Travelling upfront in a wheelchair accessible vehicle- An Occupational Therapist View

“As an Occupational Therapist, when holistically assessing your clients/service users/patients who are wheelchair users, it may be highlighted that they have issues/anxieties around travelling or that their current car or wheelchair accessible vehicle no longer meets their needs.

Wheelchair users can experience many challenges when transferring into a car seat or travelling in the rear of a wheelchair accessible vehicle. This can cause stress, anxiety, or an injury which can impact physical and mental health and wellbeing.

The option to travel upfront next to the driver

When clients are looking into their travel options regarding Wheelchair Accessible Vehicles (WAV’s), they may wish to consider the option of travelling upfront next to the driver, which is known as an Upfront Passenger wheelchair accessible vehicle conversion. This may be beneficial if they have difficulty with transfers to and from their wheelchair onto a car seat. This could also reduce the need for a carer to assist in manual handling, therefore reducing the risk of injuries.

Travel anxiety

During an assessment, it may be highlighted that your client has travel anxiety. As an Occupational Therapist, you would need to establish the reason for this. This may be due to specific issues, for example, lack of independence, ability to transfer, time, energy, sensations, perception, travel sickness, or social inclusion.

Clients who sit in the back of a vehicle can often feel more isolated or socially excluded and not able to join in conversations with the driver/front passengers, and therefore prefer the option of sitting in closer proximity. This enables them to converse more easily and feel socially included. Sitting upfront with the driver would therefore benefit those who struggle with communication, for example, clients who have difficulty with verbalising their needs.

Hearing problems

Sitting in the back of a wheelchair accessible vehicle can often mean road noise is more noticeable, therefore it may be difficult for those who have hearing problems to understand what is being said by the driver and other passengers. Sitting in the back is also a disadvantage to those requiring verbal prompts or reassurance throughout a journey.

Chronic pain & muscle weakness

Sitting above the axel in the back of a wheelchair accessible vehicle may make the client more aware of every bump/vibration which may increase discomfort when travelling. Clients that struggle with chronic pain or have muscle weakness may be affected as their pain may increase with each bump felt or they may not be able to correct their sitting position. Sitting in the back may also affect those with sensory processing differences or have heightened anxiety – which may result in the driver having to make regular stops or distract the driver.

Verbal prompts and attendance

Within an Occupational Therapist’s clinical reasoning, certain medical conditions need to be monitored more closely by the driver/carer. The wheelchair user sitting in the front may be beneficial to enable the driver to be able to provide what is required, such as verbal prompts, or it may be the case that they are alerted to a specific problem so they can stop the vehicle to attend to the specific needs.

Fatigue

It may be highlighted during assessments that fatigue is a major factor impacting on travel and transfers. Those with fatigue may struggle with transfers to and from their wheelchair and car seat, therefore there would be a clinical reason to recommended remaining in the wheelchair to conserve energy. It also may be beneficial for the carer who may also suffer from fatigue and be struggling with assisting the wheelchair user with the car transfers.

Travel sickness

Some clients struggle with travel sickness when sitting in the back and prefer to sit in the front where they have better vision through the front windscreen. There is also an advantage to being able to independently use the window controls, change the temperature and inform the driver if they need to stop.

Space for equipment

The additional benefit of an upfront passenger conversion is there is more space in the back of the vehicle to enable clients to transport larger pieces of equipment such as commodes or transfer aids that are essential for Activities of Daily Living. This is an important factor when considering holidays and days out. Limiting the distance a client can travel /tolerate or equipment they are able to take with them on their journey may adversely impact their social inclusion needs, reducing opportunities, having a substantial impact on their quality of life.

As an Occupational Therapist, it would be beneficial to consider your client’s current medical conditions and how this may be affecting them now with regards to travel, and any possible changes in their longer-term future needs. In summary, travelling upfront next to the driver can meet the clients long term needs, it is a more social and comfortable way to travel which can have a positive impact on a client’s wellbeing”.

By Joanne Weaver –  Occupational Therapist 

Sirus design a number of Upfront Passenger Vehicles;

Sirus Ford Upfront – Dedicated upfront passenger with space for five

Sirus Ford Drive/Upfront – Drive from your wheelchair and switch to upfront passenger position

All of our Upfront Passenger Vehicles are available on the Motability Scheme. You can also apply for a Motability charitable grant towards the cost of the Advance Payment. Read more about Motability