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Thread: Power Wheelchair Wish List

  1. #1

    Power Wheelchair Wish List

    It is time to start the process of getting a new chair through Medicare...first time around this maze. Any one with some sage advice about the pit falls to avoid?

    I'm making a list of what I like and don't like on my Invacare TDX-SP and would like some input from you. I am C6/7 complete quadriplegic 35 years post injury. I am tall (6'3") and thin (135 lb.) This will be my third power chair.

    The foam filled tires I have now give me a really hard, rough ride. I've heard about gel filled tires. Anyone with any thoughts or experience to contribute about these tires?

    First chair was rear wheel drive, second, mid wheel drive. I don't think I'd go back to a rear wheel. How do you feel about rear, mid, and front wheel drive?

    My current chair has no suspension which must contribute to the rough ride. Any one have a chair with suspension?

    Current chair adapted for an EZ lock tie down in my Honda Odyssey van. Will I have to change out the floor mounted unit or just get the right rigging on the underneath of the chair to use the same EZ lock?

    I'm looking into the Roho Deep Contour back system. Any other back systems you would consider? I've been using a J2 Deep Contour Back. Problem is the foam gets hard and uncomfortable in about a year and a half, long before Medicare will replace it.

    Thanks for contributing your thoughts.

    All the best,
    GJ

  2. #2
    I have started the Medicare replacement process too. I am using a Permobil M300. We got it quite right for my first power wheelchair. I had an opportunity to try front, rear, and mid-wheel drives before settling on a mid-wheel. It is the only one that handled the turns off a hallway through doorways without a lot of maneuvering. It has the Corpus 3G seating with tilt, recline, and elevating leg rests. It also has the seat elevator. The elevating seat has expanded my access to closets cabinets, the freezer at the top of the frige, etc. which made the extra out-of-pocket cost of $2400 worthwhile. I would not want a chair without this feature. I am using the Permobil seatback that is standard and a Roho high profile cushion on the seat. I have foam filled tires and the chair rides hard despite the shock absorbers loosened to the max. I cannot imagine gel filled tires being any softer and I do not want to deal with flats. In sum, I am trying to get the same model. That will enable me to strip parts from my old one when a quick fix is needed.
    You will find a guide to preserving shoulder function @
    http://www.rstce.pitt.edu/RSTCE_Reso...imb_Injury.pdf

    See my personal webpage @
    http://cccforum55.freehostia.com/

  3. #3
    gjnl, I'm very interested in the process of getting my insurance to OK a new electric. I've got them to approve manual chairs before but now I'm only using a manual chair around the house. I have bought my electric chair myself through Craigslist. I've been lucky it was only $600 and in very good condition. I have a 20% copay and this chair is @ $4000 new so that's $800. But I can see a need for a new chair before long.

    I have Medicare Complete from United Health Care, it a Medicare supplement. I curious how to properly explain to my doctor and insurance so they would approve the purchase. Please post back with how the process went for you.

  4. #4
    The only real choice is between front and mid-wheel drive. If you have no real issues in your home or daily life with very tight turns then you probably can go with either. Front-wheel-drive will get you through tougher terrain than the mid-wheel, such as your lawn, soft spots, or other obstructions that the mid-wheel may bog down on. One thing I became aware of recently is that the EZ lock bolt on the Permobil chairs can create problems with people getting stuck on thresholds and other objects more than previous Permobil chairs such as the C 300 which I have. You will have to get a new EZ lock bracket mounted on your chair and if you have this problem you will need to go to the qstraint system which from what I am told offers a better solution to the bolt obstruction problem. The qstraint system (model 150, approximately $1300 installed) allows the bolt to be mounted closer to the drive wheels, thus allowing it to ride up and over obstacles when the drive wheels do. The further the bolt gets from the center of the drive wheel axis more problems you will have with obstruction. This is not a problem with mid-wheel drives but is with front wheel drives, apparently more so with the new Permobil F3/F5. The qstraint system also allows the docking station to be mounted higher off the floor which allows the bolt to be shortened in length, thus affording greater clearance.

