Moving and Handling Archives - Occupational Therapy Blog

Occupational therapy travel with wheelchair In the United States alone, over 3.6 million people use a wheelchair regularly. Additionally, there are countless others who will need to use a wheelchair temporarily during their lifetime. The Americans with Disabilities Act was designed to ensure accessibility for disabled Americans, including the wheelchair-bound, throughout big cities and small towns in the U.S. Whether accessing a school, store, restaurant, or bus, there are specific requirements in place to help ensure equal access for everyone. Depending on their needs, there are many options for transporting someone in a wheelchair to: Medical appointments Shopping centers Concerts, etc. While there is no one-size-fits-all best choice for wheelchair transport, the critical aspect of the process is caring for the individual's needs. The most important thing to remember when transporting someone in a wheelchair is listening to and understanding their needs. Maintaining the dignity and comfort of the wheelchair-bound person should always be part of the decision making process when selecting a method of transport. While other factors, such as accessibility, time frame, and destination, will also influence the method selected, respecting the needs of the individual is key. How Do You Transport Someone in a Wheelchair? As mentioned above, there is no one size fits all solution for transporting someone in a wheelchair. There are several things to consider when working to figure out the best possible transportation option. Personal Needs Just as each individual is unique and special, disabilities all have nuances and particulars that will help shape the person's overall needs. A person with quadriplegia will have different needs than a paraplegic individual. An individual may require a more specialized type of transport, depending on their specific disability. Type of Wheelchair There are many different types of wheelchairs, each with different dimensions, weights, and turning radiuses: Manual wheelchairs Electric wheelchairs Paediatric wheelchairs All-terrain wheelchairs, etc. Some of these wheelchairs can fold up for easy transport, and others cannot. The type of wheelchair being used should be an important factor taken into consideration when selecting a transport method. Length of Travel Another important factor is the length of travel or total travel time. Depending on the individual, different provisions may be necessary for long trips when compared to a quick trip to the supermarket, for example. It is important to always plan each outing with a good understanding of the travel time involved. Time can be a factor when selecting the appropriate wheelchair and other necessary medical equipment. Destination The final destination can also be a determining factor when deciding on transportation methods. There may be resources available for health-related destinations that may not be used for personal outings, such as: Doctor's office visits Hospital transport, etc. Accessibility Accessibility can also be a factor. There may be more options for transport in big cities than in rural areas, for example. Public transportation may be available for one leg of a trip, but not the entire outing. While accessibility must be a consideration whether someone is a wheelchair user or not, a disability requiring a chair can make accessibility issues even more complex. Different Methods of Transport Several transport methods may work for individuals who use wheelchairs, each with its own pros and cons. Here are some common methods of transport. There are several methods that are common, yet they are not equally viable options for every patient. Each method has strengths and drawbacks, and depending on the level of care needed for the person who uses a wheelchair, some of these options may not be a sound solution for some individuals. Let's look at each individually Using a Personal Vehicle Using a personal vehicle is a great option for patients that can safely and comfortably be moved from a wheelchair to a standard vehicle and vice versa. Personal vehicles offer the greatest amount of flexibility in terms of scheduling and timing and provide the riders with some creature comforts and familiarity. Transport Person Who Uses a Wheelchair Using a Personal VehicleProsConsFamiliar and easyDepending on the car, access may be difficultNot dependant on transportation scheduleSmaller cars will not support wheelchairsEasy to adjust or change scheduleNot always an option with electric wheelchairsNo additional expensesNot possible for the completely chair-bound If a personal vehicle is a viable option, it is truly a great choice. The driver and companion are not subject to scheduling as with public transportation or medical taxi. Having a personal vehicle gives the riders plenty of flexibility to control their schedule and their day. There are no worries about missing pick-up times, and if a sudden change of plans is made, such as a quick stop for lunch, it isn't going to create a transportation scheduling issue. In order to safely use a personal vehicle, however, the individual who uses a wheelchair must be stable enough to be out of their chair for a period of time without difficulty. For patients with plenty of muscle control and body strength, moving from chair to car may be a simple process, but it simply isn't a viable option for others. Finally, this solution really won't work with small cars, or with electric wheelchairs. Many manual chairs can be folded or disassembled for easy transport, but that is not possible