In a Wheelchair and Behind the Wheel

Robert P. Bennett

Originally published in "The New York Times"
Sunday, September 20,1998
page 1 - section 12 - "Automobiles"

PEOPLE with physical disabilities spend their days overcoming barriers. Like the able-bodied, many with disabilities find that using a private vehicle is the essence of personal freedom.

So when disabled people shop for a vehicle, they need one that can accommodate their mobility devices as well as themselves. The vehicle may also need to be altered for special equipment, like zero-effort steering mechanisms or touch-pad controls, so a flexible design is important.

And Dan Bussani, shop manager for J. Bussani Inc., of Bethpage, N.Y., which equips vehicles with special gear, said only about half those with adapted vehicles drive. As passengers, the others, including children and severely disabled adults, may have other special needs.

While the range of vehicles acceptable to people with disabilities remains somewhat limited, the group's needs are being met better today than ever before.

There may be fewer two-door cars on the market -- the wider doors of coupes make it easier to load and unload wheelchairs -- but the doors are lighter on those that remain. Extended cabs with three and four doors, coupled with wheelchair lifts, have made the pickup truck a reasonable alternative to the car. And a wide selection of vans is available to companies that do customizing. Even sport utility vehicles can be valid choices because new models like the Subaru Forester are lower to the ground and easier to enter.

With any vehicle, disabled drivers have to consider the elevation of the seat, the distance from the ground to the door sill and the angle of the steering wheel.

Some 450 conversion companies modify up to 20,000 vehicles a year for private use, according to Becky Plank, executive director of the National Mobility Equipment Dealers Association in Tampa, Fla. These adaptations not only make it easier for people with impaired mobility to get in and out of cars, trucks and vans, they also make driving possible for amputees, sufferers of severe arthritis and the hearing-impaired.

According to the Census Bureau, 4 percent of Americans aged 17 to 75 -- some 7.3 million people -- have physical disabilities that limit their mobility.

About half these people use wheelchairs, scooters or other mobility devices, according to Jack MacNeil of the bureau's disabilities data unit.

Auto makers seem to be taking the market seriously. The leading manufacturers offer some incentives and cash-back programs to help with what can be costly modifications. These programs do not fully pay for the most extensive modifications, nor do they pay for retrofitting older vehicles. They do provide buyers of new vehicles as much as $1,000 to cover minor changes -- a fraction of the tens of thousands of dollars that could be required to, say, convert a van for a wheelchair. In some case, health insurance may cover part of the costs, and financial aid may be available from a variety of organizations and government agencies.

The key to selecting a vehicle is how well it meets one's needs, or can be modified. Most hospitals for physical rehabilitation provide evaluations.

Maureen Linden, who conducts evaluations at the Helen Hayes Hospital in West Haverstraw, N.Y., said the first consideration was whether a person can move into a car's seat without wheelchair assistance. "If people can transfer independently and load their chair, then they can drive a regular car," she said. "If not, can they transfer into the seat of a van?"

The next consideration, she said, is "if a standard car is acceptable, are the doors wide enough to load a wheelchair into the back seat?"

For most disabled drivers and those who transport disabled children, vans are the vehicles of choice. Those using power wheelchairs, which are much larger than manual chairs, usually need the extra room of a full-size van like the Chevrolet Express, Ford Club Wagon or Dodge Ram Wagon.

The choice may depend on how easily the van can be modified to accept a wheelchair or other device. Many full-sized vans cannot be easily adapted because their rear-wheel-drive configuration makes it impossible to lower the floor for easy access. Although a lift or a ramp could be added, the roof must often be raised to add sufficient headroom. Vision is also often restricted because a wheelchair tends to be higher than a conventional van seat.

In fact, several conversion companies registered a preference for Ford's big van, saying it was easiest to adapt.

"Ford's full-size vans, particularly the E-150, can be easily modified," Mr. Bussani said. "Modified mini-vans are growing in popularity, in part because they cost less while offering many options and many possibilities for customizing."

"But they also have limitations," he added. "They are less roomy, but since nearly all have front-wheel drive, they can be fitted with a lowered floor, necessary for people who use wheelchairs and scooters."

Dwain Nunn, chief operations officer for Independent Mobility Systems, a van-conversion company, said that although the Ford Windstar is a bit less roomy than a full-size, rear-drive van, it is favored by many.

Mr. Nunn said converters will generally not use an import because they are less roomy. But this may change. The 1998 Toyota Sienna is nearly as large as the domestic mini-vans are, and the new Honda Odyssey is even bigger.

Stacey Nebenzahl of Jupiter, Fla., said her family chose a Chrysler Town and Country mini-van because it was easier to drive and park. "Although it is costly to purchase and convert a mini-van for a disabled person, it has become a huge asset to me and my family," said Ms. Nebenzahl, 37, who has spina bifida. The alternative was to buy a conventional van with a raised roof.

Her mini-van has a lowered floor and wheelchair ramp. After opening the sliding door with a remote control or a switch, the van "kneels" and the ramp automatically comes down. Once inside, the wheelchair is secured by a locking system on the floor.

If a wheelchair lift is chosen rather than a ramp, the purchaser also has two broad choices: those that transport an individual while seated in the chair or other mobility device or those that carry only the device. For the most part, if a person has assistance or is able to get into a vehicle on his own, a lift that carries only the mobility aide should be suitable.

After devices that transport people and mobility devices into vehicles, hand controls are the most common adaptations. The type of control a disabled driver uses largely depends on the extent of her disability. So-called right-angle controls, which are mounted to the steering column and require a downward motion to activate, are generally considered the least complicated and most comfortable.

On the other hand, Peter Hillcoff, president of Automobility, a producer of hand controls in East Regina, Saskatchewan, said push-pull controls are best for people with limited upper-body strength.

Steering mechanisms also come in several forms. Those with good upper body strength, mobility and dexterity can use a spinner knob, which are similar to the steering wheel knobs commonly found on 1950's hot rods. People who cannot manage these, like quadriplegics or those with severe arthritis, can control steering with the help of a three-pin device that holds the hand in place.

Ron Willouby of Berea, Ky., a quadriplegic who has complete sensation but no muscle control, drives a full-size 1989 Ford van, which he bought used; it already had a lift, automatic sliding doors, hand controls and a special cuff that holds his hand in place on the steering wheel. Mr. Willouby, 46, who was injured in a diving accident 23 years ago, had previously driven a car with special hand controls and a spinner knob.

"I had a manual chair and used to have to do transfers," he said. "But that got to be pretty rough after a while. Now I drive from my wheelchair. I went from a car to a van because my transferring skills got weaker and also because it's a whole lot easier getting in and out of the van and driving from my chair. I feel safe driving in the chair because it was designed to fit me.

The tiedowns that I use are also very safe. Once I'm locked in position I won't move."

Mr. Willouby said that the ability to drive comfortably has changed his life.

"The van makes it easier for me to do the things I like to do," he said. "I go hunting and fishing a lot these days. I have a lot more confidence in myself and my driving."

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