Chapter twenty-four
OUT AND ABOUT
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Chapter twenty-fourOUT AND ABOUT |
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Note: This is the original text of the chapter in the 1992 book and it has not been updated. Page numbers refer to pages in the book.
Out and about on your own two feet
Manual and electric wheelchairs
Pamela's solution – 'Get on your bike'!
Public and community transport
Using a car
The Disability Living Allowance (DLA) mobility component
Further Reading
Though we YPAs have our fair share of mobility difficulties, and from time to time do let wheels 'take the strain', most of us aren't full-time wheelchair-users. I've written this chapter with that in mind, so if you are, on the contrary, wheelchair-dependent, please bear in mind you'll need more detailed, specialist information and advice. Your healthcare team will help you. So too will many of the other information sources I mention.
One book, free to disabled people, and well worth getting however mild or severe your mobility difficulties is Door to Door (A guide to transport for people with disabilities), available by post (no stamp needed) from the Department of Transport. It's packed with information – gadgets and benefits, walking and wheelchairs, cars, travel by taxi, bus, train, underground, air, sea, coach, and holiday travel, plus Dial-a-Rides and similar schemes – it could well start you solving problems you thought were insoluble.
The other key book is Motoring and Mobility for Disabled People by Ann Darnborough and Derek Kinrade, published by RADAR. It's weighty, but economically priced and jampacked with information on every aspect of getting from A to B.
Let's look at the simplest things first, to help those of you who can get out and about on your own feet, after a fashion, anyway! However young and deceptively sprightly you look, you probably still welcome ways of cutting down on pain, fatigue, stiffness, plus the frustrations that go with them – call it all 'aggro' for short. Here are just a few ideas for cutting down on the aggro:
Choosing the right stick
Your doctor, physio or OT can advise on the best stick for you personally. Only a limited range is available under the NHS, and you might prefer to payout a few pounds to buy a different one. A commercial supplier's leaflet (see page 144), or DLF's list will show what's available, but you should still get professional advice on its suitability for you.
I was amazed at just how much easier the right-shaped handle made things for me. It's a sort of 'mirror shape' of my distorted hand, so every twist and turn fits comfortably and helps spread the load. Don't forget to listen to professional advice on which hand to use the stick in. I was horrified to hear a lady say 'no one told me I was using it in the wrong hand'. It should be held at the side opposite the weaker leg, and moved forward with the weaker leg, so the leg gets all the support it needs. Get professional advice too on correct stick length; it makes a great difference.
A stick should always have a rubber end (ferrule) on the bottom. Avoid smooth ferrules. Choose one with the biggest road-gripping surface that will fit the stick. Keep it clean, and change it for a new one as soon as it starts getting worn down. Larger chemists (eg Boots) and walking stick shops sell them. Commercial suppliers on page 144 sell them by mail order, or you can ask for them under the NHS.
Sticks have minds of their own and easily fall. Maddening if you can't bend to pick yours up. By chance, I'm sure, my stick's handle is shaped so I can lever it up using my foot! But preferring prevention to cure whenever possible, I also fix a loop of ribbon or cord around the stick and loop it over my hand. Hand can then be used if necessary, without the need to work out where to rest the stick (but beware of tripping up over a dangling stick). You can also get special holders to support a stick when fixed to a table.
Try a folding stick if you only want one 'just in case'. You can keep it folded away in a bag till needed. However, closing and opening it up may be difficult, so try out someone else's before you buy, if you can. Chester-Care sell folding sticks; so do Cooper Care and Comfort (folding 'cumfy crutches' and walking frames too). Stick umbrellas are also available, and even walking sticks with an inbuilt shrill alarm (eg from Raymer Ltd).
A stick seat takes the weight off your feet when a seat's not available, and is usually more stable than the familiar shooting stick. Stick seats come in various sizes and weights, and with different types of 'grip'. However many are heavy to carry, and don't usually give as effective support for walking as an ordinary stick. In the right situation though, they can be a boon. I keep one at work to take with me when I have to visit another office where the seats are too low. My boyfriend carries one for me when we're out and about in seatless territories. Mine's made by Phillips of Axminster, with a canvas seat, and comes in four heights. (Also from suppliers on page 144.) G & C Products make lightweight 'Flipsticks', with a flick-down triangular seat you can perch on, and which pack into a neat carrying-pouch. You'd need to be sure you could balance comfortably and safely before you buy one.
