Power Mobility and Safety Concerns
Power mobility can enhance participation in daily activities as well as recreation for those who are in long-term care. However, the devices could also cause safety issues which need to be addressed.
The majority of participants choose to adopt a teleological perspective and allow all residents the chance to test the device, instead of exclude residents with specific diagnoses which could be considered a prejudicial risk management.
Mobility
A power mobility device provides a method for people with limited mobility to move around in their home or community and to participate in everyday activities that they might not otherwise be able to do. These devices could cause danger not only for the person who uses them, but also to those who share their space or surroundings. Therapists in occupational therapy must assess each client's safety needs to provide the most appropriate recommendations for 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 goal was to develop a framework for client-centered power mobility prescribing. The findings 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 dramatically improve the quality of life for those with limited mobility by permitting them to take part in a variety of daily living activities, both at home and in the community (Brandt, 2001; Evans, 2000). Self-care, productive and recreational occupations are vital for physical and mental well-being of older adults. For those suffering from progressive diseases, power mobilty allows them to take part in these important activities.
It was considered unacceptable by the participants to remove a wheelchair from a resident's home because it would alter their life's story and progression, and prevent them from engaging in the same things they had prior to their illness worsened. This was particularly the case for those in Facility 1 who were in a position to use their power chairs for brief periods of time, but were dependent on others to move them around the facility.
Another option is to reduce the speed that residents drive their chairs. However it could create a number issues such as privacy and the impact on the rest of the community. Ultimately, removing the chair of a resident was thought to be the most drastic and least desirable solution to security concerns.
Safety
Power mobility allows people to move around more freely. They can also participate in a wider range of activities and complete the errands. With the increased mobility comes an increased chance of accidents. These incidents can result in serious injuries for a few. It is important to think about the safety of your clients before recommending power mobility.
First, determine whether your client is able to safely operate their power chair or scooter. This could involve a physical assessment by a doctor or occupational therapist or a mobility specialist, based on the nature of your client's disability as well as their current health. In some instances, your client will need a vehicle lift to be able to load and unload the mobility device at home, community or workplace.
Knowing the rules of road safety is an additional aspect of safety. This involves sharing space with other pedestrians, wheelchair users, and drivers of cars, trucks or buses. The majority of participants in the study mentioned this theme.
For some it meant learning to drive their wheelchairs on sidewalks instead of driving through areas that were crowded or over curbs (unless specifically designed for doing such). Others drove slower and kept an eye out for pedestrians in an area that was crowded.
The last and least popular option was to remove a person's chair, which was viewed as a double punishment: losing independent mobility and preventing access to facility and community activities. Diane and Harriet among others were among those who were stripped of their chairs.
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 using the right side of the hallway) as well as encouraging residents to practice driving strategies while out, and helping them to understand how their actions can affect the mobility of others.
Follow-Up
The capacity and willingness of a child to be a part of the world can be profoundly affected by a device that can power them. However, little research has been done on the experience of children who learn to use this equipment. This study employs the pre-post method to investigate the impact of 6 months of use with one of four early power mobility devices on the children in school with severe cerebral palsy (CP).
We conducted interviews in qualitative format with 15 parents, along with pediatric occupational and physical therapists. Thematic analysis revealed three main themes. electric wheel scooter , 'Power and mobility,' described the ways in which powered devices affected more than just the locomotor abilities. The experience of learning how to drive a motorized mobility device is often an emotional and transformative one.
The second theme , 'There's no recipe book' showed that the process of learning to utilize an equipment for mobility was a process that developed in a continuous manner over time. Therapists were asked to determine what was feasible in light of the child's capabilities and requirements. In the initial phase of training and following, therapists were required to be patient with children as well as parents. Many parents and therapists mentioned a need to help families celebrate successes and problem-solve challenges associated with the training process.
The third theme, "Shared space", explored how the use a power device can impact other people's interactions and lives. The majority of those who participated in this study felt that a person must be mindful of other people when using their mobility device. This is especially true when driving on public roads. Several participants also noted that they've encountered instances where another's property was damaged by the use of a power mobility device, or where a person was injured by a driver who had not yielded the right-of-way.
Overall, the results of this study suggest that short-term power mobility and socialization training is feasible for preschoolers with CP in certain classroom settings. Future research should be focused on the effectiveness of training and outcomes of this type of intervention for young children with CP. This will hopefully lead to the development of more standard training protocols for this group.