The Powered Wheelchair Training Guide

Written by Axelson P, Minkel J, Perr A, & Yamada D.

Illustrated by Clay Butler

Published by: PAX Press, a division of Beneficial Designs, Inc., Santa Cruz, California

Section 2.1

Asking for Help

Access improvements for people with disabilities are being made everyday. However, you will still encounter situations where you need help.

Everyone with or without a disability needs help now and then. The need for assistance will vary from situation to situation, and person to person. The hardest part for many people is knowing and understanding when they have reached their limits.

Defining “Assistance”

“Assistance” has many meanings.You may need to be lifted up stairs, helped over a loose gravel pathway, up a steep ramp, across a street, up or down a curb, over a railroad track, etc.

• Independent Skills: Independent skills are those things you can do without help.
• Supervised/Assisted Skills: Supervised/assisted skills are those things you are uncomfortable doing totally by yourself, but you can do partially.You might need occasional help or someone nearby “just in case.” Being able to ask for help and being able to instruct others is very important.
• Dependent Skills: Dependent skills are those things you can only do with a lot of help.

Who Can Help?

The amount of help you need will depend on your present skills and abilities, as well as the task you need to accomplish. In some cases, you might want someone nearby because you are learning a new skill or you are just a bit unsure about the situation. At other times, you may be trying to get past an obstruction that you are unable to negotiate. This section gives you some pointers on working with different kinds of helpers, including spotters, assistants, personal care attendants or PCA’s, family or friends, coworkers, acquaintances and strangers.

Spotter

A spotter is a person who stands nearby to help if you need it. Always use a spotter when learning a new skill, such as driving down a steep ramp, and when you are not confident in your ability to handle a situation alone. The spotter could help to prevent you from tipping or falling forward out of your wheelchair. It is up to you to decide when you are uncomfortable with a maneuver and would like to use a spotter.You might need more than one spotter when learning a new skill. It is also important to instruct your spotter(s) as to exactly how you need to be spotted. For example, going down a ramp you might ask a spotter to walk alongside of the wheelchair, ready to catch your upper body should you lose your balance in the forward direction.

Assistant

A spotter becomes an assistant when you know you will need help or will require more assistance than someone standing by offering an occasional hand. Assisting often involves pushing or lifting the wheelchair in some capacity (e.g., up a curb or threshold that is too high to cross independently). An assistant might also be required to perform other tasks, such as picking up things you drop or getting things you cannot reach. In many cases, an assistant is hired and trained by the wheelchair rider. These assistants are often referred to as personal care assistants (PCA’s) and attendants.

Personal Care Assistant (PCA)

If you need help frequently or at regular times during the day, you may want to hire a personal care assistant. Some wheelchair users find it difficult to ask a family member or a friend to help because they feel they are burdening them. Relationships with family members or friends may become strained if they always feel responsible for helping you. A potential advantage of a hired assistant is that the assistant can help you with personal tasks, such as bowel and bladder care, and is generally not as emotionally involved with you. It is the job of a hired assistant to provide the help you need in a given situation.You can train your professional assistant to do things the way you want. If the arrangement does not work out, you also have the freedom to replace the PCA.

Family and friends

Family and friends with whom you spend most of your time will need to spot or assist you on some occasions. It can be valuable to rely on people you feel comfortable with when facing a difficult or challenging situation.

Do not assume that a family member or friend will always be comfortable helping you. Be sure to ask if they are willing to help. Make sure they know not to help you unless you request assistance. You probably have a good idea of which friends and family members you can trust as assistants based on your familiarity with their personalities.

Coworkers or acquaintances

Coworkers or friendly acquaintances can also make good assistants when you need help at work. If you are on good terms with a coworker, you may be comfortable casually asking for assistance (e.g., “Hi. Can you give me a push over this threshold?”). People you meet after your injury may be more comfortable with you as a wheelchair user than friends or family still making the adjustment to your new circumstances.

Strangers

When you are alone, situations may arise where you need the assistance of a stranger. For example, you may have dropped your car keys where you cannot reach them. In these cases, you may need to ask someone you do not know for help.

