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Tuesday, July 23, 2013

A Good Idea at What Cost

Since I was ill in 2010 it has become increasingly difficult if not impossible for me to get from the floor back into my wheelchair. This is an important ability since I live alone and the reality is I fall out of my wheelchair. When I do fall I can get back into the wheelchair but it is a time consuming process and extremely difficult. Getting back into my wheelchair after a fall involves crawling to a couch, going from floor to couch, couch to wheelchair without a cushion, then from wheelchair to bed to put cushion under my ass. I do not recommend falling.

The struggle to go from floor to wheelchair is a first and foremost a safety issue. Yet it also infringes upon what I can do. Swimming, camping, and biking become problematic. The problem is as much mental as it is practical. Like many others I embrace an extreme form of independence.  I hate asking for help. I have mellowed a bit as I have aged thanks in large part to participation in adaptive sports.  When skiing for example I need help to get to the lift as well as help getting on and off said lift. There is irony here that I am well aware of.

I have racked my brain for ways to get from floor to wheelchair. Enter the Para Ladder. The Para Ladder is a great idea. I have seen ads and thought this is the perfect solution.  See  Check out the photo:

This simple design solves my problem. Not so fast. The Para Ladder is essentially an 11 pound step ladder. It retails at various websites for $700 to $800.

Alternatives exist with slight modifications.  Here is a standard $70 house hold step stool.

Clearly this step stool is not ideal. The Para Ladder is a far better design. But it also costs $700+ I am happy to save over $600 and modify an inexpensive step stool. I can envision many ways to make a step stool work for my needs. If can figure this out I am sure others can as well.


tigrlily said...

A lot of people make a lot of money off of people with disability. The independent living movement has always had a branch that dealt with cheap and easy modifications to make access possible. We used blocks under the feet of standard desks and tables to raise them to a height that wheelchairs could fit under at the Boston CIL. More recently I've seen people hacking their CPAPs to adjust the pressure, instead of doing a whole new sleep study just to learn what they already know; they need to raise the pressure.

The Medical Industrial Complex generates income both by commodifying disability and maintaining the medical model of disability.

backyard mechanics, do-it-yourselfers, amateur inventors and hackers will be a crucial part of the solution to this problem. Probably 3-D printers will be as well, but since the price is still too high for these devices, the jury is still out on the exact role they will play.

Matthew Smith said...

That's disgraceful. There's obviously nothing to that metal step ladder - it's just a metal tube frame with strategically placed platforms. A good idea, but clearly not worth that much money and whoever makes it is creaming off a tidy profit.

william Peace said...

Tigrlity, There is a long history of creative adaptation in the disability community. I worry that creativity is being lost. I see newly minted cripples woefully unprepared to deal with social stigma and a for profit health care system. Think fatted lambs to the slaughter for profiteers. I am all for creative innovation and sharing that knowledge.
Matthew, The man that invented the Para Ladder is a paraplegic. He came up with the idea because like me he struggles to get in and out the wheelchair. Sadly, many people with a disability are content making money selling over priced products to their crippled peers. This is especially true with regard to adaptive sport gear.

Stephen said...

I forwarded the link to this blog post to Para Ladder inviting them to respond.

william Peace said...

Stephen, Do you think the price for the para ladder is appropriate?

Stephen said...
This comment has been removed by the author.
A said...

You know what would be so cool? A website by and for users dedicated to DYI solutions. (Does this already exist?) I don't have a lift for my daughter, but if we ever have to go in that direction I will absolutely check out the engine hoists. Love that suggestion. At the other end of the spectrum, just out of curiosity, did you ever try the iBot? We did, and really I thought it was very interesting. I've never seen anyone out on the street with one, though.

Becs said...

I'll bet you could get a local carpenter or automotive tinkerer to come up with one for far less and would be safer than the step stool.

william Peace said...

A. There is historical president for your suggestion on about creating a clearing house of practical information. Gini Laurie worked at the Toomey Pavillion Rehab Center in the 1940s. At the time polio rehab involved months if not years in rehab. Laurie created the Toomey Gazette so people could stay in touch when thye were discharged. The Gazette quickly became akin to popular mechanics for crippled people. It contained a bunch of how to features. I have often wondered if issues of the Toomey Gazette are archived in a library.

Claire said...

PVC tubing and some melamine planks. You can make something just as safe as that thing. I know because at one point, I was looking to make a crawling support device for my daughter. PVC tubing is AWESOME! Kinda like lego for adults.

william Peace said...

