On any given program, the participants will usually have a range of disabilities; some of these will affect the ability to be mobile and to independently move from place to place. Some may have aids that assist them to move about independently, others may require the assistance of the leader. This assistance may range from providing a steady arm for support to pushing a wheelchair.
Be aware of the support that individual participant’s may require before the program and prepare yourself accordingly. In some instances the participant may be developing the skills to walk independently and should only be helped when assistance is asked for. In other situations you may need to think ahead and be prepared to push a person in a wheelchair. This participant may not ask, but may require assistance to move around. If you are not prepared for this participant’s needs, the person may be left behind. Some participants may have poor spatial skills and may need supervision when using the wheelchair near path edges. Participants may not be aware that uneven terrain will affect their balance, the efficiency of crutch tips or the effectiveness of wheelchair brakes.
Find out about any equipment that the participant may use and how it works. Know about the brakes, removable parts and the safety aspects. Be aware of batteries that may need charging on electric wheelchairs.
Whatever the mobility needs of a participant, it is valuable to be prepared to assist in the most effective and appropriate way. The coordinator, parents/caregivers and the participants themselves will provide information about the type of assistance required, and some handy hints on meeting these needs. The participants will often tell you or show you what assistance is most effective. Be aware of the types of environment in which it is OK for a participant to operate independently or need to assistance.
Assistance with walking
Where the participant requires assistance with walking, ask the participant how they would like to be helped and provide no more assistance than is necessary. Encourage the participant to place weight on any aid that they may be using rather than on you, the helper. Be aware that uneven ground can be difficult for a participant maintaining their balance. Check to see that the aid is safe; for example, a walking stick has a fitted handgrip and stopper. Walk at the pace of the participant.
Using public transport
Before going anywhere it is important to plan ahead. During a program aim to involve participants in as many experiences as the environment has to offer. On occasions this could include the use of public transport.
Planning will help you to determine what the conditions will be and what facilities are available. Take into account the ability of the participant to use steps and ramps and to move down the aisles of vehicles. Also be aware of the slow mobility of the participant; this will affect the time taken to get to appropriate transport and will determine the assistance that you may need to give if the person cannot manage alone.
Assisting someone in a wheelchair
The abilities of someone who uses a wheelchair can vary greatly depending on the disability – physical, intellectual or cognitive. Previous experience in the use of a wheelchair has to be considered.
Some participants may have disabilities that prevent them from using their legs. They may have good coordination and body strength that will enable them to manoeuvre their wheelchairs to most positions they wish to reach. These participants may need only a little assistance in environments that are designed for wheelchair use. Often the chairs used by these participants are manual and are propelled by the user.
A participant may also have multiple disabilities that affect coordination and provide very limited voluntary body movement. The participant may not be able to move a manual wheelchair independently and may require assistance to push the wheelchair. Some people are able to operate the mechanical controls of an electric wheelchair. This can enable them to be reasonably independent and only require assistance at certain times. Some people with spatial difficulties need ‘steering’ assistance, especially outdoors and in potentially dangerous situations, e.g. On a wharf or pier.
Questions to ask for assisting a person in a wheelchair:
- Firstly, find out about the needs of the participant in the wheelchair.
- Is continual assistance needed to move from place to place?
- Is there the ability to manoeuvre the wheelchair?
- Is assistance required at certain times?
- Are skills to become independently mobile being developed?
- Should assistance be given when asked for?
- Is it necessary to supervise?
- Do skills vary depending on the environment? E.g. a quiet area or a crowded area?, uneven ground (roots of trees, stone), slippery surface(wet, muddy).
The coordinator, parents/caregivers and the participant are usually able to provide this information. It is also common practice to include this information on the participant’s information form.
When pushing a wheelchair you are more than just the person pushing. You are also a companion, leader or friend. Often you may also be an interpreter and you will need to be sensitive to the participant’s needs.
Points to remember:
It is important to communicate to the participant you are pushing. Before moving, let the participant know that you are going to move the chair and indicate where you will be pushing them.
When talking to a participant in a wheelchair, it is important to consider that the participant may find it difficult to hear you from behind, particularly if they cannot move their head. If you are having a conversation with a participant in a wheelchair it is best to stop pushing, face each other and sit down or bob down so your faces are at the same level.
In a group conversation, make sure that you move the chair so that the participant is part of the conversation.
Check that the participant’s arms and legs are safely and comfortably placed and that they as well as blankets and clothing are clear of the wheels.
Make the movements of the wheelchair slowly and consistently. Sudden movements may distress the participant. It is important that you help the participant to feel safe at all times.
The best path to follow is the smoothest one available, even if it means a longer route. A bump or jar may be painful to the person in the chair.
Where provided, ensure that the participant is securely belted into the chair.
Never leave the chair without putting on the brakes and ensure that the brakes are working effectively.
Allow participants to be as independent as they wish within safety limits. Do not be offended if your offer of help is not accepted.
To help a participant into a car from a wheelchair, stand the person up if possible, sit them on the edge of the car seat, then lift the legs and shift the person into a comfortable position. Be careful of the participant’s head and the low doorframe.
The section on lifting techniques will provide information about moving a person in a wheelchair to another chair or a bed.
Off Road Wheelchairs
Wheelchairs are now available that will enable the participant to travel over rough terrain. One of these chairs is available from People Outdoors. A participant will require the assistance of a leader to manoeuvre the chair and to use it safely within the terrain.
Securing wheelchairs in vehicles
When a participant is travelling in a vehicle, seated in their wheelchair, you need to ensure that the wheelchair is correctly secured. There should be anchor points in the vehicle, and there are anchor points on all chairs. These must be used, along with the correct tie-down straps. Also ensure the participant is strapped into the vehicles seat belt if possible.
If you are unsure about the securing procedures seek advice or clarification from the parent/caregivers, the participant themselves, or from another person experienced with securing wheelchairs in vehicles. In the case of an accident, an improperly secured wheelchair places the individual in the chair and the other occupants of the vehicle at high risk.