Power Mobility and Safety Concerns
Power mobility can enhance participation in daily activities as well as recreation for those in long-term care. The devices can also pose safety risks, which need to be addressed.
Rather than exclude residents who have certain diagnoses from use of power mobility as it could be viewed as risk management prejudicial, most participants chose to take an approach based on teleology and let everyone test the power mobility device.
Mobility
A power mobility device provides a way for people with limited mobility to move around their home or community and to participate in activities of daily living that they might not otherwise be able to participate in. These devices can pose a risk not only to the individual using them, but also to those who share their space or environment. Occupational therapists must carefully assess each client's safety needs to make 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 their power mobility use. The objective was to establish a framework that would allow for client-centred power movement prescribing. The findings revealed four main themes: (1) power mobility meaning, (2) learning road rules, (3) red flags - safety concerns and (4) solutions.
Power mobility can dramatically improve the quality of life for those who are mobility-challenged by permitting them to take part in a range of daily living activities both at home and in the community (Brandt 2001; Evans, 2000). Self-care, productive and leisure jobs are essential for the physical and mental health of people who are older. For many with progressive diseases, power mobilty can be a means to participate in these important activities.
It was considered unacceptable by the participants to take away a wheelchair in order to alter their life's story and progression and hinder them from doing the same things that they did before their disease advanced. This was especially true for those in the Facility 1 who had only been able use their power chairs for a brief period and were now reliant on others to push them.
Another option is to reduce the speed that residents drive their chairs. However it could create several issues, including privacy and the impact on the rest of the community. The most drastic solution to security concerns was to take away a resident's wheelchair.
greenpower mobility allows people with disabilities to get around more freely, participate in a wider variety of activities, and even do the errands. However, with greater mobility comes a higher risk of accidents. For some, these incidents can cause serious injuries to themselves and others. It is important to consider the safety of your clients prior to recommending power mobility.
The first step in assessing safety is to determine if your client is safe to operate their scooter or power wheelchair. Depending on their condition and their current health, this may require a physical examination by an occupational or physician therapist, and an interview with a mobility expert to determine if a particular device is suitable for them. In certain situations your client will require a vehicle lift to be capable of loading and unloading the mobility device at workplace, home, or community.
Learning the rules of road safety is a further aspect of safety. This includes sharing space with other pedestrians, wheelchair users and drivers of trucks, cars or buses. This is a topic that was mentioned by a majority of participants in the study.
For some this, it meant learning to use their wheelchairs on sidewalks, instead of driving through busy areas or over curbs (unless specifically designed for doing this). Others drove more cautiously and kept an eye out for pedestrians in a crowd.
The final and least popular option of removing a person's wheelchair, was viewed as a double-punishment as it would mean losing mobility and preventing the person from participating in activities with the community or at facilities. Diane and Harriet, among others, were among those who had their chairs taken away.
Other suggestions made by the participants included educating other residents staff, family members and other residents about the safety of power mobility. This could include educating residents on the fundamentals of driving (such as using the right side of the hallway) and encouraging residents to practice driving skills when they leave and helping them understand how their behavior affects other people's mobility.
Follow-Up
A device that is powered by electricity can have a profound impact on a child's ability to function and take part in life. However, very little research has been done about the experience of children who learn to use this device. This study uses an approach that is pre-post to study the impact of 6 months' experience with one of the four early power mobility devices on a group of school-aged children with severe cerebral palsy (CP).
We conducted interviews in qualitative format with 15 parents, and also pediatric occupational and physical therapists. Thematic analysis revealed three main themes. The first theme, 'Power for Mobility The theme described how using an electric device impacted more than just motor skills. The experience of learning how to drive a motorized mobility device can be an emotional and transformative one.
The second theme 'There's no recipe book' showed that the process of learning to make use of the mobility device was a process that unfolded in a continuous manner over time. Therapists were tasked with unearthing the most appropriate solution for each child's needs and abilities. Through the training and post-training phases, therapists were also required to be patient with parents and children. A number of parents and therapists emphasized a need to help families celebrate their successes and solve issues that arise during the training process.
The third theme, "Shared space", examined how the use of the power device can affect other people's interactions and lives. The majority of those who participated in this study believed one must always be considerate of other people when using their mobility device. This is particularly true when driving in public areas. Participants also said that they've seen instances where someone else's property had been damaged by the use of a motorized device or an individual had suffered injuries from a driver who failed to yield the right of way.
The results of this study suggest that power mobility and socialization training for preschoolers with CP can be conducted in a variety of classroom environments. Future research should continue to explore the training and outcomes of this kind of intervention for children with CP. This could lead to more standard training protocols for children who have CP.