Most of us aren't full-time wheelchair users though might use one temporarily now and again. Sometimes it's the lesser of two evils – uncooperative legs either confine you to stay miserably at home alone, or you opt for the chair so you can face going out with the family around the zoo or to the seaside or whatever.
Self-propelled wheelchairs are difficult for people with weak hands and stiff shoulders, and satisfactory wheelchair pushers few and far between! Pushing's an underestimated skill. Educate your pusher by getting the booklet How to Push a Wheelchair by David Griffiths and David Wynne, from the Disabled Motorists' Club.
You might have other ideas. A powered chair or electric 'scooter' definitely makes you feel independent, and you don't need a driving licence! Scooters are attractive, and useful 'icebreakers'. Children love the jolly bright yellow scoota I use from time to time. You can even whiz round large exhibitions and superstores on them. Though some have special 'kerb-climbers', kerbs are usually impossible, so you need to be sure of ramped kerbs on your route, or have a strong muscle man to hand, as the scooter batteries make them extremely heavy to lift. Beware of losing your concentration: some can tip over if you don't watch where you're going. But advantages usually outweigh the disadvantages:
"For days out I have my 'Lark' scooter. My husband and I take it in turns to ride because I like to stretch my legs now and again. The scooter creates no end of interest when we are out and I've given several people a ride to try it out. On a good day I don't use it at all! I bought mine second-hand and find it very useful." (Jacqueline S, who's had RA since her early 2Os, now in her mid 50s.)
Jennifer Purple resigned herself to a very long wait when she heard how much she'd have to save to get a battery car, but a friend's mum got in on the act:
"Unknown to me she spoke to her daughter and about two weeks later they popped round. They suggested they raised the money towards my battery car and their aim was to raise £2000 in about 18 months. After letting people in the village know of their plans they started off with a garden party on a sunny day in May with lots of people there… At the end of the day over £300 was raised. This is how things went on, the villagers raised money with discos, jokes and sponsored events. After one year over one thousand pounds was raised.
"I had still been collecting Battery Car leaflets, etc. We asked for a demonstration, but unfortunately I found I could not manage the handlebars with the controls on. I was so disappointed, as I liked it so much. But all was not lost, the demonstrator suggested cutting off the handlebars and using a joystick control, something like a helicopter. So this was how it was produced, straight from the production line, brand new. One month later it was delivered… complete with joystick control and a seat belt." (In Contact)
Kay Jones bought her electric indoor/outdoor wheelchair with mobility allowance, after being a full-time wheelchair user for about four or five years:
"So has it been worthwhile you ask? Well it took a while to learn to drive, being very powerful, the battery capacity is that of a car; I kangarooed like a learner driver for the first few weeks! I was initially nervy at going out, crossing roads under my own responsibility being somewhat new and even now I don't like crossing major roads (we have quite a few death traps here!) if alone. Kerb climbing too requires nerves as although it is safe there is an art to it and you feel rather catapulted until you get used to the effect. Also if you do not approach the kerb correctly, you won't get up it but it really only comes down to common sense.
"My first few trials I have been accompanied, as I've never been out alone. I thought I would be very panicky at the prospect of going out alone, but today, spring sun shining I ventured out alone and loved it! No doubt passers-by thought I'd escaped from the local asylum, as I kept trundling up and down, turning round, exploring unvisited roads, stopping to look at houses I'd previously been whistled past, but the feeling of being at your own command was wonderful! …if you are faced with life in a wheelchair and a car is out of the question, as it was for me, think hard about buying an electric wheelchair, it's possibly the best thing I've ever done in my life and is certainly going to open up my life with the new freedoms I now have." (In Contact)
If you need a manual wheelchair, get expert advice from the doctor/0T/physio first. S/he can help you get a push-only or self-propelled manual one on temporary or permanent loan from the NHS Disablement Services Authority (DSA).
Powered wheelchairs are more difficult to get. – If you can't walk and can't propel a manual wheelchair, the DSA may supply a powered wheelchair, but only for indoor use. They'll only consider a powered chair for outdoor use if you can't propel a manual wheelchair yourself and if they agree (rarely) your attendant isn't able to push you instead. If, however, you need a manual or a powered wheelchair for work, then your jobcentre DRO can help.
The British Red Cross Society loans out manual wheelchairs for temporary use – useful if you're staying away from home on holiday, perhaps. Motoring and Mobility (see page 189) lists wheelchair hire firms.