with electric chairs. Medical Taxi A medical taxi is a specially equipped taxi van driven by a medically trained professional and is used for transport to medical appointments, hospital visits, trips to a pharmacy, etc. They do not include a wheelchair ramp, like a wheelchair equipped van, so the patient must have some degree of flexibility, mobility, body strength, and stability. Transport a Wheelchair-bound Person by Medical TaxiProsConsDriven by medically trained personnelCan only be used for medically related servicesServices typically covered by InsuranceNot accessible to all chair-bound patientsGreat for trips to doctors, pharmaciesMust be scheduled in advanceProvide some flexibility Medical taxi transport is a great option for doctor's visits and trips to the pharmacy. Unlike public transportation, medical taxis provide one-on-one transport, and patients have the ability to add additional stops onto their trip, such as a trip to a pharmacy to pick up a prescription after a doctor's visit. During appointments, medical taxi drivers will wait for their passengers, working on the patient's schedule. Best of all, medically necessary transportation is a covered benefit under most insurance plans. Unfortunately, medical taxis cannot be used for personal services and are specifically designed to assist patients with transportation to and from the doctor and hospital visits. They aren't a viable option for a trip to the hairdresser or the mall, for example. They also aren't equipped with wheelchair ramps or space for electric wheelchairs, so patients must have some degree of flexibility and mobility and cannot be completely chair-bound. Transport/Wheelchair Van A transport or wheelchair van is a specially designed van with motorized ramps to accommodate electric and standard wheelchairs. They allow patients to remain seated in their chair during transport. This is the best option for patients who have little mobility or are not strong enough to sit comfortably or hold their body in a comfortable, upright position outside of their chair. Transport a Wheelchair-bound Person by Transport VanProsConsDriven by trained personnelSignificant cost associated with service If using for medical transport, covered by insuranceFor non-emergency and personal use, must be scheduled in advanceCan be used for both personal and medical tripsFor multiple trips, services can get costlyAllows a wheelchair-bound person to remain in the chair during transportLess availability in rural settings Transport/Wheelchair vans are used primarily to transport individuals who are confined to a wheelchair all day long and cannot support sitting outside of their chair for any significant length of time. For individuals who use electric wheelchairs and have extremely limited mobility, these services provide door-to-door transportation from home to doctor's appointments, the grocery store, restaurants, airports, etc. They are a convenient choice as they provide individualized door-to-door service, but they are also quite expensive, with costs well above a typical taxi service. In populated areas, there are plenty of transportation service choices. However, in rural areas, it is important to schedule services well in advance to ensure availability. For individuals with insurance coverage, some of the costs associated with these services can be offset with medical insurance if the service is used for medical transport. Public Transportation With the advancement of the American with Disabilities Act, public transportation has come a long way in providing services for wheelchair-bound riders. Most large and moderate size cities have wheelchair access, as well as a wheelchair ramp on public buses, subways, and trains. In addition to these traditional forms of public transportation, most areas also have a network of transport vans and smaller buses designed to accommodate several wheelchair-bound riders that can be used regularly, for example, if traveling to work, school, or into a neighboring town. Transport a Wheelchair-Bound Person by Public TransportationProsConsLower cost associated with servicesReliant on bus or train schedule, no door-to-door serviceServices are scheduled based on daily services Not accessible everywhere, service may be non-existent or limited in rural areasGreat for daily trips, round trips to work or schoolFirst come, first served.Provides some flexibility and independence for the rider Most larger cities have bus, railway, and subway services, and in all major cities across the U.S., these services have been adapted to meet the needs of those who must use a wheelchair. In addition to the regular bus and train services, most cities also have a network of buses designed to transport individuals who use wheelchairs to select locations. Many services have a daily and weekly schedule, and some services even allow for at-home pick-up for regular, daily riders. However, these services are not available in rural areas, and even in mid-sized cities, the services may be scarce once outside of city limits. Like any public transportation system, riders are at the mercy of the bus schedules, and in many places, it may require several bus transfers and long wait times to travel across town. While some cities provide these services at a low cost or even free for disabled individuals, they are not always the most convenient in terms of travel time. Ambulance Travel by ambulance is usually something that people consider only in a medical emergency. However, many insurance companies will pay a portion of ambulance trips for individuals who use wheelchairs who require transportation to