Fluid Independence: Powered Wheelchair Users' Perspectives on Autonomy, Care, and Assistive Technology

Advancements in assistive technologies promise greater independence for wheelchair users; however, lived realities reveal a complex interplay of empowerment, dependency, and unmet needs. Accessibility discourse still leans heavily on clinical or technical perspectives, underweighting the lived expertise of powered-wheelchair users. From 55 in-depth interviews, we demonstrate that independence is fluid and continually negotiated across various contexts, including caregiving dynamics, privacy trade-offs, and structural barriers. Technologies that reduce frequent “ask-points” (e.g., retrieving objects, opening doors) deliver disproportionate autonomy gains, while caregiver shortages and insurance denials persist. Dependency was experienced as intimacy, gratitude, frustration, and loss of dignity, underscoring the emotional stakes of technology adoption. Participants also heavily relied on peer networks and custom solutions to navigate technology choices. Based on our insights, we introduce an ecosystem-oriented framework and user-led directory (Assistive-Tech Commons), positioning wheelchair users as co-designers. Centering emotional well-being, household ecologies, and community knowledge enables more sustainable, dignity-preserving assistive technologies.