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Am i ready for a wheelchair van
“I’m Not Ready…”
People offer many reasons for staying away from modified vans:
“What I drive is a reflection of my personality. A seven foot
high van isn’t who I am.”
“Meeting the challenge of transferring to my car and hauling my
chair in behind me makes me feel good about myself.”
“I simply don’t have money for a lift and all the modifications
I’d have to do to a van.”
25th Anniversary Limited Edition VMI Honda Odyssey
Mostly what keeps people in their cars is the
I’m Not Ready Syndrome:
I’m not ready to give up the fun
car.
I’m not ready to give up the challenge.
I’m not ready to spend the money.
Eventually, two or three primary factors preserving function,
maximizing options and flexibility, looking into the future in order
to plan for and anticipate change drive the decision and help
clarify the choices.
Despite all the good, logical reasons
for continuing to drive those cars, many find it difficult to deny nagging
shoulder pain, decreased tolerance for the hassles of car transfers
and chair loading, or the simple fact that they don’t have the
energy they once did. Making a change is a dilemma many survivors confront
each day.
VMI Honda Odyssey Northstar
Reason #1: The Shoulders
The first consideration mentioned by many in the rehabilitation field
for making the change from car to van is maintaining and preserving
physical function. Research with those injured more than 20 years indicates
that the biggest predictor of pain and fatigue two things that can get
in the way of function was having experienced pain and fatigue
three years earlier. Not making changes when problems first arise is
an almost sure way of having them get worse.
The pain and fatigue can come from the
distance of the transfer, since getting as close to the car seat as
to a bed is difficult. Another consideration is the height of the transfer.
Having to lift up or down in the process of doing a transfer adds considerable
extra stress to shoulders. Also muscling the chair itself in and out
of the car can cause more pain and do damage. And, just the sheer number
of transfers continues to accumulate over time. What results from all
this is usually joint pain from the neck all the way down to the
wrist often arthritic in nature, and often accompanied by tendinitis.
The joint pain, the arthritis, the tendinitis are the body’s way
of saying that what you’re doing isn’t working very well
and is causing some harm.
Researchers have also linked fatigue
to future problems, including depression, lower quality of life and,
in some survivors, the need for both more durable medical equipment
and help from others. As car transfers and chair loading become more
difficult, many people report curtailing activities in order to avoid
the transfers. Too often therapists encounter aging clients who are
giving up things they enjoy – fishing, traveling, even working
– because of pain and fatigue. Still, even though people find
themselves giving up activities, they resist making the changes necessary
to avoid the hassles, the pain, the fatigue. For many it comes down
to wanting to fight off the realities of aging with a disability for
as long as possible. The arguments are predictable, in part, because
they’re so valid: like we said before, big vans are inconvenient
and hard to drive, they cost too much, people like the physical challenge
of doing transfers. Often it’s an image thing.
25th Anniversary VMI Limited Edition Honda Odyssey
Reason #2: Image
A vehicle is often an extension of one’s personality. Giving up
part of our personality rugged or adventurous individual; sporty,
fun kind of guy; or sedate, respectable, suburban family person
isn’t easy. Most everyone who buys a vehicle gives some thought
to image. Not everyone feels comfortable driving a big van: they can
be too big, not sporty enough or they simply don’t fit our self
image. While wheelchair accessible minivans are an option for some individuals,
many especially big people who use big chairs find minivans
too small for the lift they need and too tight inside for the necessary
maneuverability.
Regaining independence following injury
and rehab was for many the single most significant achievement of post-paralysis
life. Giving up the car may be viewed as giving up not only by
the survivor but also by those around him. Yet, making the changes and
using the lift may be necessary to maintain that highly prized independence:
Isn’t getting there far more important than just exactly how it’s
done?
Easy access for kids
Reason #3: Somebody Else
Decisions about what to drive affect more than just the survivor, especially
if someone else is doing the chair loading. A change to a van with a
lift could be necessary even if your back or shoulders are just fine.
Wives, husbands and caregivers age too, and they are often called on
to help with many transfers, chores and tasks requiring heavy or awkward
lifting. Survivors need to be not only aware but also sensitive to their
needs.
Reason #4: $$$$$
A switch to a modified wheelchair accessible van can add $10,000 to
$20,000 or more to the cost of a vehicle. Insurance and fuel costs usually
go up, and some modified vans even ones without raised roofs
won’t fit in standard garages and may require modified garage
arrangements as well. Yet there are costs involved in becoming less
active, not going out as much and staying home more. Active people tend
to be healthier, happier and less depressed. Going too long on deteriorating
shoulders can leave people even more dependent, eventually making hired
help more necessary.
People even some who are unemployed
and on Medicaid buy vans and somehow find ways to pay for them.
Worker’s Compensation, Medicaid Waivers, Vocational Rehabilitation
and the VA are all government programs which may help with funding.
Charitable organizations such as Easter Seals are a possibility. Fraternal
organizations may provide help. Some banks issue extended loans and
Independent Living Centers may offer low interest loans.
Lower cost home equity loans may also
be an option. There are always fund raisers through church, civic
or community organizations. And used equipment, or used modified vans
are also possibilities. We tend to figure out necessities.
Removable Front Seat Bases
Thinking Ahead
Sound decisions which will provide flexibility for five to eight years
need to be based on a realistic assessment of present function and trends
in your strength, stamina, life-style, pain and function. Is it practical
to stick with a car if strength has been decreasing and pain has been
increasing for the past three years? Transfers may not be much of a
problem now, but is it realistic to expect they’ll still be as
easy in 5 years, when you’re 56? Can you afford not to change?
More often than not, the decision to
switch from a car to a van is one of many decisions which contribute
to the lifelong process of adaptation to disability. Adaptive equipment
helps narrow the gap between aspiration and ability, between wants and
needs, and allows us to do so comfortably and safely. Adaptive equipment
can help avoid pain, preserve energy and prevent future problems. New
equipment can preserve time and energy and help enhance as well as maintain
both independence and quality of life.
Quality of life may be the prime consideration
for switching from car to van. The switch is a matter of preventative
maintenance a change which may allow us to keep the function we
have and maintain the quality of life we desire. How we regard these
changes can be as important as the changes themselves.
This is one of more than 20 educational
brochures developed by Craig Hospital while it was a federally-funded
Rehabilitation Research & Training Center on Aging with Spinal Cord
Injury. The opinions expressed here are not necessarily those of the
funding agency, the National Institute on Disability and Rehabilitation
Research of the US Department of Education.
For a hard copy of a METS brochure, click
on your selection above and hit the “print” button on your
browser. If you’d like to ask for one directly from Craig Hospital,
you can contact us by telephone at 303-789-8202, or you can e-mail us
at HealthResources@craighospital.org
We Service New England ( CT,
MA, ME, NH, RI, VT)
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