Power Mobility and Safety Concerns
Power mobility allows people who are in long-term care to take part in their routine activities and leisure pursuits. However, the devices could also cause safety issues which need to be addressed.
The majority of participants choose to take a teleological approach and give all residents the chance to test a device, rather than exclude those 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 about their community or home, and participate in activities of daily living that they might not otherwise be able to perform. However, these devices could also pose a risk for the person using them as well as other individuals who share their space or space. Occupational therapists should carefully consider the safety needs of each client before making recommendations about powered mobility.
In an exploratory study (von Zweck, 1999), OTs from three residential care facilities of the Vancouver Coastal Health Authority conducted qualitative interviews with residents regarding their power mobility use. The goal was to develop a framework for client-centred power mobility prescribing. The results revealed four main themes: (1) the meaning of power mobility, (2) learning the rules of the road, (3) red flags: concerns about safety and (4) solutions.
Power mobility can greatly improve the quality of life for people with limited mobility by giving them the opportunity to participate in a variety of everyday living activities, at home as well as in the community (Brandt, 2001; Evans, 2000). Participation in self-care as well as leisure and productive occupations is crucial to physical and mental health of older adults, and for those with chronic illnesses, power mobility offers a way to continue participating in these important activities.
Many participants considered it not acceptable to remove the chair of a resident, since this would cause a major change in their life or path and prevent them from pursuing the same activities they used to do prior to the progression of their illness. This was especially relevant to those in the Facility 1, who had been able to maintain their power chairs for brief periods of time, but were dependent on others to help them move around the facility.
Another option is to slow down the speed at which residents drive their chairs. However this could cause several issues, including privacy and the impact on the rest of the community. The most drastic solution to safety concerns was to remove a resident's wheelchair.
Safety
Power mobility allows people with disabilities to get around more freely and take part in a wider variety of activities, and even do around. However, with greater freedom of movement comes a higher risk of accidents. For some, these accidents could cause serious injuries to themselves and others. It is important to think about the security of your clients prior to suggesting power mobility.
First check whether your client is able to safely use their scooter or power chair. This could include an assessment of physical health by a physician or occupational therapist or a mobility specialist, based on the nature of your client's disability as well as their current health. In certain situations your client may require a lift for their vehicle to be capable of loading and unloading the mobility device at home, workplace or community.
Another aspect of safety is learning the rules of the road. This includes sharing space with other pedestrians, wheelchair users, and bus drivers. 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 crowded areas or on curbs (unless the wheelchair was specifically designed to be used in this way). Others drove slower and paid attention to pedestrians in an area that was crowded.
The last and least popular option was taking away the chair of a person. My Mobility Scooters was seen as two-fold punishment: losing independent mobility and preventing access to facilities and community activities. This was the viewpoint of the majority of those who had their chairs removed among them Diane and Harriet.
Other suggestions made by participants included educating other residents as well as family members and staff about the safety of power mobility. This could include teaching basic driving skills (such as the right side to walk on in the hallway) as well as encouraging residents to practice driving when they go outside and helping them recognize how their behavior affects the mobility of others.
Follow-Up
A power mobility device can have a profound impact on the child's ability to function and participate in life. However, very there isn't much research on the experience of children learning to use this equipment. This study uses an approach that is post-previous to study the effects of 6 months of using one of four early mobility devices on a group of school-aged children of children with severe cerebral Palsy (CP).
We conducted qualitative interviews with 15 parents as well as pediatric occupational and physical therapists. Thematic analysis identified three major themes. The first theme, 'Power for mobility explained how the use of an electric device impacted more than just the child's motor skills. Learning to drive a mobility device was often an emotional and transformative journey for participants.
The second theme, 'There's no such thing as a recipe book,' showed that the process of learning how to use a power mobility device was a bespoke process that developed over time in a cycle. Therapists were required to discover the most appropriate solution for the individual child's needs and abilities. Through the training and post-training phases, therapists were required to have patience with parents and children. Parents and therapists alike described the need to help families celebrate their accomplishments and address issues related to the training process.
Finally, the third theme, 'Shared space was a look at how the use of an electric device can have an impact on the lives of other people and their interactions. The majority of participants in this study believed that people should be considerate when using a power mobility device. This is especially important when driving in public spaces. Participants also mentioned that they've seen instances where property of someone else's had been damaged by the use of a power mobility device or a person had been injured by a motorist who failed to yield the right of way.
Overall, the findings of this study suggest that short-term socialization and power mobility training appears feasible for preschoolers with CP in certain classroom settings. The next research study should investigate the training and outcomes for this kind of intervention in children with CP. This could eventually lead to more standardized training protocols for children who have CP.