Simple Tips for Making Your (or Your Loved One's) Wheelchair More Comfortable

Wheelchairs are one of the most important mobility devices ever invented, but they aren’t always associated with comfort. 

Using a wheelchair for extended periods may increase the risk of pressure ulcers, joint pain, and skin breakdown. Fortunately, there are various things you can do to prevent these problems and make your or your loved one’s wheelchair more comfortable.

To gain some insights into this topic, we contacted:

• Brooke Ellison, PhD, a quadriplegic wheelchair user, professor of health policy and medical ethics at Stony Brook University, and the author of Look Both Ways

• Lily Brasch, a wheelchair user with a rare form of muscular dystrophy, student at Columbia University, and the founder of the Born to Prove Foundation.

Below, we highlight some simple tips and tricks for increased wheelchair comfort whether you use a wheelchair daily or every once in a while.

Wheelchair comfort –– Important things to consider

“Comfort in a wheelchair is multidirectional, involving modifications made to the wheelchair, proper positioning, and measures applied to wheelchair users, themselves,” Dr. Ellison said. “The effects of these factors must be addressed for a wheelchair user to be as comfortable as possible.”

In other words, there is no "one size fits all" solution to wheelchair comfort. Everyone is different, but to find a solution that works best for you, consider the following:

Where pressure points exist on the body

Using a wheelchair places stress on the bony prominences or pressure points throughout the body. If you don’t take steps to pad these areas, pressure ulcers may develop.

“Identifying pressure points on your or your loved one’s body can make an enormous, even life-changing difference, in the comfort and usability of a wheelchair,” Dr. Ellison said.

“Points of pressure can be identified through a pressure mapping session, which can be coordinated through a wheelchair seating specialist. Once completed, caregivers can monitor locations on the wheelchair and on the wheelchair user's body to ensure no ulcers are developing.”

The wheelchair user’s position

“Much of a wheelchair user’s comfort is contingent upon how they’re positioned within the chair,” Dr. Ellison said. “Individualized cushions that are designed for a wheelchair are only effective to the degree that they are positioned properly against the wheelchair user's body.”

“A quick inspection of your loved one’s position within the chair can reduce discomfort and the likelihood of any pressure ulcer development.”

Whether the wheelchair has any potentially harmful pieces or components

“As a caregiver, make sure that contact is being made between your loved one and the wheelchair on the fleshiest, least bony parts of their body, and that this positioning is consistent from one day to the next,” Dr. Ellison said.

“What is most important is identifying where these points are on the wheelchair. A caregiver can easily inspect the wheelchair with their hands, looking for parts that could potentially cause injury or a wound, and then cover those locations with a softer material.”

The wheelchair user’s skin and clothing

“To be comfortable in a wheelchair, your loved one needs to be comfortable in their own body,” Dr. Ellison said. “Many caregivers moisturize pressure points and bony prominences with lotion, or if they have access to it, more nutrient-rich protective lubricants to make sure the skin is soft, malleable, and resilient.”

“Massaging potentially vulnerable parts of the body, like the elbows, hips, and back of the head can maximize blood flow to those areas and reduce the likelihood of problems arising.”

Dr. Ellison continued, “additionally, ensure there aren’t any wrinkles in your loved one’s clothing or fabric, as they can easily lead to the development of a wound. This also helps establish comfort and reduce pressure.”

What parts of a wheelchair can be modified for comfort?

Almost any part of a wheelchair can be modified to increase user comfort, including:

• Cushions

• Seat

• Footrest

• Backrest

• Lumbar supports

• Headrest

• Neckrest

• Foot pedals

• Handrests

• Electronics and/or adjustable components (for motorized wheelchairs)

Full-time wheelchair users may want to consider other accessories like storage pouches, folding trays, lap pads, or cup holders.

Easy ways to make your wheelchair more comfortable

Customizing your wheelchair is a very personal decision, but there are several things you can do, regardless of budget, including:

Meet with a seating specialist

If you plan on using a wheelchair for the first time, consider meeting with an expert who can make personalized recommendations.

“Wheelchair evaluations can be done by seating specialists, occupational therapists, or rehab technicians,” Dr. Ellison said.

Upgrade the seat cushion

“Not all wheelchair cushions are created equal and, given that the legs and buttocks absorb the greatest amount of pressure on a wheelchair user’s body, it’s absolutely essential the seat is properly chosen to meet the user’s needs and body type,” Dr. Ellison said.

“As a loved one’s body changes over time, so, too, should the wheelchair seat cushion. Regular evaluations should be made to ensure that proper contact is being made on the cushion and that no pressure ulcers are developing.” 

Properly position the headrest and armrests

Not everyone who uses a wheelchair needs head or armrests, but if you do, Dr. Ellison says it’s vital to position them correctly.

“Evaluate the head and armrests periodically to ensure that they are appropriate for the user, i.e. making proper contact and not creating any red marks.”

Pad the metal and plastic components

“Many wheelchair users devise solutions to discomfort on their own, through self-created innovations and interventions,” Dr. Ellison said.

“Some people use pliable, self-adhesive foam purchasable on the internet to cushion hard or obtrusive wheelchair parts, like metal bars or screws. Others use pieces of cloth, like blankets or towels, to buffer these potentially damaging parts of the wheelchair.”

Wheelchair Comfort: Pro Tips for Caregivers

As a caregiver, there are things you can do to help wheelchair users feel more comfortable too, including:

Being aware

“It’s absolutely critical for caregivers to be aware and vocal,” Dr. Ellison said. 

“Comfort in a wheelchair can range on a daily basis, just as can the development of a pressure wound, so it’s extremely important to check areas of the body consistently so that someone can remain in their wheelchair without a problem.”

Be respectful

“I know first-hand that using a wheelchair can present psychological challenges that may be subtle to others, but obvious to those who are in the chair,” Brasch said.

“I have experience with both walking and sitting in a wheelchair. When sitting in a chair I notice that other humans avoid eye contact and become more invasive with their offers of help. While this stems from good intentions on their part, I feel it’s important to acknowledge this reality and address it for the sake of wheelchair users’ psychological comfort.”

“To caregivers: in order to maximize a wheelchair user’s psychological comfort level, please make a conscious effort to look in our eyes and address us as you would any other person.” 

“To wheelchair users: your chair does not make you any less of a human or any less worthy. Other’s discomfort around you is not a representation of your worth.”

Don’t be afraid to try different things

Wheelchair comfort varies from day to day and week to week. The aging process and various other factors can affect how you or your loved one feel. Experiment with different cushions, blankets, and pillows. At the end of the day, living pain-free is the most important thing.

Making Your Wheelchair More Comfortable - Takeaways

Using a wheelchair doesn’t have to be a hassle. By following these simple tips and tricks, you can reduce the risk of musculoskeletal problems, pressure ulcers, and skin breakdown. 

“Ensuring comfort in a wheelchair isn’t something you should feel embarrassed or apologetic about, it’s a necessary part of quality-of-life, allowing someone to fully participate in the world: to engage in education, to be active in employment, to see friends and family, to take part in their communities,” Dr. Ellison said.

“For wheelchair users, the wheelchair is the avenue by which they can interact with the world, and it must be comfortable.”