Claire, When my son was a little boy in the summer I made crazy PVC sprinkler system with garden hose. Love PVC. Cheaper than copper and easy to cut and glue. Even I can do plumbing with PVC

Carwile said...

i scrape my ass with paraladder

A said...

A paraladder wouldn't help me get my kid off the floor, but a comfy self-inflating hassock that went from
flat to 24 inches or so would be very nice... and easy to transport, when it was flat. Invent this, someone!

A said...

BTW, I meant DIY, of course. Just noticed I scrambled the letters.

william Peace said...

Carwile, I am stunned the Para Ladder has no padding. I can easily see how one could scratch skin.
A. The Para Ladder clearly is only for men and women with good upper arm strength.

Lynn said...

The fact that it has the handrails *and* folds flat makes it a clever design. That's a helluva price tag for "clever," though. And I agree, my first though upon seeing the picture was to cringe at how skin-unfriendly it looks. For seven hundred bucks, it should be like sitting on a cloud - a cloud that levitates you into the chair while you relax and sip a Margarita.

When I went to check out the Abilities Expo in San Jose last year, I walked around having pretty much this same reaction to most of what I saw. Clever, but who can afford this?!? And while people are trying to make a buck selling clever, whiz-bang bells-and-whistles to the 1%, there are *no* market forces at work to improve the baseline level of equipment that most regular people have to struggle along with. Entry-level wheelchairs and walkers today are identical to the ones being sold 25 years ago when I graduated from PT school. These products could be SO much better, but there's no money in improving them, so they remain frozen in time, dragging down the quality of life of millions of users.

I agree with Claire - PVC is the way to go for railings. This might be a good, relatively skin-friendly product to use for the steps; it's a little low, but if it sat atop a base that raised the whole thing a couple of inches and also anchored the PVC railings, you'd have a nice functional unit. And it costs only half as much as the step stool :-)

Lynn said...

P.S. If one actually had $700 (or even $500) to throw at this problem and wanted or needed a lower-exertion method of gaining altitude, there are a number of rechargeable battery-powered bathtub lifts on the market, which can raise up to 300# from 2" to 18" at the touch of a button. This further highlights the silliness of a product with no moving parts costing as much as it does.

A said...

While I could get my daughter off the floor with a bath lift, they
are heavy to lug around. Something that inflated like a plastic inflatable mattress but with enough stability designed in (eg baffles, wide base, contoured seat) so it wouldn't be tippy or perilous would be terrific. And deflated, it could fit in a backpack, of course. I look forward to downloading this into my 3D printer.

Martha said...

I work for a metal worker - I am sending him this right now to see what he can come up with!

Rene de la Tour said...

My name is Rene' de la Tour and I am the inventor of the Para Ladder. I also set the price. From reading the post on this site I can see there is a lot of misunderstanding regarding the pricing of the Para Ladder and that I am perceived as a greedy business owner capitalizing off of other handicapped individuals. None of which is close to the truth but I can understand how it may seem so. Please let me explain and address a few opinions and views on this blog. I hope by the by the time you finish reading my explanation you have a better understanding of the Para Ladder business and myself. And, I welcome all comments and suggestions:


I share the frustration of the publicregarding the cost of a Para Ladder, but unfortunately I have not yet uncovered a solution allowing me to lower the price without cutting quality. We will never cut quality.

The Para Ladder is made offshore which allows us to price the Para Ladder at 1/3 of the cost of having it manufactured in the U.S. I felt it was more important for the paraplegic population to be able to purchase one of our devices at the lowest price possible opposed to having a sticker on the device saying "Made In the USA".

Rene de la Tour said...

PART 2 -
The PL is exceptionally well made, far superior to a Home Depot type product, and is designed to last for many years. If you were able to use one or have an opportunity to handle a Para Ladder the product would clearly stand out as a highly professional made device. Part of the reason Childrens Hospital, Johns Hopkins Hospital, Shepard Spinal Center, Jim Thorpe Rehabilitation facility, the VA Medical Centers nation wide and other rehab facilities rely on training their patients on the Para Ladder is because it is such a well constructed device and the only device designed to assist a paraplegic perform an UNASSISTED floor to wheelchair transfer. The second reason is it is the ONLY patented, FDA approved designed specificly for paraplegics. Over a 1,000 limited mobility individuals are living a better quality of life thanks to the Para Ladder, and they can safely preform an UNASSISTED floor transfer while maintaining their dignity.