    I would not go with standard Permobil back, I think they stink. Rather I would go with one of the three available aftermarket backs. I think the Invacare matrix elite offers a good solution, namely midline support with scapular cutouts for shoulder mobility and wraparound lateral supports lower down on the torso for stability, with various depths available. If you go with Permobil I would download and print out the order form, which is quite lengthy and you will see all the options available.

    I would also get the power extending feature on the foot rest, as when you tilt and recline and then elevate the foot rests, the legs tend to lift off the cushion. The extending feature will allow your legs to stay properly positioned when fully tilted, reclined, and leg elevated for pressure relief.

    To me, the only other quality option would be the motion concepts seating system with the Invacare ROVI base, which is mid-wheel.

    I am going through the process now. According to the order form, seat elevator goes for $3000. It will increase your seat to floor height by 1 inch.

    I would recommend that when you try the chairs pull into your driving area in the van and see how your visibility is.

    You need to consider the reliability of the brand, ability to service it, your DME dealer's ability to service it, and manufacturers organizational strength behind the power chair. You don't want a chair from a company that fills a niche need, like being able to climb stairs, but is limited in history, distribution, and serviceability.

  5. #5
    Thanks for the replies. I look forward to hearing from others and how the process is going for "Crags" and "SCIfor55yrs."

    As for me, the process officially begins on Monday. I'm scheduled for a wheelchair evaluation with an occupational therapist and a durable medical supplier. Medicare requires a wheelchair evaluation by an independent occupational or physical therapist, one not employed by a company that supplies the wheelchair. For years, I have used a durable medical supplier in my area for chairs, cushions, back replacements, and repairs. This durable medical supplier is new to me and works with these occupational therapists at this medical center.

    I contacted Tom Borcherding (great friend to us at Care Cure Community) at Permobil/Roho and asked if there was a way to get a demonstration of the Roho Deep Contour back system. He arranged for a regional representative to contact me and find out my needs. She will have a couple of "demo" backs available for me to evaluate at the wheelchair evaluation on Monday.

    More, after the evaluation.

    I haven't had a wheelchair evaluation by a physical or occupational therapist since my injury in 1982. Any evaluations and recommendations have come from an ATP, Assistive Technology Professional or SMS, Seating an Mobility Specialist employed by the durable medical supplier I mentioned earlier. If you've had a seating evaluation, I'd appreciate hearing your take on the process, any preparation I should do, etc.

    All the best,
    GJ

  6. #6
    Senior Member Flatiron's Avatar
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    Pay attention to the turning radius & Overall Length.
    My older chair had a Turning Radius of 23 in. & Overall Length of 35.5"

    I didn't think about that with my new chair & it's got a Turning Radius of 35.75 in. & Overall Length of 47". Terrible in small places.
    They're both rear wheel drive too.

  7. #7
    One of my major problems, because of my height, in any chair, manual or power has been fitting under tables at libraries, restaurants, and the homes of friends, not to mention many sinks in bathrooms that supposedly meet with ADA standards. From what "Crags" posted, the elevated seat option increases the base height by 1 inch (maybe more) would put most pubic accommodation tables too low for me. Even as it is, sometimes, NL has to crawl under a restaurant table, flip up my foot rest and rest my feet on the cross legs of a table. She is a good spirit, but it is very undignified to be crawling under a table and adjusting my feet, just so.