Powered wheelchairs/scooters come in all shapes and sizes but are expensive (though VAT-free). DLF's Wheelchairs leaflet includes electrically operated wheelchairs and there's a useful guide How to Choose a Pavement Vehicle, available free from Banstead Mobility Centre. Chat to your OT/physio too. If you qualify for DLA mobility component, you can use it for buying a powered chair. Motability has negotiated special terms with some manufacturers. If money's no object all sorts of refinements are available, including a powered wheelchair with a seat you can raise to reach high shelves and lower as you wish!
You can see and try several types in one go at places like the Transport and Road Research Laboratory's Mobility Roadshow (see page 186), or at the NAIDEX shows (page 144) and some disabled living centres (see page 143).
Some are available second-hand. It's a good idea to seek advice on purchasing from the British Association of Wheelchair Distributors. The DLF keeps lists, and Exchange and Mart magazine carries adverts. So does RADAR's monthly bulletin, and the magazines of the Disabled Drivers' Association and Disabled Motorists' Club. New and reconditioned ones are available from other places too, eg at the Keep-Able Centre (see Motoring and Mobility). Ask your DIAL what's available locally and try the Yellow Pages.
Pamela Waterhouse developed RA in her early 30s, and was depressed and frustrated at not being able to get out of the house on her own. She couldn't drive. However…
"One day I was falling asleep watching 'Pebble Mill at One' when an item jerked me wide awake. They were demonstrating ordinary bicycles with battery run motors attached – a miracle designed for me, I thought. It took a long time to convince the family that it would be suitable but finally, in August, we travelled up to the factory in the Midlands for me to have a trial run. This proved to be quite an ordeal in front of the men of the factory and with the salesman running, puffing alongside me, especially as I hadn't ridden a bike for nearly twenty years! Eventually, they found a bike which could be adapted low enough for my short little legs and we travelled home with my newly acquired miracle folded up in the back of the car.
"The feeling of independence which the bike has given me is unbelievable. Of course, things haven't been all plain sailing. Like the time I had a puncture up a mountain and had to waylay a friendly farmer. And like the time the wind blew my hat off and a bus ran over it!… But the pleasures far outweigh the tribulations. To be able to pop down to my mother's for coffee, to go to choir practice, fostering meetings all on my own with the wind blowing in my hair is a real joy." (In Contact)
She couldn't at first use the bike on her 'worst' days because it had to be pedalled a few yards before the motor could be turned on. But:
"the firm which produce this miracle have been most helpful. They've adapted the motor now so that it can be used straight away without my having to pedal. This makes it even more useful because I can now restart on the steepest of hills…"
Electric tricycles are available for people who can't manage bikes. Neatwork is one company that specialises in adapted bikes and tricycles for disabled people and their families (even tandem trikes!). Or look in the Yellow Pages or Thomson Directory. The firm Pamela used no longer does bikes.
Some areas, eg Edinburgh and London, operate special schemes so you can use ordinary taxis at special rates. Ask your local DIAL, CAB, or social services what's available locally, eg 'Dial-a-Ride', cars) driven by volunteers (eg WRVS), wheelchair accessible buses. In London I use the Taxicard scheme for black cabs (for London residents only, details from LRT Taxicard Section). Black cabs aren't easy to get in. – My method is to back on to the tip-up seat, easing my legs round and into the cab, which avoids strain on the, hip and knee joints. I stay on the tip-up seat (a little precariously!) for the whole journey. Recent cab models have tip-up seats that swivel out making the process easier.
The DRO/Employment Service will subsidise taxi fares to work if you're severely disabled, on the Disabled Persons' Employment Register, and having to pay extra travel costs because you can't use public transport.
Remember, do plan ahead. Find out all you can about your journey beforehand and work out how you'll cope. Tripscope (see page 277) could help – it's a telephone helpline (office hours), which can help you work out the best way to travel, taking into account your special needs. If you need help from anyone on your journey (eg BR) ask well in advance. Phone again shortly before you travel as a reminder.
For bus travel information, get the Bus and Coach Council's Getting Around (free). Ask too at the nearest coach station of the company or companies operating in your area, or at a local travel agent. For rail information look at British Rail and Disabled Travellers (from your local station) and A Guide to British Rail for Disabled People (RADAR), with details of access and facilities at over 400 stations.
