How to prescribe a wheelchair that actually works for your client

Prescribing a wheelchair isn’t just about choosing equipment, it’s critical to your client’s safety, independence, and long-term function. For support coordinators, case managers, and carers, it can be difficult to know what to consider, especially when balancing client needs, funding requirements, and future planning.

When wheelchair prescription isn’t done properly, it can lead to discomfort, reduced independence, and avoidable complications. When it’s done well, it supports safer movement, better positioning, and more effective participation in everyday life.

Why wheelchair prescription matters

A poorly prescribed wheelchair can impact far more than mobility. It can affect posture, limit function, and reduce a client’s ability to engage in daily activities.

A well considered wheelchair prescription can:

  • Support safe and efficient mobility

  • Improve posture and positioning

  • Increase independence in daily activities

  • Reduce reliance on carers and supports

  • Enable greater participation in the community

This is why wheelchair prescription should always involve a qualified occupational therapist or physiotherapist with experience in assistive technology.

Start with the person, not the equipment

One of the most common challenges we see is jumping straight to equipment options, rather than understanding the individual first.

Effective wheelchair prescription should always consider:

  • Physical ability (strength, posture, endurance)

  • Functional goals (home, community, social participation)

  • Cognitive or behavioural factors

  • Home environment and accessibility

  • Level of support available

Every recommendation should be tailored to how the client lives day-to-day, not just how they move.

Manual vs powered wheelchairs

Choosing between manual and powered options is a key part of wheelchair prescription, and it’s not always straightforward.

Manual wheelchairs may be suitable when:

  • The client has sufficient upper body strength

  • Distances are shorter

  • Support is available if needed

Powered wheelchairs may be more appropriate when:

  • Fatigue or endurance is a concern

  • Greater independence is needed in the community

  • The client has more complex mobility needs

In many cases, trialling both options helps determine what will actually work in real life settings.

Environment and everyday use

A wheelchair might work well in a clinic, but that doesn’t always translate to real life.

It’s important to assess:

  • Access within the home (doorways, bathrooms, layout)

  • Outdoor terrain and community environments

  • Transport requirements (vehicles, hoists, storage)

  • Day-to-day routines and activities

This ensures the wheelchair supports the client across all environments, not just one.

Funding considerations within the NDIS

Wheelchair prescription is often closely linked to assistive technology funding through the NDIS.

To support successful outcomes, it’s important to:

  • Align recommendations with the client’s NDIS goals

  • Provide clear clinical justification

  • Consider long-term value and durability

  • Plan for future needs, not just current presentation

Working with an experienced OT can help streamline the process and ensure documentation supports funding approval.

Trialling and ongoing adjustments

Wheelchair prescription should never be a one step process.

Trials are essential to:

  • Test comfort and usability

  • Identify any positioning or pressure concerns

  • Assess performance in real environments

Even after prescription, ongoing adjustments are often required to ensure the best possible fit and function over time.

Need support with a wheelchair prescription for your client?

Contact us today for expert guidance and tailored assistive technology solutions.

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Understanding the importance of mobility aids for independence