PWC troubles

[RinT]

My PALS, who has limb onset, has reached the point of using wheelchairs exclusively (no walking allowed) and increasing leg weakness. Pretty soon will be starting Hoyer lift.
I worry because she has an extremely hard time driving her new PWC in the house. The speed is turned down along with control sensitivity, but she gets distracted and runs into furniture. Already she has trapped a foot bruising it badly and today ran against a big bookcase, breaking the back. Very thankful it did not topple over on her. This was in a fairly wide open area. She is older, in her 70s and tbh, somewhat erratic car driver even before ALS symptoms appeared.
Any ideas? We can continue moving her in manual wheelchair awhile, but they say she'll probably need better torso and neck support down the line. I almost wish there was a remote control option..

 

[lgelb]

Sorry to hear. She certainly needs to use the power chair as she progresses. I would have an attendant control installed on the back and you can also use the one already on the arm as an attendant control, though you might need a different joystick head (they come in different shapes/sizes). In some cases, a mini or micro joystick might be easier for her to operate than whatever she has now, esp. if she has small hands. But if distraction is the issue, that will not help.

As with anything else, you may need to play the "I" card as a rationale for taking away her self-driving -- "I couldn't live with myself if..." "We want you to be safe/comfortable/focusing on the sights outside in your chair," etc. If her vision is impaired, you could also use that, and also could point out wheelchairs are fiddly, that you will be operating the Hoyer anyway, and the two work together.

It is also easier to talk to each other when you are operating the chair, and she can still give you direction as to where she wants to go. So there's kind of a Driving Miss Daisy card for her retaining control over her movements.

I know this all sounds easier than it will probably be, but you will have to weigh it against the risks that you have already outlined.

Best,
Laurie

 

[RinT]

Thank you!! I didn't even know attendant controls were a thing. She actually hates driving it indoors and would be thrilled to let us do so with her directions. I will look into that

 

[swalker]

If you let us know the wheelchair brand and model, we might be able to provide more specific help.

My main wheelchairs are all Permobil brand. Three of them are front wheel drive and one is rear wheel drive.

On each of these four wheelchairs, I have two profiles (one for indoors and one for outdoors). I have 5 speed settings available for each profile.

The profiles and the speeds within a profile can be changed via a programmer and software that runs on my computer. Most folks will not have access to the programmer and software, but all Durable Medical Equipment (DME) providers I have worked with do. They can modify the profiles and speed settings to accommodate a wide range of user capabilities.

Permobil wheelchairs use the RNet control system, which can simultaneously have both a joystick for the user and a separate joystick on an attendant control. The attendant control is typically mounted on the back of the wheelchair and is smaller so that it does not protrude as much.

One of my wheelchairs came with an attendant control, but I removed it and am saving it for when I need to have my wife drive me around in the wheelchair.

While learning to drive the wheelchair, I did a bit of damage to our house! There is certainly a learning curve. Now that I am more experienced, I damage the house much less often, but still occasionally put a mar in the drywall. I am now very comfortable driving the wheelchair in tight quarters.

Steve

 

[RinT]

Hers is a Permobil M3. She loves it outdoors, she is in a low traffic neighborhood with lots of room, but inside it's been nerve wracking even after a lot of practice. They installed the T control for her as she has to use whole hand and also fine tuned the sensitivity in speed and side-to-side control a couple times. She's familiar with the indoor/outdoor profiles and their speed levels, indoors we have to keep it at least a 2-3 on the Indoors 1 profile for it to be able to move on the carpet. But I'm afraid the issue is mostly attentiveness.

I don't care about the drywall and furniture which has taken some abuse, haha! But she told me once when she was home with an aide she got her head stuck against something (!) so, the back of wheelchair joystick sounds very good.

 

[swalker]

While there are certainly modifications that can make the wheelchair easier to control in tight spaces, it sounds like none of those modifications would completely address your concerns. Adding an attendant control seems like the logical next step.

Midwheel drive wheelchairs like the M3 can suffer from caster jerk, which can make controlling them a bit more difficult, especially at slow speeds. They can also become more readily stuck on uneven surfaces when the casters take the weight off of the drive wheels.

Midwheel drive wheelchairs are often recommended by the DME vendors because a common perception is that they are easier to learn to drive. Perhaps they are more intuitive for some people, but I find them harder to drive than the front wheel or rear wheel drive models.

While I primarily use front wheel drive wheelchairs and now have a lot of experience with them (over 6000 miles), I have still injured myself. Most recently, I managed to ram my foot into an obstacle and broke at least 2 (and maybe 3) toes. That was unpleasant.

The most important thing is to find a setup that will keep her safe. It sounds like an attendant control would be a significant step toward accomplishing this.

Steve