Wheelchairs, Transfers & Antigone’s New Car

The last few months have been turbulent – figuring out how to live our lives with Antigone no longer walking independently, even with walking aids, and no longer able to do standing transfers between seats, beds, toilets, wheelchairs, cars etc.

Wheelchairs

There are many different wheelchairs, but there are two broad categories – standard wheelchairs for independent use, and transit wheelchairs or for dependent use.

• Standard wheelchairs are typically for people without lower limbs or with lower limb problems. The user propels themselves using push rims attached to the wheels and holds the wheelchair in one place using parking brakes positioned in front of the wheels.
• Transit wheelchairs may be most familiar from hospitals, where they are used by orderlies to transport patients from the emergency department to wards, or to or from xray departments etc.

Antigone does not have lower limb weakness or problems. She has no problem physically with standing and bearing her own weight. Her issues are cognitive, with communication difficulties between her brain and her legs (and arms), and balance difficulties. Thus, standard wheelchairs are not appropriate for her. We have used standard wheelchairs as transit wheelchairs for years, since 2023, and we often removed the push-rims to reduce weight and width.

‘Transportable wheelchairs‘ are wheelchairs with appropriately engineered ‘tie-down points’ for being held securely in a maxi-taxi or other specially engineered vehicle.

Transfers

‘Transfer’ is a medical jargon word for transitioning from one place to another. Most people think nothing of it. When you want to move from a bed or a sofa or a toilet, you get up and walk. But if you use a wheelchair instead of walking you need to transfer to and from it (or be transferred for less independent people). The most common transfer is the ‘standing transfer’, in which you stand up, step sideways, then sit on the wheelchair or other surface. Less independent people may need verbal and/or physical guidance for standing transfers.

The verbal phrase ‘to get up’ becomes meaningless without one or more of these abilities:

• to reliably communicate between the brain and limbs
• to sequence many small ‘steps’
• to balance standing

Antigone can no longer do standing transfers, even with significant physical and verbal assistance. Thus, transfer devices are needed. These include:

• Manual sit-to-stand transfer devices like the one Antigone is pictured on below – these require upper and lower limb strength and weight-bearing ability. Their use is of benefit because using them helps to maintain limb strength.
• Electric sit-to-stand transfer devices which are similar, but use an electric motor instead of limb strength to get to the standing position. We use one of these for when Antigone hasn’t the energy for a manual device – mostly nocturnal toilet visits. Weight-bearing ability is still required.
• Kera sit-to-sit transfer device – a manual device for transfers which does not require limb-strength or weight-bearing ability.
• Electric hoists use an electric motor for everything. We haven’t needed to use these. They require a sling arrangement which supports back, buttocks and upper legs.

Transfer device research

Transfer device research has been crucial. We use two transfer devices at home – manual mostly, and electric for when Antigone is really tired. We have thoroughly searched for a lightweight, portable transfer device. Two heavy options are pictured below. Unable to find anything suitable for sale, I made one.

Antigone and her choir support worker Janey discovered that transfer devices can also be used to assist standing, as pictured below at One More Chorus, a weekly singing event Antigone attends on most Monday evenings.

Travelling by Car

We used to park our car on the street. I had made a level section of our nature strip for Antigone to use getting in and out of the car (instead of the steeply sloping nature strip). There was a single step up to footpath level and two small posts which could be used for assistance when stepping up or down. This was no longer possible. The bluestone channel was too rough for wheeled devices, and the bluestone lane had similar problems.

So we are now parking in our driveway instead. The paved ramp I made early this year was made at just the right time. Our herb garden is now a ramp and our paved area is anow a dichondera lawn.

Using a car becomes quite a hassle when you have to get a wheelchair out of the back every time you stop, and a transfer device to get from the car to the wheelchair. Especially if the transfer device weighs 20kg. Someone designing these things thinks I should have two workouts – before and after every time Antigone needs to transfer to and from a car seat, or a toilet, or whatever.

Our occupational therapist said if Antigone can’t do standing transfers we would need to get a transportable wheelchair and use maxi-taxis, or buy a late-model van and get a lift installed at the back. Those options were not attractive to us. We like driving together in the front seats of cars.

A little more research and I came across just what we needed – a car for Antigone for which transfers could be done in the house – a Toyota Porte with (i) a passenger seat able to function as a wheelchair, (ii) an electric swivel and lift mechanism to get it (and her) in and out of the car, and (iii) a sliding door. Antigone’s seat is higher than mine, so we get to see eye-to-eye now. An added benefit is that her quiet voice is closer to my ears.

We bought a newly-imported 2013 Toyota Porte on 8 August. What a life-changer!