ATP Series

"Do Not Hose Down Your Power Chair!"

5 Keys to Keeping Seating & Mobility Clean... in the Pandemic & Beyond

• By Laurie Watanabe
• Jun 01, 2022

Even before COVID-19, users of seating and wheeled mobility sometimes pushed boundaries when cleaning their equipment. How many of your clients or their caregivers have given power chairs a “car wash” with a garden hose?

What used to be straightforward manufacturer instructions for cleaning and maintenance have become more complicated, with additional directives from the Centers for Disease Control (CDC) and local health departments. Skilled nursing facilities, group homes, and assisted living centers have layered on their cleaning protocols, on top of the other instructions.

As these protocols grow more complex, here are five keys to keep in mind.

1. Cleaning Is Important (But It Isn’t Disinfecting)

There’s a difference between routinely cleaning a wheelchair — e.g., removing hair from casters — and disinfecting it.

Lindsey L. Sharpe, PT, DPT, ATP, is the Regional Clinical Education Manager/Southeast for Permobil. “Cleaning certainly can mitigate spread of infection, but also is a part of routine maintenance, which is necessary on all seating and mobility equipment,” she said. “Regular cleaning not only keeps wheelchair and seating equipment looking nice, but it also keeps it running optimally. For example, if manual chair users do not regularly remove hair that builds up around caster bearings, casters will not spin freely, which can impact rolling resistance and the chair’s performance.

“Additionally, we recommend wiping down your manual chair and/or your power wheelchair base with a soft cloth regularly to clean off dust and dirt that can build up and negatively impact its functionality and performance.”

2. Liquids & Power Chairs Don’t Mix

A good general rule, Sharpe said, is to prevent liquids from directly contacting the wheelchair. “If you want to clean your tires, wheels, the base of your power chair, the best way is to take a cloth, put a cleaner or a sanitizer on that, and do a wipe-down,” she said. “We never want to spray liquid directly into that base, because that’s where so many of the electronics are stored, where the batteries are stored. In a power chair, that could lead to a short in the system or potentially the chair not functioning at all if those electronics get wet.”

And put the garden hose away: “We do not recommend hosing down your power chair. When COVID started, we didn’t know if it could be transferred via surfaces, so we had to approach it as if it could. Stricter recommendations were coming out about cleaning equipment, but people were panicking and hosing down their wheelchairs.”

Also, try to avoid harsh chemicals. “All manufacturers have recommended guidelines for cleaning and maintaining their equipment,” Sharpe said. “Typically, no harsh chemicals are recommended for cleaning wheelchair and seating equipment. Harsh chemicals can damage the integrity of the cushion cover, foam, or whatever material the seating or mobility product is comprised of. This can ultimately lead to a product needing to be replaced sooner than it normally would. Recommended cleaning depends on the material the product is made from and what that material can tolerate without creating integrity issues or breaking down the equipment in some way.”

3. Start with the Manufacturer’s Instructions...

Yes, equipment comes with user’s manuals. No, most people don’t love reading them.

But they contain information on maintenance, and they’re the best place to look for advice on cleaning and disinfection.

“All manufacturers have recommended guidelines for cleaning and maintaining their equipment,” Sharpe said. “And every

manufacturer has their own recommendations.”

4. But Keep in Mind New COVID Protocols

“Then we have to consider if the product is in a facility such as a hospital or nursing home, because facilities have their own equipment-cleaning requirements that typically differ from the manufacturers’ recommendations,” Sharpe added. “Facility policies became more strict at the beginning and height of COVID, when infection control/sanitization of equipment was pushed to the forefront of hospitals, clinics, and nursing homes. Many facilities created dedicated infection control teams who are looking at current research, CDC [Centers for Disease Control] recommendations, county health department recommendations, etc.

“Those infection control specialists are often the ones setting cleaning and sanitization standards in the facility… and these often differ greatly from manufacturers’ recommendations, as they are thinking about controlling the spread of infection/disease/illness among the people who share that space. The thought process is very different than thinking about an individual who lives at home.”

As an example, Sharpe noted a Charlotte, N.C., hospital “whose county health department requires that they double bleach every cushion cover between patient use.” Not surprisingly, “We’re replacing cushion covers much more frequently than is typical because the covers are not designed to tolerate that level of harsh chemicals, especially at that frequency.”

5. So, Education Is Key, Across the Board

To reduce the element of surprise, seating teams can explain to everyone involved — from the person using the wheelchair to caregivers and funding sources — that, for example, cushion covers will wear out much more quickly under bleach protocols and will need more frequent reordering. Follow-up visits or calls can be a good time to discuss cleaning needs, Sharpe said, if equipment delivery day is too busy or overwhelming.

Clients and caregivers also need education on how daily use can impact how often seating and wheelchairs should be cleaned. “The world of wheelchairs is gray,” Sharpe said. “It seems nothing is black and white, as our users are unique. If someone is continent and sits on his cushion two hours per day, indoors only, he may find himself cleaning his cushion cover less frequently.”

On the other hand, there is the client — true example —who is a professional welder, sits in her chair 12 hours a day, and gets metal shavings on her air-cell cushion daily. That cushion cover will need frequent cleaning.

So it goes also for high-touch surfaces and components, from handrims and brakes on manual chairs to joysticks on power chairs. And of course, tires. “For dirt and debris, whether it’s a manual chair or a power chair, a lot of users love artificial grass rugs,” Sharpe said. “They keep those at their front or back door, or they line their ramp with it. Those rugs are tacky, but also tall and wiry, and they pull dirt and debris out of the tires. They’ll roll over the rug a couple of times before they go inside so that they’re not tracking in dirt and debris.”

Truly, the need for routine cleaning and disinfection are good things, even if cleanings are needed often. “It means they are using their chair and they’re living their lives,” Sharpe said. “I tell people, “You’re a heavy user, an active user. I mean that in a really good way. That’s what I want you to be.”

This article originally appeared in the May/Jun 2022 issue of Mobility Management.