Older wheelchair users are more likely to be seriously injured from tipping or falling than younger people who use wheelchairs. Following safety tips protects both users and caregivers from harm and strain.

Wheelchairs assist people who cannot walk or bear weight on their legs. The Centers for Disease Control and Prevention (CDC) reports that about 12% of adults in the United States live with a medical condition or injury that affects mobility and may require wheelchair use. This percentage includes around 7 out of every 100 older adults.

When individuals begin using a wheelchair, particularly older adults, they must follow key safety rules to avoid common but sometimes serious injuries relating to tipping and falls. Understanding risks and practicing safe use can help protect both users and caregivers.

This article discusses the safety guidelines for riding in a wheelchair and what caregivers assisting wheelchair users need to know about maneuvering these assistive devices safely.

Wheelchairs and Medicare

Medicare Part B and Medicare Advantage (Part C) cover 80% of the cost of renting or purchasing a manual or electric wheelchair under the durable medical equipment (DME) benefit.

To qualify, a person must have a mobility-related health condition, and a Medicare-approved doctor must certify medical necessity. The wheelchair must also come from a Medicare-approved supplier.

Beneficiaries may choose to rent or buy, and ownership transfers to them automatically after 13 months of rental.

First, a person must choose the wheelchair type that best fits their needs. Manual chairs rely on the user or caregiver for movement, while electric wheelchairs provide powered mobility for those with limited upper-body strength.

Secondly, wheelchair users always need to read and follow the operating manual closely, observe safety precautions, and perform regular maintenance. Caregivers can assist with this where necessary.

  • adjusting the seat so a person’s feet rest flat on the floor with their knees at right angles
  • locking the brakes or wheels, switching off the motor, and flipping the footplates before transfers, while placing the chair close to the bed or adding support seating as needed
  • avoiding pulling backward on doors or objects, as sudden releases can cause tipping
  • checking the armrests and leg rests for secure attachment before use
  • keeping heavy items off the rear of the chair to prevent tipping
  • installing anti-tip wheels or bars for added stability
  • keeping clothing and covers clear of wheel spokes
  • using a safety flag when on roads and adding headlights or flashing taillights at night

Caregivers also play a crucial role in wheelchair safety, especially when assisting older adults who may have difficulty managing safety practices independently. For this reason, caregivers need to know and apply the same safety tips as users.

In addition, those who regularly lift or maneuver a wheelchair can risk getting a strain injury. To avoid this, they need to maintain a stable stance with a straight spine, engage their core, bend their hips and knees, avoid twisting, and use leg strength instead of back strength.

When helping the person sit up in bed:

  1. move their legs to the edge
  2. pivot their body
  3. guide them into a sitting position with support

When helping them stand:

  1. lock the wheelchair
  2. place their feet on the floor
  3. keep the knees bent and the back straight
  4. hold them close and use your body weight to assist

When helping them sit down:

  1. pivot toward the chair
  2. bend your knees and lower them slowly
  3. ensure their hands are on the armrests.

Additionally, people can use a gait belt to provide extra support if necessary.

That said, caregivers also need to be mindful of some additional precautions:

  • Inspect the wheelchair: Check the brakes regularly, lubricate the wheels, tighten parts, and, for electric chairs, clean battery compartments and secure connections.
  • Clean the wheelchair: Sanitize the chair regularly, especially frequently-touched areas, to prevent the spread of germs that can cause infection.
  • Communicate clearly: Speak with the wheelchair user to adjust the chair for their comfort, letting them know before pushing the chair or transferring them.
  • Keep the environment safe: Remove clutter at home and watch for slopes, uneven ground, or obstacles outdoors.

As people age, their bodies naturally change, and abilities such as vision, strength, and balance may decline. These changes affect older wheelchair users by making it harder to stay safe in their chairs.

For instance, vision problems can increase the risk of running into obstacles, while a foot slipping off the footplate can cause tipping or sudden forward falls.

These incidents may result in anything from minor scrapes to serious injuries like fractures. Because older adults already have a higher risk of serious injury from falls, and about 50% of wheelchair users report musculoskeletal pain, primarily in the shoulders, it is important to reduce the risk of falls related to wheelchair use.

About 12% of United States adults, including seven in 100 older adults, rely on a wheelchair for mobility. Most wheelchair-related injuries occur from tipping or falling, but users and caregivers can reduce the risk of this by adopting safe habits.

Important steps include choosing the right chair with a doctor’s guidance, keeping it well-maintained, adjusting the seat properly, and locking the chair during transfers. A person also needs to keep clothing away from wheels, avoid placing heavy loads on the back, and add lights or flags for outdoor safety.

Caregivers need to maintain a safe posture when handling the chair, alert the user before moving it, assist carefully with transfers, and keep the environment free of hazards.