medical appointments, especially when public transportation could cause a medical risk, such as for patients receiving chemotherapy or dialysis. Ambulances can be used to transport patients to and from home and medical appointments. Transport a Wheelchair-bound Person by Medical TaxiProsConsDriven by medically trained personnelCan only be used for medically related servicesServices may be covered by insuranceNot financially feasible without some insurance assistanceProvides a safe environment for immunocompromised patients Provide some flexibility An ambulance service should always be used in the event of a medical emergency involving a patient who uses a wheelchair. However, non-emergent medical ambulance services are also quite common. Insurance companies will require the patient's physician to obtain pre-authorization for these services. That means the ambulance service must be deemed medically necessary and must be pre-approved before a patient can take advantage of the service. In the event of a true medical emergency, pre-authorization is not required. Non-emergency ambulance transportation services are often used when patients cannot ride in a communal setting with other patients. Patients with a highly contagious illness, or patients who could be physically compromised by being around others, such as chemotherapy patients, will often be approved for these transportation services. If a patient requires these services, their doctor should contact the applicable insurance company to start the authorization process. Creating Wheelchair Accessible Minivans For families of individuals who are wheelchair users, full-sized minivans can be converted into wheelchair transport vans. Minivans such as the Honda Odyssey or Dodge Grand Caravan, or full-sized vans like the Ford Transit can all be converted successfully. Families can also purchase brand new wheelchair transport vans from vehicle mobility companies around the country. These vans can be converted into vehicles designed for the individual who uses a wheelchair to drive or be set up for a non-disabled driver. For families interested in a wheelchair transport van, it is important to contact a reputable dealer that specializes in wheelchair mobility, not a regular car dealer. Paying for a Converted Van There is a wide range of costs associated with transport van conversion. Depending on the type of controls required - standard, hand-operated, or even voice-operated, there are plenty of options to suit the needs of any family or disability. A reputable dealer can discuss the available features and costs and help families build a van that works best for their individual needs. Traditionally, Medicaid and Medicare, and private insurance companies will not pay benefits toward purchasing or converting a vehicle into a transport van. However, many states and counties do have resources available to assist individuals who use wheelchairs. Families should contact their local county Department of Human Services to find out what services and programs they may be eligible for in their community. State Grants and Other Services Within the United States, several organizations and state run programs can assist families with purchases designed to assist citizens who use wheelchairs. Whether converting a van into a wheelchair transport vehicle or adding ramps and other accessibility features onto a home, it is important to understand the various resources available to families. In addition to services that help cover the costs of wheelchair transportation to services that assist in home expenses, patients can explore resources at a Federal, State, and local level. Most states provide Disability Grants for individuals who use wheelchairs, and each county within the 50 states offers support as well. Frequently, however, these services aren't automatic and require the disabled individual to apply for assistance, grants, and aid. Families should contact their local County Assistance Office and schedule an appointment with a caseworker at the Department of Human Services to get started. Additional Resources Beyond simple transportation, there are many programs and organizations that assist wheelchair users with adaptive technology to assist with: Communication Employment Other activities of daily living There is disability grant assistance available in every state that can be used to help individuals who use wheelchairs live a more independent lifestyle. Vocational services and job assistance are also available at a county level in every state within the United States. Interested families should access the Department of Human Services web page to find a list of state resources and programs for their state. In addition to local and state resources, families can access the United States Government Disability webpage at https://www.usa.gov/disability-programs to get familiar with various programs to assist individuals in every facet of life. Whether a family needs assistance with transporting a family member who uses a wheelchair or helping a loved one build some independence, there is plenty of help available. Content Disclaimer The information contained above is provided for information purposes only. The contents of this Blog article are not intended to amount to advice, and you should not rely on any of the contents of this Blog article. Professional advice should be obtained before taking or refraining from taking any action as a result of the contents of this Blog article. OccupationaltherapyBlog disclaims all liability and responsibility arising from any reliance placed on any of the contents of this Blog article.