What is Co-Design, and how can I use it to choose a new wheelchair?

Amy de Paula, Forward Occupational Therapist

Getting a new wheelchair can be both exciting and daunting. There are many approaches and choices within the process. Sometimes choice has been determined by cost, funding, or availability of quality advice. Sometimes choice has been put in the hands of a ‘professional’, or desirable professional advice has not been available. A new and helpful word has emerged in the sector: co-design.

What is Co-Design?

Co-design is a social process, a creative mix of viewpoints to achieve a design greater than anyone could come up with on their own¹.

We all have goals or aims or just ways that we want to live our lives. People with a lifelong disability often identify that their wheelchair is a part of them or a part of their personal space2. As such, the choice and care of this essential item becomes as inherently a part of their life as caring for themselves. It also deserves the same dignity and support as other self-care, such as access to appropriate professionals. Like other forms of care, this should not take away the individual’s right to choice.

What features are important in my new chair?

Wheelchair prescriptions are a complex configuration of features, with hundreds of decisions. Large decisions, like powered vs manual chair; and small decisions, like what angle the foot support should hang from. Who makes those decisions and why? The best scripts are well thought out and approached from multiple angles. This is why co-design is helpful. Each angle is discussed and laid out collaboratively by different people who can understand them from a different perspective.

In planning what features are going to be important, it is good to think about four main areas²:

• Myself: What I need for the chair to fit me and my mobility
• What I do: What the chair needs to be able to accommodate for my goals, roles and activities
• Where I need to go: What features are required so that my chair performs optimally in my most valued and necessary environments
• Cultural, personal and relationships: How will the chair interact with my significant others, and how does it fit with my lifestyle. What have I learned from chairs in the past?

Tips for finding the right people for the process:

When choosing who you want to co-design with, it is perfectly reasonable to discuss how much experience the professional you are considering adding to your team has in wheelchair and seating prescription and in your disability specific needs. Do you need a team of thousands? Absolutely not, but finding the right people is important. The process usually includes an Occupational Therapist or Physiotherapist, but can also include Rehab Engineers, suppliers, nurses, your medical team, family, friends and peers with lived experience. Co-design offers you the option to add to your team who you need.

Getting the fit right:

Adjusting to a new chair is a transition. In part, it just takes time. But there are also adjustments in most systems that can completely alter the fit and success of your mobility. Small changes in seating can make considerable changes in pressure care and function. Small changes in suspension or controllers in power wheelchairs can have a significant impact on the ride feel and on how you can use your chair. Don’t assume nothing can be done after delivery if it doesn’t feel right.
Like any big transition, plan for it. Work out what might be challenging and set aside time to work through these challenges. Ask your co-design team for advice and use their skills to your advantage.

Final advice:

Be curious. Ask questions and listen to answers. Don’t ask for an exact replica of your existing system until you are sure that is what you want. New technology and designs can offer new options that might work for you, and if you aren’t sure what will, build the right team to give you the answers you need.

1. Steen, M. (2013). Co-design as a process of joint inquiry and imagination. Design Issues, 29(2), 16-28.
2. Ripat, J., Verdonck M., & Carter, R. J. (2018). The meaning ascribed to wheeled mobility devices by individuals who use wheelchairs and scooters: a metasynthesis. Disability and Rehabilitation: Assistive Technology, 13(3), 253–262. https://doi.org/10.1080/17483107.2017.1306594

With acknowledgements to Wendy Harris, Robyn Ryan, Jason Lowe, Blair McFarlane, Kirsty Kinch, Bronwyn Chandler and Liz Dallaway