backwards.
- The second caregiver can now take hold of the front of the wheelchair frame, and the two can slowly lift the wheelchair up each step.
Narrow Spaces
- When moving through a narrow corner, the caregiver lifting the wheelchair could result in back strain. For this reason, the best option is to use a pivot turn.
- Before moving through a tight space, the wheelchair user should ensure that the hands and elbows are not hanging outside of the frame. Moreover, the feet should be firmly on the foot plates.
- Always make sure that there is a planned alternative route and avoid making any sudden movements.
- To do the pivot turn, the brake on the side of the wheelchair that you wish to turn should be applied.
- The wheelchair can then be turned in place around the corner.
Transporting Your Wheelchair
The good thing about manual wheelchairs is that, for the most part, they are collapsible, making them ideal for storing and transporting. However, there is a certain knack to taking your wheelchair from place to place, and these hints and tips will help you do this easily.
- Please keep in mind that the wheelchair is heavy and so care should be taken when lifting it.
- Begin by removing any components that come off, such as the foot plates. These can be placed into the car separately.
- The wheelchair can now be folded following the steps we discussed earlier in this guide. If your vehicle is very small, it may be possible to fold the handles using the catches at either side.
- Carefully lift the wheelchair into the car; it can be placed either onto the back seat or into the trunk. However, if you are using the back seat, you will need to secure the wheelchair with a seatbelt.