For travel in London: contact London Regional Transport (LRT)'s special Unit for Disabled Passengers. Look at 'Visiting London' on page 276. In Newcastle-upon-Tyne, the Tyne and Wear Metro was designed to be fully accessible to all disabled people and has specially designed interchanges with parking for disabled people and access to bus stations. Manchester's new trams are also designed to be accessible.
For information on air travel: get the appropriate British Airports Authority (BAA) Who looks after you at… Airport? These outline facilities at Heathrow, Gatwick, Stansted, Glasgow, Edinburgh, Prestwick, Aberdeen. Contact other airports direct for information. Ask individual airlines about special arrangements too. Even if you can walk, but it's a real struggle, using a pre-booked wheelchair/electric buggy can make all the difference. Some airlines produce special information leaflets, eg British Airways, from BA Customer Services. Also useful: Care in the Air – Advice for Handicapped Travellers, free, from the Civil Aviation Authority (CAA).
Travel by sea: several ships now have lifts and toilets for disabled people, but find out for sure and make arrangements well in advance. Ask individual ports and ferry companies for information on access, eg assistance with parking your car near a lift. On some ships fare concessions are available for registered disabled people who are members of the Disabled Drivers' Association or Disabled Drivers' Motor Club.
Other useful travel information appears in chapter 34 on 'holidays', and in the publications mentioned on page 189. RADAR has a range of access guides available by post.
Whether you're a passenger, a driver, or a would-be driver, the two publications mentioned at the start of this chapter, Door to Door and Motoring and Mobility will tell you far more than I ever could about subjects like choosing a car (new or secondhand), car finance, makers' discounts, DLA mobility component, Motability hiring and HP schemes, adaptations and accessories, assessment centres, learning to drive, taking your car on holiday, breakdown and recovery services, etc. ARC's Driving and Your Arthritis is worth getting too (free, but send SAE). Here are a few titbits to be going on with.
The Orange Badge scheme
Get a leaflet and application form from your social services department. With an Orange Badge you can, whether driver or passenger, park free and without limit at on-street parking meters and in time-limited waiting areas. You can also park for a limited period on yellow lines in England and Wales, and without time limit in Scotland, except in bus lanes or where loading and unloading is prohibited. You must park safely and cause no obstruction.
You qualify for a Badge if you get DLA mobility component, or if you have a 'permanent and substantial disability which causes inability to walk or very considerable difficulty in walking'. You don't have to be registered disabled. Your doctor may be asked to confirm the disability, and you may be asked to go for a medical examination. Some local authorities may make a small charge. (OB rules are under review as I write.)
Seat belts
There are gadgets to help with reaching a stowed seat belt. Birch Products' Pulla belt is a removable, adjustable plastic clip which grips the seat belt, to form an extension handle. Beacon Associates' Clever Clip has a locking device which grips an inertia (self-adjusting) seat belt to stop it fully recoiling, thus leaving a longer end to catch hold of.
Specialised advice on car purchase and adaptations
If you're already a licensed driver who develops a disability lasting more than three months, you're required by law to inform the Driver and Vehicle Licensing Agency (DVLA). Don't despair if the arthritis starts making driving more difficult. Problems can often be overcome. Finding out about just two or three adaptations (eg hand-brake assistance, mirrors/lenses to overcome stiff neck problems reversing) could well be all it takes for you to continue happily driving your usual car. A disabled driver may qualify for exemption from road tax: check with DVLA.
If you're starting from scratch, you have to report any illness when you apply for a provisional licence. You'll be asked to fill in an extra form. Get What You Need to Know About Driver Licensing free from DVLA. Disabled people taking the driving test are allocated extra time to allow for explanation of adaptations and for getting in and out of the car.
Useful information and assessments are available in several places. MAVIS is the Department of Transport's Mobility Advice and Vehicle Information Service, and has a variety of adapted cars you can try out on a private driving circuit. Contact MAVIS or the Disability Unit of the Department of Transport for details of your nearest assessment centre. Banstead Mobility Centre runs a mobile assessment service which travels throughout Britain. Assessments can be made too by MIS, the Mobility Information service, a voluntary organisation (see page 187).
Getting a report from an assessment centre like Banstead on your ability to drive might give you useful additional evidence to submit to DVLA, and would give you ideas on suitable car and adaptations. However, some centres (eg MAVIS) say you need a provisional licence before they'll assess you!
