Trying to decide on a new cushion gives most wheelchair users a wonderful opportunity to indulge in some serious head scratching. The experience also lends itself well to a bit of confusion and some intense anxiety. Presently there are a large number of cushions being offered up. Of course these cushions come in every conceivable shape, size, and form. While it is impossible to answer the age-old question of which cushion is the best one, it is possible to at least set you on a path that can help lead you to a better one.

There are some prerequisites that you should take care of before deciding on which cushion to lay your hard earned dollars and your butt down on. First, familiarize yourself with some of the products that are available. Get on the Internet and just browse the cushion manufacturers pages. Try to stick with manufacturers rather than retailers. The manufacturers information is better, as long as you ignore the accompanying hype. If you want a short cut to these manufacturers just go to either the wheelchair cushion manufacturers listing or the wheelchair cushion review section on United Spinal’s Techguide. Take note of the different materials the cushions are made of, the different shapes and contours, and cushion weight and types of covers. Start to formulate some thoughts on which types might work for you.

Next, start thinking about some of those special needs you may have.

• If you have limited use of your arms and need to be able to move the cushion during transfers, or into a car, or from one chair to another, then stay away from heavy cushions.
• Realize that some cushions require more maintenance than others. Some need to be pumped up with air, others need to be pounded into shape regularly, while some are just sit and go. How much maintenance are you willing and able to deal with?
• If incontinence is a problem, make sure that an incontinence cushion cover is available and that the cushion and cover are washable. Just as imporant, make sure the cover is easy to change.
• If you are just making it under desks and tables in your wheelchair, or if you don’t like sitting up high, than stay away from those high cushions.

If possible talk to other cushion users. Find out what they like and dislike about their cushions. How it holds up to daily use and how easy it is to live with.

Once you finish all of your homework you will be ready to move on to the next step. If you have complex or changing needs, or if you are unfortunate enough to be considered at high risk for developing a pressure sore, you may want to try to locate a facility in your area that has a seating clinic or a seating and mobility clinic. The clinicians should have experience in your particular type of disability. If you are a sixty year old quadriplegic you may not be well served by a seating clinic that treats primarily children.

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While we are on clinics- Prior to making an appointment, ask if the clinic has pressure mapping equipment. Pressure mapping makes it possible for you to see a visualization of the pressure between you and your cushion. It’s really great! You can try different cushions and see how they handle pressure. You can move around on the cushions and see where the pressure goes. You can also do your pressure lifts and shifts and see if they really eliminate pressure. It is a great tool and a super learning experience.

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Realize that seating is more than getting something soft under your butt. It is also about your posture and how you are positioned in the chair. Proper positioning while in a wheelchair works for you. You feel and look better and you will also be able to function better. Roll in front of a mirror and decide what you don’t like about your posture.

• Is your trunk leaning to one side?
• Is one hip lower than the other?
• Are your legs too far apart or too close together?
• Do you tend to slouch while sitting?
• Do you look worse this time then the last time you looked?

These are the types of things that you should discuss at the clinic. Write your thoughts down and also make some notes about what you do and do not like about your present cushion along with information on any pressure sores you have or have had. Take your notes to the clinic with you and read or give them to the staff there. The notes will help them to help you. Make your wishes and thoughts known to the clinic staff. They are not mind readers. Telling them only that you need a new cushion tells them almost nothing.

Make sure you get answers and explanations. Ask, ask, ask!
• Why was this specific cushion selected for you?
• How do you maintain and manage it?
• How long will the cushion last (worn out cushions are butt killers)?
• What can you do to relieve pressure aside from just using the cushion?
• What other issues come into play when managing your sitting pressure?
• How often do you need to inflate, pound, or rotate your cushion?
• Will it work for you in your vehicle if you drive?

Other wheelchair users are a good source of information. They can offer you insights into things like durability and ease of use of the cushion. You will need to remember that everyone’s physical condition is different, this may therefore lead to different outcomes.

Take your cushion and seating needs seriously. Remember, your cushion is connected to your butt.

Good luck with your seating.