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Is it time for a wheelchair?

It’s one of the hardest conversations families have. Many older adults worry a wheelchair means “giving up.” In practice, the right chair — often used only part of the time — can mean getting back to appointments, family events and outings, safely and with energy to spare.

Written by Abhiraj Radhakrishnan, PT, MPT · 7-minute read

 

Signs it may be time

A wheelchair is worth considering when someone no longer has the strength, balance or endurance to walk safely for the distances daily life requires. Common signs:

• They can only walk short distances — even with a walker — before needing to stop
• They are very tired or short of breath after walking a short way
• Falls or near-falls keep happening despite using a walker
• They skip appointments, shopping or family events because walking there is too hard
• Pain limits how far they can go
• They have been weakened by an illness or hospital stay and long distances are not yet realistic

Part-time use: walking and a wheelchair

A wheelchair doesn’t have to replace walking. Many people walk at home — where distances are short and they can keep up their strength — and use a chair for longer outings like the mall, hospital visits or a day out.

Keep walking and exercising where it’s safe. Staying active helps protect strength and balance. A physiotherapist can help you find the right balance between walking and using the chair.

Types of wheelchairs

Type	How it works	Often suits	Keep in mind
Transport chair	Pushed by someone else. Usually has a basic sling seat without proper seating support, so it isn’t suitable for sitting for long periods.	Occasional outings with a helper	Light and easy to fold, but your parent can’t move it themselves. Not covered by ADP.
Manual wheelchair	Large rear wheels the user pushes, or a helper pushes	People with enough arm and/or leg strength and coordination to move themselves	Gives independence; needs proper sizing and a good cushion.
Power wheelchair or scooter	Battery powered, controlled by the user	People who can’t push a manual chair, but can drive safely	Needs good judgement, vision and reaction time; heavier and harder to transport.

More detail: see Types of wheelchairs for the five manual wheelchair types, tilt chairs and power options — with pictures.

Why fit matters

A chair that doesn’t fit can cause back and neck pain, poor posture, sliding forward, and pressure injuries (bed sores) from sitting. Seat width and depth, back height, footrests and the right cushion all need to match your parent’s body and needs. A seating assessment by an occupational therapist or physiotherapist is strongly recommended — especially if they will sit for long periods.

• Lock the brakes before every transfer in or out of the chair.
• Flip footrests out of the way before standing up.
• Check tires and brakes regularly.
• If your parent sits for long periods, they should shift their weight often — ask about a pressure-relieving cushion.

Paying for it: Ontario’s Assistive Devices Program (ADP)

If your parent lives in Ontario, has a valid health card, and will need the chair for 6 months or longer, ADP can help:

• ADP covers manual wheelchairs, power wheelchairs, power scooters and positioning items like cushions and back supports — but not transport chairs or most rentals.
• ADP pays 75% of the approved cost; you pay 25%. People receiving Ontario Works or ODSP may have the full cost covered. Income isn’t a factor.
• Your parent must be assessed first by an ADP-registered occupational therapist or physiotherapist, then buy from an ADP-registered vendor. ADP aims to review applications within about 8 weeks.
• Don’t buy first — otherwise you may have to pay the full cost.

Step by step: our ADP funding guide walks you through the whole process — with a quick check to see whether you may qualify.

Need a chair for a short time, for example after surgery? ADP doesn’t cover short-term needs or most rentals — many medical supply stores rent wheelchairs by the week or month.

Talking with your parent

• Start with what matters to them — a grandchild’s recital, church, the garden centre — and how a chair could help them get there.
• Suggest trying one for a single outing first.
• Make it clear it’s about saving energy for the things they enjoy, not about giving up walking.
• Involve their doctor or therapist — a professional’s advice is often easier to accept than family’s.

Getting an assessment

If you’re noticing the signs above, ask your parent’s family doctor about a referral, or contact a physiotherapist or occupational therapist. If your parent suddenly can’t walk or stand, or has new weakness or confusion, call 911 or see a doctor right away.

Sources
Mobility Assistive Device Use in Older Adults — American Family Physician, 2021
Geriatric Assistive Devices — American Family Physician, 2011
Mobility aids — Assistive Devices Program, Government of Ontario

This article is general information, not a personal assessment. Every person is different — have a physiotherapist or occupational therapist check which chair is right, and how to use it safely.