Power Mobility and Safety Concerns
Power mobility improves participation in daily activities as well as recreation for those in long-term care. However, these devices can also pose safety risks that must be addressed.
The majority of participants choose to adopt a teleological perspective and allow all residents the opportunity to test a device, rather than restrict residents with certain diagnosis which could be considered an unfair risk management.
Mobility
A power mobility device is a way for people with limited mobility to move about their home or community and to participate in activities of daily living that they would not be able to perform. However, these devices could also pose a risk to the person using them and also to other people who share their space or space. Therapists in occupational therapy must evaluate the safety needs of each client to make the best suggestions regarding powered mobility.
In a study that was conducted by OTs in three residential care facilities of the Vancouver Coastal Health Authority, qualitative interviews were conducted with residents to evaluate the extent to which they used power mobility. The aim was to develop a framework that could allow the use of power mobility that is centered on the needs of the client. The results revealed four main themes: (1) the meaning of power mobility, (2) learning the rules of the road, (3) red flags concern about safety and (4) solutions.
Power mobility can enhance the quality of life for those who have mobility limitations. This is due to the fact that it lets them participate in everyday activities at home as well as in the community. Participation in self-care, productive and leisure occupations is crucial to mental and physical health for older adults, and for those with progressive diseases power mobility can be a way to continue participating in these important activities.
Most participants found it not acceptable to remove the resident's chair since this would cause a major disruption in their life story or path and prevent them from continuing with the same activities that they were doing prior to their illness progressed. This was particularly relevant for those in Facility 1 who had been in a position to use their power chair for a brief period and were now dependent on others to push them.
Another option is to slow down the speed at which some residents drive their chairs. However it could create several issues, including privacy and the impact on the rest of the community. In the end, taking away the chair of a resident was thought to be the most drastic and least preferred solution to safety concerns.
Safety
Power mobility lets people move around more freely. They can also take part in a broader range of activities, and complete around on their own. With the increased mobility comes an increased chance of accidents. For some, these accidents could cause serious injuries to themselves or others. It is important to consider the safety of your clients prior to recommending power mobility.
First, determine if your client is able to safely operate their power chair or scooter. Depending on the nature of their impairment and the state of their health, this could involve a physical evaluation by a physician or occupational therapist, or having a conversation with a mobility specialist to determine if a particular device is suitable for them. In some cases the use of a vehicle lift may be required to allow for your client to load and unload their mobility device at home or in the community at work.
Understanding the rules of road safety is an additional aspect of safety. This includes sharing space, with other wheelchair users, pedestrians and bus drivers. This was a theme that was mentioned by a majority of participants in the study.
For some it required learning to use their wheelchairs on sidewalks instead of driving through areas that were crowded or over curbs (unless specifically designed to do this). Others drove slower and looked out for pedestrians in a crowd.
The final and least desired option was to remove the chair of a person, which was viewed as a double punishment loss of mobility independent and preventing access to facilities and community activities. This was the viewpoint of the majority of participants who were able to remove their chairs among them Diane and Harriet.
Participants also suggested that residents, family members, and staff be educated on the safe use of power mobility. This could involve teaching the basics of driving (such as using the right side of the hallway) as well as encouraging residents to practice driving strategies when they leave and assisting them in understanding how their behavior can influence other people's mobility.
Follow-Up
The ability of a child and their willingness to participate in life can be greatly affected by a device for power mobility. However, very little research has been conducted about the experience of children who are learning to use this device. This study employs the pre-post method to investigate the impact of six months of experience using one of four early power mobility devices on children in the school age group with severe cerebral palsy (CP).
Qualitative interviews were conducted with 15 parents as well as pediatric occupational and physical therapists. green scooter identified three major themes. The first, 'Power in mobility explained how the use of a powered device changed more than just the locomotor abilities. The process of learning to drive a powered mobility device is often an emotional and transformative one.
The second theme 'There's no recipe book' revealed that learning how to utilize a mobility device was a process that developed in a cyclical manner over time. The therapists were asked to determine what was feasible depending on the individual's capabilities and requirements. During the training phase, and after, therapists had to be patient with children as well as parents. Therapists and parents alike emphasized the need to assist families celebrate their successes and resolve issues that arise from the training process.
The third theme, "Shared space", examined how the use of a power device can impact other people's interactions and lives. The majority of participants in this study felt that a person must always be considerate of other users when using a mobility device. This was particularly applicable when driving on roads that are public. Participants also mentioned that they had seen situations where property of someone else's had been damaged by the use of a motorized device or a person had been injured by a driver who didn't yield the right of way.
The results of this study show that socialization and power mobility training for preschoolers with CP can be conducted in specific classroom settings. Future research should continue to explore the training and outcomes of this kind of intervention with young children with CP. This will hopefully result in the development of more standard training protocols for this population.