Power Mobility and Safety Concerns
Power mobility allows individuals who are in long-term care to take part in their daily activities and leisure pursuits. The devices can also create safety concerns, which must be addressed.
The majority of participants opt to adopt a teleological perspective and give all residents the opportunity to test a device, rather than exclude those with specific diagnosis which could be considered a prejudicial risk management.
Mobility
A power mobility device provides a way for people with limited mobility to move around in their home or community and also to take part in everyday activities that they would not be able to participate in. These devices cause danger not only for the person who uses them, but also to other people who share their space or environment. Occupational therapists must carefully assess each client's safety needs to provide the most appropriate recommendations regarding powered mobility.
In an exploratory study (von Zweck 1999), OTs from three residential care facilities within the Vancouver Coastal Health Authority conducted qualitative interviews with residents regarding their power mobility use. The objective was to develop a framework for client-centred power mobility prescribing. green power revealed four major themes: (1) power mobility meaning, (2) learning road rules, (3) red flags safety concerns, and (4) solutions.
Power mobility can enhance the quality of life for people with limited mobility. This is because it lets them participate in daily activities at home and in the community. Participation in self-care, productive and leisure occupations is crucial to physical and mental health of older adults, and for many people with chronic illnesses power mobility can be an opportunity to continue taking part in these important activities.
The majority of participants felt it was unacceptable to remove the chair of a resident, since this could cause a huge change in their life or trajectory and essentially prevent them from continuing with the same activities they used to do prior to their disease progression. This was especially relevant for those in the Facility 1 who had only been able use their power chairs for a brief period and were now dependent on others to push them.
Another solution would be to reduce the speed that some residents drive their chairs. However it could create various issues like privacy and the impact on the rest of the community. The most drastic solution to security concerns was to take away the wheelchair of a resident.
Safety
Power mobility allows people to move more freely. They can also participate in a greater variety of activities, as well as do the errands. With increased mobility comes an increased chance of accidents. For some, these incidents can cause serious injuries to themselves and others. This is why it is important to consider the security of your client before recommending that they utilize power mobility.
The first step in determining safety is to determine if your client can safely operate their power scooter or power chair. This could involve a physical assessment by a physician, occupational therapist or mobility specialist, depending on the nature of your client's disability as well as their current health. In some instances, your client will need a lift for their vehicle to be capable of loading and unloading the device at their home, community or workplace.
Understanding the rules of road safety is a further aspect of safety. This includes sharing space with other pedestrians, other wheelchair users and drivers of cars, trucks or buses. This is a topic that was mentioned by a majority of participants in the study.
For some, this required learning to use their wheelchairs on sidewalks instead of driving through areas that were crowded or over curbs (unless specifically designed to do so). Others drove more slowly and paid attention to pedestrians in a crowd.
The last and least preferred option, which was to remove the wheelchair of a person was seen as a double-punishment that would result in the loss of mobility and hindering the person from participating in the activities of the community and facilities. Diane and Harriet among others were among those who had their chairs removed.
Participants also suggested that family members, and staff be trained on the safe use of power mobility. This could include teaching driving basics (such as the right side to walk on in the hallway) and encouraging residents to practice driving skills when they leave, and helping them understand how their behavior affects the mobility of other people.
Follow-Up
A child's ability and willingness to participate in life can be profoundly affected by a device for power mobility. There is little research into the experiences children experience when they learn to make use of these devices. This study uses a post-previous design to examine the effects of six months of use with one of four early mobility devices on a school-aged group of children who suffer from severe cerebral Palsy (CP).
We conducted interviews in qualitative format with 15 parents, along with occupational and physical therapists for children. Thematic analysis identified three major themes. The first theme, 'Power for mobility The theme described how the use of an electric device impacted more than just the child's motor skills. The experience of learning how to drive a powered mobility device can be an emotional and transformative experience.
The second theme, 'There isn't a recipe book,' showed that the process of learning how to utilize a power mobility device was an individual process that evolved over time in a cyclical fashion. Therapists were required to discover what was realistic for each child's needs and capabilities. Throughout the training and post-training phases, therapists were expected to be patient with parents and children. Therapists and parents alike emphasized the need to help families celebrate their achievements and address issues related to the process of training.
The third theme, "Shared space", explored how the use a power device can impact other people's lives and interactions. The majority of participants in this study believed that a person must always be considerate of other people when using their mobility device. This was particularly applicable when driving on public roads. Several participants also noted that they've encountered situations in which someone else's property was damaged through the use of an electric mobility device, or where a person was injured due to a driver who failed to yield right-of-way.
The results of this study show that socialization and power mobility training for preschoolers with CP can be done in specific classroom environments. The next research study should study the training and results for this kind of intervention in young children with CP. This could eventually lead to more standardized training protocols for children with CP.