For many older adults and people with disabilities, there comes a time when getting in and out of a car requires more than a grab bar or door strap. For caregivers, modifying or purchasing a vehicle to transport a mobility-challenged loved one can seem overwhelming, involving a host of equipment options and myriad safety and financial issues.
It’s not a process to take lightly. “People spend a lot on this stuff, and they should make sure it’s the right stuff,” says Elin Schold Davis, an expert on mobility for older adults at the American Occupational Therapy Association.
Depending on your situation, the right stuff could be anything from a crash-tested wheelchair to a heavily modified minivan. Even experienced caregivers familiar with transporting loved ones can be daunted by today’s array of accessibility hardware, says John Schall, CEO of the Caregivers Action Network, a nonprofit education and advocacy group.
Here are some key things to consider and resources to consult.
Experts recommend that people with limited mobility continue to use a vehicle’s regular passenger seat for as long as possible rather than riding in a wheelchair. “That’s the better choice,” says Kathleen Klinich, a mechanical engineer and associate research scientist of the University of Michigan Transportation Research Institute (UMTRI).
A car’s original seats must meet federal safety standards requiring a frontal crash test at 35 mph. There’s no such government mandate for wheelchairs in cars. But shifting into the regular car seat may be impractical, or even impossible, for wheelchair users with severe mobility limitations or caregivers who are themselves older or lack the strength to repeatedly lift or support someone in and out of a vehicle seat, Schall says.
People in these situations may want to seek out wheelchairs rated WC19, a voluntary industry standard adopted by some manufacturers for devices doing double duty carrying passengers in vehicles. The standard is based on crash testing and is certified by the Rehabilitation Engineering and Assistive Technology Society of North America. The UMTRI website provides a list of WC19-rated chairs.
These devices, sometimes described by sellers as a “transit option,” cost roughly $400 to $1,000 more than non-WC19 chairs, according to Klinich. Medicare generally will pay most of the cost of a wheelchair that is prescribed by a doctor for use at home, as will some private insurers, but they will not cover the extra expense of getting a chair rated for transportation safety, she says.
“Insurance not paying for it is kind of the barrier” to wide acceptance of WC19 chairs, Klinich adds. “I think if Medicare started doing it, others would.”
Securing the chair
If riding in a wheelchair is the preferred choice for your situation, you’ll need to install a mechanism to clamp the chair in place in the vehicle. These are often marketed as “wheelchair securement” systems. Well-known brands include Q’Straint and Sure-Lok.
One option is a tie-down system, with four straps that hook on to the wheelchair frame to secure the chair. The straps can be anchored to bolts, brackets or tracks mounted on or built into the vehicle floor. For each ride, someone other than the wheelchair user has to attach the strap-and-hook mechanisms to the chair and cinch them tight to keep the chair secure. (Some systems can automatically retract the strap to reach the proper tension.)
WC19 chairs come with places to hook the straps, according to UMTRI. If you’re using another kind of chair, attach the hooks only to welded parts of the frame, not adjustable or moving parts like wheels or foot supports.Basic tie-down kits start at a few hundred dollars, but they can cost considerably more with features like automatic cinching of the strap or attached lap and shoulder belts.
A potentially more expensive but less taxing option is a docking station. With these floor-mounted brackets, there’s no need for a second person to manually secure the wheelchair. The user rolls the chair into a V-shaped opening that narrows into a slit, under which a lock snaps closed around a bar attached to the bottom of the chair. Pressing a button electronically releases the chair when the ride is over. Docking stations from the main manufacturers, Q’Straint and EZ Lock, cost around $1,500 with installation.
Makers of both tie-down and docking systems typically sell to distributors of mobility equipment, and that’s where you’ll want to shop. The National Mobility Equipment Dealers Association (NMEDA) offers an online directory of accredited dealers and installers.
Depending on the system you use, the securement setup can be placed in the front passenger seat position, allowing the wheelchair user to ride “shotgun,” or in rear locations. It’s up to you, but wherever you put the wheelchair hardware, the original car seat has to come out.
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Getting the wheelchair into the vehicle is easier if the vehicle has been modified, typically with a lowered floor and built-in ramps. That way, someone using a power wheelchair can motor into the vehicle without help. Even with a manual chair, the lowered floor means less effort for the user to roll it or for the caregiver to push it up and into place.
Outfitting an auto for greater accessibility is a major commitment. It can cost anywhere from $16,000, to modify a vehicle you already own, to more than $80,000, to buy a new, late-model conversion, according to BraunAbility, which sells accessible autos and other mobility equipment through a national network of dealers.
Most modified vehicles are minivans, which offer the most room inside and already have large sliding doors that ease wheelchair access. Some dealers offer converted SUVs, but they are generally pricier than vans. Converting an SUV requires replacing a conventional swing-open side door with a sliding version.
BraunAbility’s modified Chevrolet Traverse SUV lists for about $82,000 new. The company’s new converted vans start at around $52,000 but can cost well over $80,000, depending on the model (choices include Chrysler’s Pacifica and Voyager and the Toyota Sienna) and the ramp location (rear or side entry) and type (fold-out or power operated). At MobilityWorks, another dealer, older used conversions run from around $25,000 to $60,000.
To find a vehicle and design that the mobility industry has reviewed for compliance with federal safety standards, consult the NMEDA's list of safety-certified models offered by its member dealers.
You may be able to get financial help for obtaining a wheelchair-ready vehicle. “The most robust funding sources are [from the] government,” says Amy Schoppman, director of government relations at the NMEDA.
Some states have programs to help residents get mobility equipment, and military veterans with a service-related disability can apply to the U.S. Department of Veterans Affairs for an auto grant of about $22,000 for the purchase of a specially equipped vehicle.
James R. Healey is a contributing writer who covers automotive news. He was an auto writer and a weekly columnist at USA Today for 27 years. His work also has appeared in Car and Driver and at Trucks.com.