Just like in the story of Goldilocks and the Three Bears, a "just-right" fit is imperative for people confined to wheelchairs. However, some people are more interested in choosing a chair to suit their sense of style or one that is within their price range; facilities are also guilty of overlooking the importance of the wheelchair. A chair that's too big or too small (or poorly constructed) can have harmful consequences. Nursing Homes/Long Term Care Management recently spoke with health science researcher Deborah Gavin-Dreschnack, PhD, about matching the individual to the wheelchair to ensure optimum safety, comfort, and protection.

Would you discuss the assertion that wheelchairs designed for short-range perambulation--"standard" wheelchairs--are being used as chronic resting places by the elderly? Also, that wheelchairs in most common use are unlikely to help most elderly women?

Dr. Gavin-Dreschnack: While some community nursing homes are beginning to purchase a mix of wheelchairs (e.g., narrow, extra-wide, hemi [a chair that is or has the adaptability to be lower to the floor, enabling users to reach the floor for foot propelling], recliner, etc.), the majority still appear to buy "fleets" of wheelchairs, most of which are standard width with sling seats and backs. The problem is that these chairs, regardless of width, do not provide proper pelvic stability, but rather provide a "hammocking" effect that does not distribute weight effectively and causes the hips, legs, and knees to roll inward. Elderly women, particularly those who are short in stature and might have kyphotic spines, often cannot reach the wheels for independent propulsion. Another factor is the weight of the standard wheelchair, which can be 40 to 50 pounds, rendering it difficult, if not impossible, to self-propel. The height of the wheelchair seat from the floor also is an important consideration for nursing home residents who need to use their feet to propel. This is common after strokes that have affected one side of the body.  Medical Supply.