Power Mobility and Safety Concerns
Power mobility allows individuals in long-term care to participate in their daily activities and leisure pursuits. However, the devices can also pose safety risks which need to be addressed.
Instead of excluding residents who have certain diagnoses from power mobility option as it could be viewed as prejudicial risk management, most participants preferred to take the teleological approach and let everyone try out a device.
Mobility
A power mobility device provides an option for those with limited mobility to move around their community or home, and participate in everyday activities that they may not be able to do. These devices can pose a risk not only to the individual using 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 an exploratory study carried out by OTs at three residential facilities of the Vancouver Coastal Health Authority, qualitative interviews were conducted with residents to assess their use of power mobility. The objective was to develop an approach to 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 enhance the quality of life of people who have mobility limitations. This is due to the fact that it allows them to participate in everyday activities at home and within the community. Self-care, productive and recreational jobs are essential for the physical and mental health of the elderly. For many with progressive diseases, power mobilty offers a way to participate in these essential activities.
Participants found it unacceptable to remove a resident's wheelchair in order to alter their life's story and progression, and prevent them from engaging in the same activities that they had prior to their illness worsened. This was especially relevant to those in the facility 1, who had been capable of maintaining their power chairs for short periods of time and were forced to rely on others to push them around the facility.
Another option is to reduce the speed that some residents drive their chairs. However, this could raise 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 desirable solution to security concerns.
Safety
Power mobility allows disabled people to move around more easily and participate in a greater variety of activities, and even do errands. However, with greater mobility comes a higher risk of accidents. These accidents could result in serious injuries for certain. It is essential to think about the safety of your clients prior to suggesting the use of power mobility.
First, determine whether your client is able to safely use their scooter or power chair. Depending on their impairment and the state of their health, this could require a physical examination by a doctor or occupational therapist, and having a conversation with a mobility expert to determine if a particular device would be appropriate for them. In some instances your client will require a lift for their vehicle to be capable of loading and unloading the mobility device at home, community or workplace.
Another aspect of safety is to learn the rules of the road. This includes sharing space with other wheelchair users, pedestrians and the drivers of buses or cars. This was a theme that was mentioned by most participants in the study.
Some people learned to drive their wheelchairs on sidewalks instead of driving through busy areas or on curbs (unless the wheelchair was designed for this purpose). For others it meant driving slowly in a busy environment and watching out for pedestrians.
The last and least popular alternative was to take away a person's chair, which was viewed as a double punishment: losing independent mobility and preventing access to facilities and community activities. Diane and Harriet, among others, were among the participants who had their chairs taken away.
Other solutions that were suggested 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), encouraging residents to practice driving strategies when they go out and helping them understand how their behavior can influence the mobility of others.
Follow-Up
A child's ability and willingness to take part in the world can be profoundly affected by a device for power mobility. However, very there isn't much research about the experience of children learning to use this equipment. This study uses an approach that is pre-post to study the impact of 6 months' experience with one of four early power mobility devices on the children in school with severe cerebral palsy (CP).
mymobilityscooters were conducted with 15 parents and children's occupational and physical therapists. Thematic analysis revealed three key themes. The first, 'Power and mobility explained the ways in which powered devices changed more than just locomotor abilities. The experience of learning to drive a motorized mobility device is usually an emotional and transformative one.
The second theme 'There's no recipe book' revealed that learning to utilize a mobility device was a process that developed in a cyclical manner over time. Therapists were asked to decide what was appropriate depending on the individual's capabilities and requirements. During the training phase, and following, therapists were required to be patient with children and parents. Many parents and therapists mentioned a need to help families celebrate successes and problem-solve issues that arise during the process of training.
Finally, the third theme called 'Shared space was a look at how the use of a power device could have an impact on other people's lives and interactions. The majority of participants in this study believed that it is important to be mindful when using a power mobility device. This was especially relevant when driving on public roads. A few participants also mentioned that they've encountered instances where another's property was damaged through the use of the power mobility device or where a person was injured due to a driver who failed to yield right-of-way.
Overall, the findings of this study suggest that short-term socialization and power mobility training is possible for preschoolers with CP in certain classroom environments. The next research study should investigate the training and outcomes for this type of intervention in young children with CP. This will hopefully lead to the development of more standard training protocols specifically for this group of children.