As for pricing -
The dealers who sell our Para Ladder do make a small profit.
But you may be surprised to discover that everyone working for We Care Designs, LLC is a volunteer, including myself. There are no paid employees, no bonuses, no dividend plan, no money going out of the company to anyone. And we are not a 501C.

Every dollar earned is reinvested into business expenses and for purchasing more inventory. This reinvestment plan I designed so we can sell Para Ladders at a minimal cost. I would like to sell it for less and understand the misunderstanding of some of the public because I have been a T9 paraplegic for 47 years and had 3 shoulder operations so when I buy items for myself I can see the financial abuse that handicapped individuals face.

Rene de la Tour said...

PART 3 -
I make "0" for every Para Ladder sale. I share my office, at no charge to We Care Designs to warehouse, sell, ship and handle all aspects of the Para Ladder business. At no charge, we handle all marketing, pay all insurance, pay the FDA fees, pay the patent yearly fees, attorney fees, warehouse fees, handle all shipping, and all the other necessary facets of running the Para Ladder business. We do this because we know there are people that could not afford a Para Ladder if salaries were paid and the Para Ladder was priced at true retail. I know many para's need the Para Ladder as much as I do and we are doing our best to try and keep the price as affordable as possible. I believe working for years without drawing a dollar, taking time from my family to see that someone gets their Para Ladder in a timely manner or an ad gets in a publication on time is helping other paraplegics.

I understand that you and some others think the Para Ladder is over priced. May I ask you to compare the price of a few devices to the Para ladder cost and rethink your opinion.
a)Compare the cost of a Para Ladder to a $350 ROHO Low Profile Single Compartment Wheelchair Cushion. It is made of about $15 of rubber. The ROHO is half the price of a Para Ladder and is mold injected rubber, thats it!
b) Want a Nuprodx MultiChair 3000TX, Portable Folding Shower Chair at $1036? Its made of thin aluminum and a plastic seat and back.
c) Want a Saratoga Colorado Sport Table Top Hand Cycle at $790...... and another $750 just for the table it sits on?
d) How about a 65 pound Invacare Chrome Hydraulic Patient Lift for $800....and don't forget to have an attendant to help crank you up.
All of the products listed above are offered by "For Profit" companies, and the excessive pricing is directly due to paying salaries, bonuses, etc.
Using the same business physiology the Para Ladder could be priced at $1,800, but few paraplegics could afford to pay this rate out of pocket.
We are proud of our operation and the price we offer the Para Ladder.

All things considered, the Para Ladder is priced as affordably as possible. If our sales were to increase considerably, we may be able to
lower the price by ordering in larger volume. I am hoping this occurs in the foreseeable future so all wheelchair users can afford a Para
Ladder. I am trying to make this happen ASAP.

I hope the information above helps you and others understand the Para Ladder pricing. If you have a suggestion that would lower the cost of the Para Ladder without compromising its integrity I would love to hear form you.


René de la Tour
Inventor / Owner
We Care Designs, LLC
428 Bill Drive
Mandeville, LA 70448
985-373-1113 Direct
985-727-7824 Fax

Rene de la Tour said...


The Para Ladder has been tested with 600 pounds with out failure. It is well built!

If you can perform a pressure release you can use a Para Ladder. It does not require as the strength as you may think. We have users ranging from 5years old to 90 years old. Remember you are not lifting your entire body, just your upper body.

As for no padding, if you desire padding one can cut Yoga matting and use contact cement to secure it to the seats. Want more padding? Use the garden kneeling pads from Home Depot and contact them to the seats. each cushion is made with close cell foam and will not absorb water.

Hope this helps.
Rene' de la Tour

william Peace said...

Rene, Thank you for your long and detailed reply. Of the posts I have put up you own the lone company I would not accuse of trying to make a huge profit at the expense of people with a disability. I see now I should have made this clear. I do not doubt the Para Ladder is well manufactured. I am also sure it is vastly superior to anything I would purchase at the Home Depot or other big box store. It is a clever design and from my perspective the only flaw I see is the lack of padding. I understand this can be added by the purchaser. But as you know skin care is critically important hence I believe it should an integral part of the product.
I appreciate the explanation for why the Para Ladder is so expensive. Looking at it from my end, an individual consumer, it is well past my budget. The same could be said for the vast majority of paraplegics. According to various sources nearly 60% of paraplegics remain consistently unemployed after injury. Over 50% of paraplegics live at or below the poverty line. I focus specifically on paraplegics because the product is designed for such individuals.
I think we are in some ways talking past one another; we have comparable goals--empower our paralyzed peers--but go about his differently. Based on your mention of who uses the para ladder, the VA and rehab hospitals, it is clear to me your market is not paralyzed individuals but institutions. For institutions $600 or $700 is easily affordable if not down right cheap. Thus think of it from a user perspective. Your well designed product could be jury rigged for well under $100. When one worries about how to buy gas, pay rent, and groceries the financial equation is simple. The para ladder is well beyond people's budget.

william Peace said...

