Car Modifications for Welcabs & Patient Transfers for Wheelchair Users in Singapore

Introduction

Getting a loved one safely in and out of a car is a tricky task and for caregivers, physically demanding and technically complex. Repeated heavy lifting in awkward positions to balance the user’s weight and wheelchair vis-a-vis car doors, opening heights, safety locking brackets etc, place stress on caregivers and may also be uncomfortable for the person receiving care. 

For families considering purchasing a new vehicle or adapting an existing one, there are transfer aids and vehicle adaptations that caregivers can assess to make outings safer, easier and more comfortable, depending on considerations around a full wheelchair-accessible vehicle or simple, affordable solutions. Costs vary widely depending on the vehicle model, conversion type and custom requirements. 

Always begin with a detailed assessment to ensure the right fit for your family’s needs. Before making a decision, consider obtaining assessments and quotations from two or three providers to compare available options. You should also check the relevant regulatory requirements with the Land Transport Authority (LTA) and your occupational therapist first.

The right vehicle adaptations can make a meaningful difference to everyday life. Many caregivers find that reducing the physical demands of transfers gives them greater confidence to bring their loved ones out for medical appointments, family gatherings or leisure activities.

Welcab and Conversions: Making Your Vehicle More Accessible

A Welcab (wheelchair-accessible vehicle) is a proprietary or specially modified car to make travelling easier for wheelchair users in several ways. 

Rear Ramp Welcab

Depending on your family’s needs, one type of Welcab that can be proprietary or modified, is the rear ramp type MPV (multi-purpose vehicle) where a wheelchair can simply be pushed up the rear of a car without the user leaving the wheelchair at all. These Welcabs are the most suitable for users who do not have upper body control. These cars are usually 3-row 7-seater MPVs with big, boxy cabins, and the fit will be snug if there are middle row seats and a wheelchair behind. Some Welcabs remove one of the second row seats all together. Wheelchairs will not be able to recline or tilt and wheelchair user will have to sit upright. 

Users will also tend to feel that this kind of Welcab is the shakiest ride for them, because the wheelchair center of gravity is higher than normal car seats and are tension anchored on four sides, rather than being hard-fixed to base of the car body.

There are small variations amongst car models that have rear ramps including:

a.    manual or motorized ramps
b.    fixed hook safety locking brackets or mechanized winch system (to help pull the wheelchair upslope)


Photo credit: Toyota Noah Hybrid Welcab, WelcabSG 

Many car companies do not carry these custom built Welcabs, especially new car distributors, sadly. There are parallel import car sellers that do bring these in new but they are rare in recent years. One such specialized importer of Welcabs is:

•    Welcab SG: Offers a range of full-sized MPV Welcabs including Toyota Noah Hybrid, Alphard, Vellfire, and other models with ramp or specialised access solutions.

Due to their demand, some car companies offer LTA approved car modifications with professional engineer test certifications. Companies that offer modifications to MPVs that can fit a rear ramp and wheelchair include:

•   Ikodo / Kodo Mobility Solutions: Wheelchair ramp conversions for MPVs and other vehicles. Request a professional assessment first.

•    SCW Automotive: Car lifts, ramps, and experience converting vehicles like the Toyota Noah for accessibility.

It is important to check with these companies before you commit to buying a car to convert to a welcab because there are critical heights, lengths, widths and positions of anchor requirements that must be met by the car to be feasible. Also, every wheelchair passenger is of a different height and the type of wheelchair also has different dimensions. 

Manual or Powered Swivel Seats 

Several providers offer this kind of vehicle accessibility conversion solutions, including:

•    Ikodo / Kodo Mobility Solutions: Dealer offering swivel seats (the seat rotates and extends), removable wheel carriages, and passenger seat modifications. Request a professional assessment first.c

•    Wong Fong Motor Workshop: BraunAbility dealer offering swivel seats (the seat rotates and extends), removable wheel carriages, and passenger seat modifications. Request a professional assessment first.

•    Arian Mobility: BraunAbility dealer offering swivel seats (the seat rotates and extends), removable wheel carriages, and passenger seat modifications. Request a professional assessment first.

There are two types of conversions this kind of Welcab can take: front passenger seat (swing car door) or middle row passenger seat (sliding car door). Both kinds have manual and powered models. For this kind of Welcab, the user has to transfer from their wheelchair onto this swivel seat that is fixed to the car at the point of boarding. This can be done by the patient themselves if able, or carried by caregivers, or with another kind of transfer aid. For most elderly users who can still stand a little during pivot, this is especially useful for them to get into a low sedan car because he/she sits on the swiveled out seat without having to balance on one leg first to get in the traditional usual way. 

