The car is the hard part. You cannot stand on the surgical side to pivot into a low sedan seat, and the wheelchair has to travel with you, so a van you roll into and stay seated in is the easier ride. Ours is $115 each way or $230 round trip within five miles of one of our offices, then $2 a mile after that.

Why is a car harder than people expect?

A car transfer is a one legged move. Somebody has to get you from the chair into a seat that sits lower than the chair does, with no weight going through the operated side, and then get the wheelchair into the trunk. In a hospital driveway with two people and a nurse watching, that often works. In your own driveway three weeks later, with one family member and a cold morning, it is where people fall.

In a wheelchair van you never leave the chair. The ramp comes down, you roll on, the chair gets secured with a four point tie down, and the limb stays supported the whole way. There is no lift, no pivot, no trunk.

Is the ride home from the hospital, or from rehab?

Usually from rehab. Most people do not go from the surgical floor to their living room. There is an inpatient rehab or skilled nursing stay in between, sometimes a week, sometimes several, and the ride families forget to plan is the second one, out of rehab and home. Nobody schedules that ride for you the way discharge planning handles the first transfer, and families often find out the morning of.

Ask the case manager two questions early: who is arranging the ride home, and is the house going to work when you get there. The second question matters more than it sounds.

What about the front steps?

This is the part that sends people back to rehab. A van gets you to the curb. Four granite steps into a Brockton three family, or a side door with a landing and a turn, does not care that the van was accessible. A ramp is the right answer and it is also the slow answer: a permanent ramp means a contractor, a measurement, and often a permit, and that runs weeks.

For the day itself, two trained staff and a motorized stair chair get you up the steps seated and belted. That is $200 a visit , and it is what most people use for the trip home and again for follow up appointments until a ramp is in. We will give you the chair's rated weight capacity on the phone.

How long will the wheelchair be part of daily life?

Longer than most families plan for. A prosthetic socket cannot be made properly until the swelling in the residual limb settles, and that takes weeks. Some people leave the hospital with a temporary limb, most do not walk out on one. Rehabilitation after a leg amputation is commonly measured in months, and can run close to a year before things feel settled. Plan the house and the rides around the chair, and treat the prosthesis as good news that arrives later.

What trips come after the ride home?

More than people expect, which is why the ride home is worth solving as a system and not as one trip. In the first two months you are typically going out for wound checks, the surgeon or vascular follow up, physical therapy, and the prosthetist for casting and fittings. Each of those is a round trip, each one involves the steps, and they land on weekdays whether or not somebody in the family can take the morning off.

If the appointments repeat on a pattern, tell us the pattern and we will hold the slots instead of you booking each one cold.

Who helps at home in the first weeks?

A home health aide, for the parts that are physical and constant: transfers in and out of the chair, getting to the bathroom, bathing, dressing, meals, laundry, and being in the house so the first trip to the bathroom at night is not done alone. Nighttime bathroom trips are where falls happen in the first month, and a fall onto a fresh surgical site is the thing everybody is trying to avoid.

Home health aide care is $45 an hour , one to eight hours a day, no minimum contract and no assessment fee. An overnight is $540 for a twelve hour night. Around the clock is $1,080 a day . Most families after an amputation start with mornings and one or two overnights a week, then cut back as transfers get steadier.

What does an aide not do?

Dressing changes and wound care. Our aides are trained, background checked and insured, but they are not nurses and they do not administer medication. Surgical wound care after an amputation belongs to the visiting nurse the hospital or rehab sets up, and that is usually covered under Medicare for a defined period. The aide covers the hours the nurse is not there, which is almost all of them.

Cheaper options to ask about first

• The case manager or social worker at the hospital or rehab. Ask directly whether a discharge ride can be arranged and whether any of it is covered. Sometimes it can.
• PT-1 , if the person has MassHealth. It is the state's non emergency medical transportation program and it pays for rides to covered appointments. The form goes through the medical provider, it takes lead time, and it will not help you at nine o'clock tonight, but for a long run of therapy and prosthetist visits it is worth starting.
• The local Council on Aging . Most Massachusetts towns run a van, often free or a few dollars. Ask whether it takes a wheelchair and whether it goes out of town, because many stay local.
• The Medicare Advantage plan , if there is one. A lot of plans include a set number of one way trips a year and members never use them. Call the number on the card and ask.
• The prosthetist's office . They see this every week and often know which local service other patients use.

If one of those works, use it. Hire a private van for the trips those options cannot cover: the discharge day, the appointment outside the town van's range, the morning something moved.

What does the whole first week cost?

A typical discharge day with us is the van one way plus the stair chair, so $115 plus $200. Add a first wound check round trip at $230. If you want an aide for four hours each morning that week, that is $180 a day. A family covering mornings themselves and buying only the two rides and the steps is spending a few hundred dollars, not a few thousand.

Where do you go?

We work out of Woburn, Brockton and Springfield and cover most of eastern and central Massachusetts, including the Boston hospitals, Lahey, Newton-Wellesley, Baystate and the rehab hospitals in between. Call 781-957-8076 and tell us the discharge date, the address, and how many steps are at the door. That last one decides how many staff we send.

This page is general information about arranging transportation and home care, not medical advice. Follow the instructions your surgical team gave you.