Part 2.
Rene, I am not surprised there is no profit margin in the para ladder. I also am not surprised the dealers that sell it make a small profit. And to reiterate I get this is not a money making enterprise for you and para ladder employees. I am not a business man so take this suggestion from an academic with a grain of salt. Jack up the price to an obscene price--more than the $1,800 you mention. Create an institution price and an individual price. Academic journals do this. I could subscribe to a journal for $75 while a library pays over $1,000. Use the institutional price to subsidize the individual price point. Is this legal? I doubt it.
As for the products you list in your part three comment, I agree the mark up is insane. In fact one could make the argument the mark up is unethical. Here I think Roho stands out as the biggest offender. These cushions do not last long and cost pennies on the dollar to make. I despise roho even though I have used the cushion since I was 18 years old.
At the end of the day I cannot help but conclude your clever well made para ladder is an interesting product that a very small number of paralyzed people can afford. This is not your fault of course. I get what you are doing but the sad reality is the people that need the para ladder the most simply cannot afford to purchase it and instead do what I have suggested--jury rig a comparable device.
Again thanks for your detailed comments. It has greatly enhanced this discussion.

Rene de la Tour said...

Mr. Pearce and readers,
Thank you for your reply and insightful suggestions. As much as I would like to apply your suggestion of the two tier pricing to help subsidize the people who cannot afford my device, it would not work. I have been given pricing guidelines by the VA and other large facilities to prevent them from having to subsidize any product. In fact, they want a discounted price to that of the out of pocket buyer and if discovered that you sold you device for less to others they would cease any further purchases.

You may find it enlightening that 50% of the Para Ladder sales are made by individuals out of pocket. I have to assume most of this group have either received large settlements, been successful in business or have family assistance.

I elected not to form a 501c because it would not benefit the out of pocket buyer and I did not want the government telling me how to operate my business, but you have triggered an interesting thought. Suppose we ( the para population ) were able to solicit a philanthropist to step forward with a humanitarian donation, not for another art museum wing but a donation to We Care Designs used solely for subsidizing those who cannot afford a Para Ladder. Surely there has to be a wealthy person in this country who would love to help improve the lives of financially suppressed handicapped individuals with the donation of a device that would improve the quality of life and dignity to the less fortunate.

If anyone reading this blog wants to help our challenged group then step up to the plate and try to be the one that brings forth a philanthropist that is willing to make a donation that will help thousands of limited mobility individuals such as paraplegics, amputees, spinal bifida, multiple sclerosis, post polio, senior citizens, etc. A wonderful chance to help thousands of less fortunate individuals live better lives.

Rene de la Tour said...

The Para Ladder Use -
Recently we have discovered another wonderful use for the Para Ladder. With the assistance of the Para Ladder four people in hospice were able to remain home until they passed opposed to being placed in a nursing home. As these people got weaker they started falling. Normally at this point hospice suggest placing the person in a nursing home but each person using a Para Ladder was able to return to a standing position following a fall that did not result in an injury. When their condition worsened they could be assisted up the Para Ladder by a family member with minimal risk of back injury (see example on video at They were also pleased with the dignity of using the Para Ladder in the privacy of their own home. When they reached a point that they were confined to a bed they were able to do so in the comfort of their own home until they passed. What a blessing to have a humane and loving end for your loved one.

william Peace said...

Rene, I assumed my suggestion would not work. The sort of philanthropy you suggest, i.e. a person willing to make a large donation, is becoming increasingly rare. I also have grave reservations about such a strategy as the charity model of disability causes as much damage as it helps. While a far cry from the Jerry Lewis style humiliation parades on the MDA telethons of days gone by, I am extremely hesitant to seek funding this way.
I am amazed 50 % of sales are out of pocket purchases. How many do you sell a year?

Lynn said...

If I may offer a slightly tangential brainstorm... if one were looking to set up a stationary unit in one's home for getting up off the floor independently, the attachment of some sort of sling seat or climbing harness to an inexpensive device like this one would allow vertical movement with the mechanical advantage of a 4:1 lift ratio. (With apologies for the "perfect for deer and antelope" marketing :-D )