Powered Wheelchairs: Who Benefits, What to Check and Home Readiness

Who benefits

A powered chair is worth considering for an older adult who:

• cannot propel a manual chair because of weak arms, shoulders or hands, or limited stamina;
• has breathlessness, heart failure or severe fatigue that makes pushing exhausting;
• has progressive conditions such as Parkinson's disease (in advanced stages), multiple sclerosis or motor neurone disease, depending on control ability;
• wants to be independent and not depend on someone pushing;
• spends many hours in a chair and needs seating options such as tilt or recline; or
• lives in an environment with smooth access for a powered chair.

It is not suitable for everyone. Safe control needs good vision, attention, judgement and reaction speed. People with significant cognitive impairment, severe visual loss or poor judgement may be a danger to themselves and others. An assessment is essential.

Types of powered chair

Indoor powered wheelchairs. Compact, with a small turning circle, for use at home. Some fold or dismantle for transport.

Indoor-outdoor chairs. Larger wheels, stronger motors, longer range and better suspension, for use around the neighbourhood.

Folding or portable powered chairs. Lightweight, with lithium batteries, that fold for a car boot, useful for travel but with limited range and capacity.

Power-assist attachments. Add-on motors that fit a manual chair, giving a boost. These can be an affordable bridge.

Mobility scooters. Three- or four-wheeled vehicles steered with a tiller. They suit people who can walk a few steps and sit upright, and who need help over distance. They are less suitable indoors and for people with weak trunk control.

Specialist chairs. With tilt, recline, elevating leg rests and head supports for complex needs, usually prescribed by therapists.

Key features and what they mean

Drive system. Rear-, mid- or front-wheel drive affects turning and stability. Mid-wheel drive turns in a small space, ideal indoors.

Motor and battery. Two motors drive the wheels. Batteries are either sealed lead-acid (heavy, cheaper) or lithium (lighter, longer-lasting, costlier). Range typically varies from about 10 to 30 km on a charge, depending on load, terrain and battery. Check the battery's capacity in amp-hours and its charge time.

Speed. Often 4 to 6 km/h for indoor chairs and up to 8 km/h or more for outdoor chairs. A speed limit setting helps new users.

Controls. A joystick on the armrest is the most common. Alternatives include joysticks with larger knobs, mini or compact joysticks for weak hands, head or chin controls and switch controls, for people with limited hand function.

Seat. Width and depth to match the user; height; cushion; options for tilt and recline; and supportive back and head rest. See wheelchair measurements and pressure care in a wheelchair.

Suspension and tyres. Better suspension and pneumatic tyres give a smoother ride outdoors, but pneumatic tyres can puncture.

Brakes and safety. Automatic electromagnetic brakes that engage when the joystick is released, a manual release for pushing, an emergency stop and anti-tip wheels.

Weight. Powered chairs weigh 30 to 100 kg or more. Heavy weight affects transport and stairs.

Seat belt, lights and indicators. For safe use on roads and in the dark.

The assessment

A therapist, ideally an occupational therapist or specialist wheelchair service, should assess:

• the user's physical ability to operate controls;
• vision, attention, memory and judgement;
• seating and posture needs;
• the home and community environment;
• transport and storage; and
• a trial of one or more chairs.

A trial in the user's own home is ideal. Do not buy a powered chair without trying it. Ask a doctor for a letter if required for insurance or purchase.

Home readiness

A powered chair changes the home. Check:

• Doorways. The chair is typically 60 to 70 cm wide, and a doorway needs at least 80 cm clear for comfortable use, with extra room for the hands and turning.
• Turning space. A chair needs about 1.5 metres of turning space for a three-point turn; an indoor chair with tight turning may need less.
• Floors. Smooth, firm surfaces. Thick carpets and rugs can stop the wheels or catch; remove loose rugs.
• Thresholds. A low threshold may be crossed; higher ones need a ramp; see portable ramps for thresholds.
• Ramps and steps. Ramps must be gentle (about 1 in 12) with edges and a non-slip surface. A powered chair cannot use steps.
• Lift. If you live in an apartment, check the lift size and weight limit.
• Charging. A safe plug point in a ventilated, dry place near where the chair is parked, ideally on a dedicated socket.
• Storage. A parking spot out of the way.
• Bathroom. Many bathrooms are too small for a powered chair; plan a transfer point. See bathroom layout for wheelchair users.

Safety rules for the user and the family

• Learn in a safe space, with an instructor, before venturing out.
• Use a slow speed setting at first.
• Keep both hands free of loose clothing and bags that could catch the wheels.
• Wear a seat belt if advised.
• Be careful on slopes and kerbs. Never drive across steep slopes; use dropped kerbs.
• Avoid wet ground and deep puddles, since electronics can fail.
• Look out for pedestrians, children and animals. On roads, keep to pavements where possible.
• Do not carry passengers or heavy loads beyond the limit.
• Switch off when transferring, and engage the brake.
• Charge regularly, and do not run the battery flat.
• Plan for power cuts, with a fully charged battery and an alternative way to move.

For carers, see also pushing a wheelchair safely.

Maintenance and running costs

Powered chairs need regular care.

• Battery: charge after use; replace every few years; follow the maker's advice for storage.
• Tyres: check pressure and tread.
• Controls and cables: keep dry and check for damage.
• Brakes and motors: servicing by a technician.
• Cleaning: wipe frame and upholstery; avoid water on electronics.
• Warranty and service: confirm that spares and service are available in your city, since repairs can take time.

Running costs include electricity, servicing and replacement batteries, which can be a large expense. Ask about the total cost of ownership.

Cost and funding

Powered chairs are far more expensive than manual ones, with prices rising with range, tilt and recline, controls and brand. Ask for a written quote including delivery, set-up, training, warranty and any extras. Check whether health insurance, an employer or a charity might help, and ask about GST. Consider renting for a trial or a short-term need; see renting or buying a wheelchair. Beware of very cheap imports with no service back-up.

Alternatives

• Manual chair with a carer, which is simple, cheap and light; see transit wheelchair or standard wheelchair.
• Power-assist add-ons, for people with some arm strength.
• A mobility scooter, for people with good trunk control who live where outdoor use is possible.
• A rollator, if walking is possible with rests; see rollator buying guide.

When to ask a professional

Always seek an assessment before buying a powered chair. Ask a doctor about any condition affecting vision, cognition or control, and a therapist about seating and pressure care. Training with the chair is part of safe use. Our care advisors can help arrange an assessment and trial.