Every two years, the Transport and Road Research Laboratory (TRRL) at Crowthorne holds a Mobility Roadshow, covering all aspects of mobility, including electric wheelchairs/scooters, various mobility aids and accessories, and a vast array of cars which you can try out on the test track there if you have a provisional licence. It's an ideal place for looking, trying out, and collecting oodles of useful leaflets.
Don't be shy of visiting local showrooms and, for a start, just trying cars for comfort, ease of access, and driving controls. Some manufacturers make a special point of catering for drivers with disabilities, but in the end it's only you who can really decide what's best. Keep a note of what you like and dislike about each car and take your time deciding. Janet Flower tried car after car after car. Eventually she found one so perfect she didn't have to pay extra for any adaptations, even though it was more expensive than she'd bargained for:
"My problem is not having much bend in my knees, making it difficult to get the seat in the right position, without being too far away from the steering wheel so my arms can't reach it… When I tried the Swift, I was amazed! It has an adjustable steering wheel as standard, so having got the seat right, with my feet using the brake/accelerator comfortably and safely, I was then able to lower the steering wheel, and found I could hold and control that comfortably and safely too. It was unbelievable, having almost resigned myself to the process of having adaptations carried out…
"All the features are easy to operate – the wing mirrors electrically adjust, the bonnet and tailgate lock and unlock from inside the car, it even has air conditioning as standard. It doesn't have power steering but is incredibly light to handle, and has power assisted brakes. I've had to have a strap attached to the tailgate, as being short I wouldn't be able to close it otherwise, but that's all that has been needed." (In Contact)
Second-hand cars should only be bought with the greatest of care. It's sensible to pay for an independent assessment by the AA or RAC. Exchange and Mart magazine has a section on' Adapted Cars', but bear in mind that someone else's adaptations may not suit you.
Other useful organisations
The Mobility Information Service (MIS) is a voluntary organisation, which can organise assessments, and publishes leaflets on all aspects of choosing, buying and converting a car (and electric wheelchairs and 'scooters'). Wheels Under You is cheap, comprehensive, and specially for young or newly-disabled people. The Mobility Information Pack includes road tests on suitable cars.
Disabled Drivers' Association (DDA) produces an informative quarterly magazine and advises on all mobility matters such as vehicles, conversions, ferry concessions, insurance, legal requirements, etc. Has local groups nationwide, and a holiday hotel (see page 275).
Disabled Drivers' Motor Club Ltd has a similar service to DDA, and has lists of disabled drivers around the country willing to demonstrate their cars.
Finance
If you're awarded the DLA mobility component, Motability (see page 189) can help finance a new or used car. Alternatively, you don't have to have the mobility component to apply under the AVS Finance scheme (details below), or you might prefer the wider choice and flexibility a bank loan gives you, but check and compare interest rates.
Aid Vehicle Supplies (AVS)
Commercial company with large range of car types for hire-purchase (some on a no-deposit basis) and used car purchase. The scheme includes extras (eg life assurance cover) and claims to be more flexible than Motability. Finance is provided by the Greyhound Equipment Finance Ltd (a British subsidiary of the famous American bus company).
Motor insurance
See chapter 19.
The DLA mobility component, which replaces the old Mobility Allowance from April 1992, is paid at two rates, the higher to people who can't walk or are 'virtually unable to walk'; the lower to people whose disability means they can get about out of doors only if they're under the guidance or supervision of another person. You have to be likely to remain that way for at least six months.
Mobility component isn't means-tested or taxable, and you don't have to own a car or even be able to drive to qualify. You can spend it any way you want – on an electric scooter, on taxis, on a car, etc. It's awarded for a period of between one year (the minimum), and life. It might be awarded for, say, two or three years initially, and reassessed again later.
As I write, the details of how DLA operates are still being finalised. Read the section on DLA on page 130, but bear in mind that some of what I'm writing may have changed by the time you read it, so get up-to-date information from the sources on page 127, eg BEL, CAB, your self-help group (eg Young Arthritis Care, NASS) or the Disability Rights Handbook.
To apply for the old Mobility Allowance, you had to have a medical examination, but most initial claims for DLA components will, instead, be decided on a detailed self-assessment form completed by you. You can get free telephone advice from the DSS on completing the form (phone the BEL helpline, page 127), or get advice from your local CAB. See too my notes on pages 128 and 137 on completing forms.
