Power Mobility and Safety Concerns
Power mobility enhances participation in daily activities and recreation for those in long-term care. However, the devices can also create safety concerns which need to be addressed.
Most participants chose to take a teleological approach and provide all residents with the opportunity to test the device, instead of exclude residents with specific diagnoses that could be viewed as an unfair risk management.
Mobility
A power mobility device is a method for people who are unable to move around their home or community and also to take part in everyday activities that they may not be able to do. However, these devices can also pose a risk to the person who uses them, and other people who are in their space. Occupational therapists should carefully consider the safety needs of each client before making recommendations about powered mobility.
In an exploratory study conducted by OTs in three residential care facilities of the Vancouver Coastal Health Authority, qualitative interviews were conducted with residents to evaluate their use of power mobility. The goal was to develop an approach to client-centered power mobility prescribing. The results revealed four major themes: (1) power mobility meaning, (2) learning road rules, (3) red flags security concerns and (4) solutions.
Power mobility can greatly improve the quality of life for individuals who are mobility-challenged by allowing them to participate in a range of daily life activities, at home as well as in the community (Brandt, 2001; Evans, 2000). Self-care, active and recreational activities are essential to the mental and physical health of older adults. For many who suffer from chronic illnesses, power mobility offers a way to participate in these important activities.
Most participants found it unacceptable to remove a resident's chair, as this could cause a huge disruption in their life story or course of action, and ultimately stop them from continuing with the same activities that they had been doing before the progression of their illness. This was particularly applicable to those in the Facility 1 who were only allowed to use their power chairs for a short time and were now dependent on others to push them.
Another solution would be to reduce the speed that residents drive their chairs. However, this could raise a number issues such as privacy and the impact on the rest of the community. Ultimately, removing the chair of a resident was deemed the most drastic and least preferred solution to security concerns.
Safety
Power mobility allows people with disabilities to get around more freely, participate in a wider range of activities and complete errands. However, with increased mobility comes a higher risk of accidents. For some, these incidents could cause serious injuries to themselves or others. It is crucial to consider the safety of your clients prior to suggesting power mobility.
First check whether your client is able to safely use their power chair or scooter. Depending on their impairment and the state of their health, this could involve a physical evaluation by a physician or occupational therapist, as well as an interview with a mobility expert to determine whether a specific device is suitable for them. In some cases your client will require a lift for their vehicle to be capable of loading and unloading the mobility device at their home, workplace or community.
Another aspect of safety is knowing the rules of the road. This includes sharing space with other pedestrians, wheelchair users, and drivers of trucks, cars or buses. This was a theme that was mentioned by a majority of participants in the study.
Some people learned to drive their wheelchairs on sidewalks instead of driving through busy areas or on curbs (unless the wheelchair was specifically designed to be used in this way). Others drove more slowly and paid attention to pedestrians in an area that was crowded.
The final and least desired alternative was to take away the chair of a person. This was viewed as a double punishment that would result in losing mobility independently and preventing access to facility and community activities. Diane and Harriet, among others, were among those who had their chairs removed.
The participants also suggested that residents, family members, and staff members be educated on the safe use of power mobility. This could involve teaching the fundamentals of driving (such as driving on the right side of the hallway) and encouraging residents to practice driving techniques when they go out and helping them to understand how their actions can affect the mobility of others.
Follow-Up
A power mobility device can have a profound impact on the child's ability to function and take part in life. There is little research on the experience that children go through when they first learn to utilize these devices. This study uses an approach that is pre-post to study the impact of 6 months' experience with one of four early power mobility devices on the children in school with severe cerebral palsy (CP).
Qualitative interviews were conducted with 15 parents as well as pediatric occupational and physical therapists. Thematic analysis identified three main themes. The first theme, 'Power to move', described how using an electric device impacted more than just locomotor skills. Learning to drive a mobility device can be an emotional and transformative journey for participants.
The second theme, 'There's not a cookbook,' revealed that the process of learning how to use a power mobility device was a bespoke process that evolved over time in a cyclical fashion. green power scooter were required to determine what was feasible based on each child's abilities and requirements. In the initial phase of training and following, therapists were required to be patient with children as well as parents. A number of parents and therapists emphasized a need to help families celebrate their successes and solve issues that arise during the process of training.
The third theme, "Shared space", examined how the use of an electric device can affect other people's interactions and lives. The majority of those who participated in this study believed a person must be mindful of others when using their power mobility device. This is especially important when driving in public spaces. Many participants also reported that they've encountered instances where another's property was damaged due to the use of a power mobility device, or where a person was injured by a driver who failed to yield the right-of-way.
The results of this study suggest that socialization and power mobility training for preschoolers with CP can be done in certain classroom settings. Future research should be focused on the effectiveness of training and outcomes of this kind of intervention for children with CP. This could eventually lead to more standardized training protocols for children with CP.