Alternatively, you may be out with a friend and find yourself in a situation where the assistance of a second person is necessary. For example, you may need an additional person to help lift the front end of your wheelchair up a curb.

How to Ask for Help

How you ask for help will vary from situation to situation. Ask for assistance in a way that allows the person to comfortably decline.You can practice asking for assistance with a companion acting as a stranger. This will help you learn how to ask strangers for assistance, as well as teach your companion to help only when asked. This type of practice also helps you learn how to instruct others to safely assist you.

Remember that there can be many valid reasons for people to decline to help you. Some people have disabilities that may not be visible, such as arthritis or heart disease, and they may be reluctant to disclose their condition to you. Other people’s beliefs or customs may present a barrier to assisting you.

Gracefully accept refusals to help. After all, you don’t want help from a person who feels uncomfortable with the task because their apprehension can increase the risk of injury for both of you. Consider the following before asking a stranger for help:

• Do not ask for assistance from anyone you feel might be a threat.
• Consider the people around you and approach only those who look prepared to provide some physical assistance.
• Body size is not that critical when performing most assisting skills. Do not assume a smaller person is not strong enough to help you.
• Ask for assistance from people involved in activities similar to your own. For example, if you are shooting baskets in the park and lose the basketball in a bush, ask another ball player for assistance.
• If you enjoy challenging environments, such as hiking trails, remember that this type of environment attracts a lot of people who, like yourself, might be looking for an adventure. They may see helping you as yet another challenge and be very eager to assist.
• If there are few people around and you know you will need assistance soon (e.g., there is a curb around the corner), ask someone if they would be willing to follow you to the place where you will need help.
• Try “Do you mind giving me a hand up this curb?” or “Could you help me down this steep curb ramp? I can talk you through what I need you to do.”

Observe the people around you and ask those who look ready and willing to assist.

Be clear and concise when giving instructions. Most of the skills in this book include instructions you can give an assistant.

• You are in charge. Instruct your assistant not to do anything unless you specifically ask.
• Read Section 6.1 for more information about protecting the back. Make sure friends and family who assist frequently read that chapter also.
• Tell your assistant where to stand.
• Indicate how to hold onto your wheelchair (e.g., “Please do not lift from the foot supports because it might break off. Hold the frame next to my knees instead”).
• Give body mechanics suggestions (e.g., “Bend at your knees and keep your back straight”).
• Always instruct your assistant to move on your count of three to coordinate the efforts of all parties.
• Remember to thank your assistant for the help.

Manually Rolling Your Wheelchair

It will be difficult or impossible to manually push your wheelchair with the motor engaged. Know how to explain the disengagement of the motors so an assistant can push you if necessary. Be sure you know where the motors are located and how to operate the motor disconnect system.

Describing Safe Body Mechanics to the Spotter or Assistant

Be sure to protect your spotter or assistant from injury by reminding her to watch her body position. Remind your spotter or assistant to:

• Bend at the knees, not at the waist.
• Use her legs for strength rather than the weaker muscles of the back or arms. This will help prevent back strain.
• Keep her knees bent, not locked straight.
• Never twist at the waist. Instead, she should keep her torso facing the same direction as her hips. This will help prevent back strain.
• Keep her back straight. Hunching over or rounding at the shoulders can cause back strain.
• Keep breathing. Sometimes people forget to breathe when they are involved in physical activity. When someone holds their breath, they are more likely to tense their muscles and when their muscles are tense, they are more prone to strain and injury.

When You Do Not Want or Need Assistance

Sometimes people will try to help even when you do not ask. This can be very frustrating.

• A simple “Thanks, but I would like to do this by myself” or “Thank you, but it is actually easier for me to do this without assistance” can be effective.
• “Please don’t grab my wheelchair” or a similar instruction is sometimes necessary for the more aggressive helper.

Experiencing New Environments

It is important to have assistance available when you try things for the first time (e.g., your first time using a crosswalk with curb ramps). Having a companion along to both spot and assist makes it safer to experiment with new or different skills.

The goal is to develop full independence. This does not necessarily mean that you will be able to perform all skills independently. Rather, it means that you are able to understand when and where you may need assistance, how to ask for it, and how to instruct others to assist safely.

Last Updated: February 20, 2003