    All the best,
    GJ

  8. #8
    My wife Carolyn's back was extremely sensitive & painful; after using several back cushions for a few months each she ended up with the Roho, which worked well for her.
    - Richard

  9. #9
    Rearwheel drive are being thoroughly discouraged and probably not produced in as large a number as mid-wheel and front wheel drive. They are good for a backup chair, but for the active user probably not a wise choice. Seat to floor height is always an issue with power chairs, they basically all suck. With my C 300 now five years old they were able to drop the rear seat pan down almost an inch below the side rails. With the new F5 that is no longer possible, so an 18 inch seat pan is the same front and rear. The front seat to floor height is pretty competitive with manual chairs, the problem is the rear seat to floor height. In power chairs you are sitting on a flat metal plate, that's it. In manual chairs you can drop the rear seat to floor height by changing the axle plates, thus creating the dump angle that we need to sit comfortably without constantly falling forward.

    Dropping down the rear seat to floor height also drops our head height down and makes visibility out of the windshield that much better. In a power chair the only way to create the dump angle we need is by raising up the front end through the use of tilt. This has the unfortunate effect of raising the knees and making it all that much more difficult to fit under tables. Whenever I would go out and need to fit under a standard table I have to eliminate the dump angle thus creating a lousy situation for sitting comfortably during the meal or otherwise. All of the power chairs are pretty darn close in terms of seat to floor height. Most are in the range of 17 to 18, some of a tad more, few any significant less, especially when accounting for an elevator. An inch makes a difference. The therapists roll their eyes when I bicker over an inch, but they don't know the problems it causes. With my new chair I am going to think about going from a four-inch high profile Roho to a 3 inch. That would have the net effect of lowering the rear seat to floor height. However, the most important priority is skin protection. I've never had a problem yet so I probably would be inclined to try and drop down to a 3 inch.

    This issue is so bad that I invested in a home office table that has electric up-and-down so I can change the table height depending on what chair I am in. To permanently fix a table at my power chair height would make it unusable to use in my power assisted/manual chair and vice versa. For those that are considering this and where cost may be an issue, you can get the manual crank model at a much reduced cost. The only downside is having to need somebody to crank it up and down or if your hands work, making sure crank is in an accessible location.

    I just wish certain public places, such as restaurants, computer training labs, etc. would have one or two of these tables reserved for disabled people. My library has one but always has crap on it.

    Also may want to research the battery type, whether group 34 or 24. I just became aware of this. I believe group 24 a longer lasting, though I believe more expensive. Something to consider when discussing purchase options.

    If one goes with a Permobil chair, I'm not sure whether an aftermarket back will incur any additional personal cost. If it does add this to the cost of the seat elevator, and a possible change in vehicle lockdown and you have a real damn pain in the ass terms of additional cost for the sake of a new power chair.

  10. #10
    Thanks for all of those thoughts, "Crags." I'm not very excited about having to start this process. My chair is only 7 years old and in great shape. But, it will be needing new batteries, new tires, new casters, a new back system, and sooner than later a new seat cushion, and motors and gear boxes have been know to fail (like within 2 years of use). I've been advised by a durable medical equipment dealer that Medicare prefers to supply a new chair rather than repair or replace individual components of the chair after five years. What's more, Medicare, after the chair is 5 years old, will deduct the costs from the purchase of a new chair if you keep your old chair and have Medicare replace these components on your old chair.

    I'm not convinced I need the elevating seat, especially at the out of pocket cost and seat height increase. Yeah it would be great to talk to standing people at more of an eye level, but unlike "55," I can't access my closet and I'm not active in the kitchen like he is. Likewise, I'm on the fence about getting recline and tilt in space. Tilt in space has worked great for me, and I'd get it again without question. I understand the new recline systems have something called anti-shear that helps with the problem of clothes becoming disheveled in the reclining process.

    I have a Roho Contour Select Cushion that works great for me. There are 3 heights of cells, low in the ischial area, medium behind my knees, and tall (4.25 inches) on both sides of my hips. Effectively, this provides some dump and doesn't raise my sitting height much because I'm not really sitting on the tall cells. https://roho.com/product/products/cu...elect-cushion/

    All the best,
    GJ
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    Last edited by gjnl; 10-23-2016 at 05:35 PM.

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