Guatemala is not the easiest country to negotiate for travelers with a mobility issues. Although many sidewalks in Antigua have ramps and cute little inlaid tiles depicting a wheelchair, the streets are cobblestone, so the ramps are anything but smooth and the streets worse.
Many hotels in Guatemala are old converted houses with rooms around a courtyard; such rooms are wheelchair accessible, but the bathrooms may not be. The most expensive hotels have facilities such as ramps, elevators and accessible toilets. Transportation is the biggest hurdle for travelers with limited mobility: travelers in a wheelchair may consider renting a car and driver as the buses will prove especially challenging due to lack of space.
Antigua-based Transitions (www.transitionsfoundation.org) is an organization aiming to increase awareness and access for people with disabilities in Guatemala.
Download Lonely Planet's free Accessible Travel guides from http://lptravel.to/AccessibleTravel.