The advantage of front passenger seat conversion is good visibility for the user for the car ride. Many sedan cars can take this conversion of a single normal front passenger seat into a swivel seat. However, there are some that cannot due to shape of dashboard during swivel, or height of base vis-à-vis the overall opening height for the user body. The disadvantage is that openings of most front car doors are low or sloping in shape, so the user will have to dip their heads or slant their bodies so they can swivel in. 

Photo credit: “Turny® Manual: The hand-operated swivel base for your car seat, making wheelchair-to-car transfers easy.” 

The advantage of second-row passenger seat conversion is for the MPV, where the height of door opening and sliding door does not get in the way. The down-side to this, is that you can only convert bigger MPVs with sliding doors to use this model of swivel seat.

Photo credit: “KODO Excel swivel seat is a kind of equipment to make easy entrance of SUV, MPV etc.” 

Converted Car Seat Wheelchairs with Removeable Wheel Carriages (Manual or Powered)

These are the most technically complex sort of conversion and hence caregivers must be trained to operate these safely, especially for individuals who require higher levels of assistance on the powered swivel seats. These solutions typically require professional assessment and training before use.

The feature of these converted car seat wheelchairs is that they can be used as normal wheelchairs when disengaged from the car and onto a removeable wheel carriage, but also engaged and locked in to the base of the car with the removeable wheel carriage stored in the car trunk for car rides. On a normal day when not in use, this wheelchair stays in the car as a normal car seat and the user should be on another normal wheelchair, making this Welcab wheelchair only used for when going out. Once the user is on this wheelchair car seat, ideally there is no further transfer necessary, whether getting in or out of car. 

Because of this feature, caregivers have to learn to use the levers, sliding and pivoting mechanisms for engagement and disengagement of the car wheelchair seat to the wheel carriage, for both manual and motoroised versions. Both front passenger seat and second row passenger seat conversions are available. This is likely the costliest type of Welcab and there are proprietary versions and converted MPV versions.  

Photo credit: Carony® Classic: Transfer from wheelchair to car seat without lifting

Photo credit: KODO Emerald – Hydraulic Detachable Welcab
 

Affordable Transfer Aids for Everyday Use

A full vehicle conversion may not be necessary—or feasible—for every family. There are several lower-cost aids that can significantly reduce the effort required during transfers.
 

Swivel Cushions

Placed on the car seat, swivel cushions are rotating disc below cushions that allow the user to rotate more easily when getting in or out of the vehicle, reducing twisting and lifting for both caregiver and user. They are widely available from local retailers and online marketplaces at around ~$20-$50. However, the user is required to have some sort of ability to lift their own legs and turn their torso for this to be used independently. Otherwise, the caregiver has to lift their legs and turn their torso for them at the same time.

Photo credit: The Golden Concepts Swivel Cushion 

Transfer (Gait) Belts

Transfer belts provide caregivers with a secure and comfortable grip when assisting someone to stand or pivot, improving safety during transfers. 

Photo credit: The Golden Concepts Transfer Belt with Thigh Strap 

NUH has shared videos of transfer of wheelchair use into front passenger car seat, without a transfer gait belt, with one or two caregivers but the concept and the positioning is the same and very important and relevant to watch. This type of transfer is certainly easier when the wheelchair user is able to stand and pivot and hold onto the caregiver around the upper torso. Even though this does not necessarily mean that a car transfer is impossible for wheelchair users who are unable to do so, appropriate assistance and adaptations can help to make the transfer safer and more manageable.

Photo credit: Car Transfer with 1 carer (Pivot Transfer), NUH Occupational Therapy 

Safety First

Before purchasing any transfer equipment or vehicle or vehicle modification solutions, it is advisable to seek an assessment from an Occupational Therapist (OT).

An OT can:

•    Assess the care recipient’s mobility and transfer abilities.
•    Recommend equipment that is appropriate for both caregiver and care recipient.
•    Provide caregiver training on safe transfer techniques.
•    Advise on vehicle modifications that best suit your family’s needs.

Using equipment that is not suitable—or using it incorrectly—may increase the risk of injury to both the caregiver and care recipient. Speak with your hospital or healthcare provider to arrange an OT assessment. Subsidies may be available for eligible individuals.

Disclaimer:
This article is intended for general information only and is based on caregiver experiences and publicly available resources. Product offerings, regulations, subsidies and eligibility criteria may change over time. Please verify the latest information with the relevant providers, the Agency for Integrated Care (AIC), SG Enable, the Land Transport Authority (LTA), or your healthcare team before making any decisions.

Home Nursing Foundation (HNF) and CarersHub.sg do not endorse or sponsor any products or service providers mentioned in this article.