Car Seat Cushions for Older Passengers

Why car seats are hard on older bodies

• Low seat height. Many cars have seats at 30 to 40 cm from the ground, well below the 45 to 50 cm that is easiest for older knees and hips. The lower the seat, the harder it is to stand up.
• Deep bucket shape. Side bolsters grip the hips and make it hard to swing the legs out.
• Firm, shaped back. Designed for younger, upright posture, they may not suit a rounded or stiff back.
• Vibration and road shock. Long drives jar the spine, especially on rough roads.
• Limited movement. Sitting for long periods in one position stiffens the body and slows circulation.
• Entering and leaving. The door frame, the sill and the dropping and twisting movements are risky; see getting an elderly person in and out of a car.

What a cushion can do

A car seat cushion can:

• Raise the seat by a few centimetres, making getting in and out easier;
• Improve comfort on long journeys by spreading pressure and absorbing shocks;
• Support the lower back, when combined with a lumbar roll; see lumbar cushions;
• Reduce sliding with a non-slip base; and
• Help skin on very long drives.

It cannot make an unsafe seating position safe, and it cannot replace a correctly fitted seat belt.

Safety first: seat belts, airbags and head position

A car's safety systems are designed with a person sitting in a standard position. Anything that changes that position can alter how those systems work.

• Seat belt fit. The lap belt must lie low across the pelvis, the bony part of the hips, not across the soft abdomen. The shoulder belt must cross the middle of the collarbone and chest, not the neck. A thick cushion raises the body relative to the belt, so the lap belt may ride higher and the shoulder belt may cut across the neck. Check the fit after fitting any cushion.
• Head restraint. The top of the head restraint should be about level with the top of the head. A cushion that raises a person by several centimetres may leave the restraint too low, increasing whiplash risk. Adjust the restraint upwards.
• Roof clearance. A taller seat means less space above the head; check that the head does not touch the roof, especially over bumps.
• Airbag distance. Sitting higher or further forward changes the distance to the steering wheel or dashboard airbag. Keep the seat adjusted so that the chest is at least about 25 cm from the airbag cover.
• Sliding under the belt. Soft, thick cushions can let the pelvis slide forward under the lap belt in a collision ("submarining"). Choose firm, thin cushions.
• Cushion stays in place. A loose cushion becomes a missile or slides in a turn. Use a non-slip base and straps.

As a rule, choose a firm cushion no more than about 5 cm (2 inches) thick unless a professional advises otherwise, and check seat belt and head restraint after fitting. Do not use cushions designed for wheelchairs or beds in cars without checking. Never place a cushion behind the seat belt.

If your parent needs a very different seating position, such as a high cushion or a wedge, ask an occupational therapist or the car manufacturer.

Types of cushion for cars

Firm foam booster pad. A flat, firm foam cushion with a non-slip base, 3 to 5 cm thick, that raises the seat slightly. The simplest and safest choice.

Wedge cushion. Thicker at the back, tilting the seat forward slightly to open the hip angle and ease standing. Only a few centimetres of rise; should be firm.

Gel or gel-foam pad. Spreads pressure and keeps cooler on long journeys. Heavier. Check the thickness.

Memory foam pad. Moulds to the body but can slow movement and may feel warm; may be too soft for belt safety. Use thin, firm versions only.

Coccyx cut-out cushion. For tailbone pain; ask a doctor or therapist; see cushions for piles and tailbone pain.

Swivel cushion. A rotating pad that lets the person turn to bring their legs in or out; helps stiff hips. Must be secure and non-slip, and not used while the car is moving without locking.

Lumbar roll or back cushion. Supports the curve of the lower back; keep it thin so it does not push the body forward and change the belt line.

Neck pillow. Supports the head on long drives for passengers; check it does not push the head forward; see neck pillows for travel and sleep.

Sheepskin or beaded covers. Add airflow in hot weather, with little thickness.

Choosing a cushion

• Thickness. Thin and firm: about 3 to 5 cm for a booster.
• Firmness. Firm enough that the person does not sink; avoid very soft cushions.
• Non-slip base and straps. Essential.
• Shape. Flat or slightly wedge-shaped, with no raised edges that interfere with the belt buckle.
• Cover. Breathable and removable. Mesh or cotton covers are cooler in the heat.
• Size. Fits the seat without hanging over the edge.
• Weight. Light enough to move between cars.
• Compatibility. Check that side airbags and seat sensors are not blocked; some cars have occupant sensors in the seat that should not be covered by a thick cushion. See the car manual.
• Try before you buy. Sit in the car with the cushion and check belt, head restraint and visibility.

Making long drives comfortable

• Plan breaks every one to two hours, to stand, stretch and walk.
• Use cushions as a support, not an excuse to sit for hours.
• Move the feet and ankles while seated; see sitting for long hours.
• Keep the car cool and avoid direct sun. A gel pad can get warm in a hot car, so check the temperature before sitting.
• Wear loose clothing, and avoid heavy items in pockets that press on the buttocks.
• Keep water and medicines in reach.
• Seat the passenger in the front where possible, with the seat slid back and slightly reclined, if comfortable.
• Take a helper for long trips.

For wheelchair users and long journeys, see wheelchair and car travel.

If the cushion is not enough

If your parent still struggles to get in and out, consider:

• a car with a higher seat, such as a small SUV or MPV;
• a swivel seat or a handle that clips into the door frame, if recommended by a therapist;
• a taxi or driver with a suitable vehicle; or
• professional advice on transfers.

When to avoid cushions

Do not use a cushion if:

• it prevents the seat belt from fitting properly;
• it raises the head too close to the roof;
• the car's manual or manufacturer advises against it;
• it covers a seat sensor or airbag component;
• it is soft and unstable; or
• it makes the driver unable to reach the pedals or see the road. Drivers must keep correct posture and control; see a doctor if driving is difficult.

When to ask a professional

An occupational therapist can assess car seating and transfers, and advise on cushions, swivel aids and other equipment. Ask a doctor if your parent has back pain, tailbone pain, hip or knee problems, dizziness or breathlessness during travel. Our care advisors can help choose equipment and plan comfortable trips.