Some applicants will still be required to have an assessment by a doctor, and you could still ask to have one if you feel it would help support your application. If so, the following notes may help you prepare for it, though they're based on the old MA medical examination, and there may be changes.
You'll be asked to go to a surgery near you. You can claim travelling expenses including taxi fares if you can't use public transport because of your disability. If you can't get to a surgery, a home visit may be possible.
The examining doctor will have to complete a form. It may request a statement from you, the claimant, on your disability and how it affects your walking, so go with prepared notes, based on the information here on how your eligibility is likely to be assessed. Read your notes beforehand as if you were the DSS assessor, who will know nothing about you except what is on your claim form. Ask yourself, does 'the claimant' have a good case?
The doctor will ask questions, and give you a physical examination. S/he may also ask you to go for a walk either in the surgery or in the street, to assess how far you can walk. Unless you obviously can't walk at all, what the doctor and the DSS will be looking for is evidence that you are 'virtually unable to walk' or 'the exertion required to walk would, in itself, constitute a danger to your life, or would be likely to lead to a serious deterioration in your health', or that you can't walk outdoors without supervision or guidance. Your physical condition is what counts, not how it is affected by external circumstances, so for instance where you live (eg far from the nearest bus stop) isn't taken into account. Nor is the type of work you do, nor your ability or inability to use public transport.
When assessing whether you're 'virtually unable to walk', the doctor and DSS check whether your 'ability to walk out of doors is so limited, as regards
(you) can make progress on foot without severe discomfort, that (you are) virtually unable to walk.'
Most of us spend our lives putting a brave face on things, grimacing inwardly while lying to the world that the pain's not too bad. You need to do the opposite when being assessed. Tell the truth and stress how much it hurts and how much you can't do (though don't overdo it). If the pain starts the moment you stand up, say so. An optimist describes a glass as being 'half full'; a pessimist describes it as 'half empty' – both statements are true, but you're assessed on the evidence produced by the pessimist, not the optimist.
'Severe discomfort' isn't the same as 'excruciating agony'. When walking with the doctor, don't be distracted into chatting, but concentrate on when you first feel severe discomfort, stop, and say so. Any extra distance after that is ignored. Your assessor is not assessing how stiff your upper lip is! Instead of arranging your assessment appointment for when you're at your best, make a point of going when you know you'll be at your worst, so the doctor sees just how bad you really are. If you happen to be having a 'good' day, explain what you're like on 'bad' days. You might want to take a friend or relative along for moral support, but if so make sure they're briefed, for once, not to say how wonderful you are at coping!
The DSS will also be looking for evidence that you're likely to remain 'virtually unable to walk' for at least six months. With something like RA, where walking ability varies from day to day, you may have difficulty qualifying on this count. You could try keeping an accurate diary to send with your claim form. Even though you might be able to walk on some days, that might not disqualify you, provided the DSS consider that, looking at your physical condition as a whole, it would be true to say that you're normally virtually unable to walk and likely to remain like that for at least six months.
Is there any other evidence that might help your case? If so include it either in a separate note with the self-assessment form, or, if you have an examination, in your statement at the doctor's. For instance, have you had hip or knee joint replacements which have since loosened, and walking loosens them further, causing 'severe discomfort'? How do steps and stairs affect you?
The decision will be posted to you, but don't panic if you're refused. You can appeal. For help with an appeal you'll need advice from experienced people, so contact your local DIAL or CAB and self-help group. If you don't appeal, or your appeal is turned down, you can still try claiming again at a later date if your condition worsens and you think you might then qualify. The new Disability Appeal Tribunal (DAT) will be made up of one legally qualified chairperson, one medically qualified member and one non-medical member who as far as is practicable should have professional or voluntary experience in the needs of disabled people or has a disability.
Motability
Voluntary organisation, set up on government initiative, and financed by the major banks, aims to help people with disabilities to use their DLA mobility component to buy or lease a new car, or to get an electric wheelchair or good used car on hire purchase. See their leaflets Motability Car Hiring and Hire Purchase Schemes and Used Car Hire Purchase Schemes.
You can use the scheme even if you're not able to drive the car yourself, but are nonetheless buying it for your benefit. This may however confuse the car salesman and/or the car insurance company! You and they will need to distinguish between the registered 'owner' of the car (you, the non-driver) and the 'keeper' of the car, the actual driver (who must be insured). DVLA Swansea will confirm the regulations if necessary (tel: 0792 782341 or 42091 or 72134).