Power Mobility and Safety Concerns
Power mobility enhances participation in daily activities as well as activities for people who are in long-term care. However, the devices can also cause safety issues which need to be addressed.
Most participants chose to adopt a teleological view and allow all residents the chance to test a device, rather than exclude those with specific diagnosis that could be viewed as an unfair risk management.
Mobility
A power mobility device is a method for people with limited mobility to move about their home or community, and also to take part in everyday activities that they may not be able to do. However, these devices may also be a danger to the person who uses them, and other people who are in their space. Occupational therapists should carefully consider the safety requirements of each client before making recommendations on 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 assess their power mobility use. The objective was to establish an environment that allowed the use of power mobility that is centered on the needs of the client. The results revealed four major themes: (1) the meaning of power mobility, (2) learning the rules of the road, (3) red flags concerning safety, and (4) solutions.
Power mobility can enhance the quality of life of individuals who have mobility limitations. This is because it allows them to participate in everyday activities at home and in the community. Self-care, productive and recreational occupations are vital for physical and mental well-being of older adults. For many with chronic illnesses, power mobility allows them to take part in these vital activities.
The participants felt it was inconvenient to take away a wheelchair, as this would disrupt their life's narrative and direction, and prevent them from doing the same activities that they did before their disease progressed. This was especially true for those in the facility 1 who were capable of maintaining their chairs for short periods of time, but were forced to rely on others to push them around the facility.
Another option is to slow down the speed at which residents drive their chairs. However, this could raise several issues, including privacy and the impact on the rest of the community. In the end, removing the chair of a resident was deemed the most drastic and least desired solution to security concerns.
Safety
Power mobility allows those with disabilities to move around more easily and participate in a greater variety of activities, and even complete around. With increased mobility comes an increased risk of accidents. For some, these incidents 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 whether your client is able to safely operate their power chair or scooter. This could involve an assessment of physical health by a doctor, occupational therapist or mobility specialist, based on the nature of your client's disability and their current health. In some cases, your client will need a lift for their vehicle to be able to load and unload the device at their home, workplace or community.
Another aspect of safety is learning the rules of the road. This includes sharing space, with other pedestrians, wheelchair users and drivers of buses or cars. This topic was mentioned by a majority of participants in the study.
Some people learned to drive their wheelchairs along sidewalks instead of driving through busy areas or on curbs (unless the wheelchair was specifically designed to be used in this way). Others drove more cautiously and looked out for pedestrians in an area that was crowded.
The most popular and least desired option, which was to remove the wheelchair of a person was seen as a double punishment as it would mean losing mobility and preventing the person from participating in community and facility activities. Diane and Harriet among others were among those who had their chairs taken away.
Other ideas suggested by the participants included educating other residents, family members and staff on the safe operation of power mobility. This could include educating residents on the basics of driving (such as using the correct side of the hallway) and encouraging residents to practice driving techniques when they leave and assisting them in understanding how their actions can affect the mobility of others.
Follow-Up
The capacity and willingness of a child to take part in the world can be profoundly affected by a power mobility device. There has been little research into the experiences children go through when they first learn to make use of these devices. hop over to here uses an approach that is pre-post to study the effects of six months of experience with one of the four early power mobility devices on a group of school-aged children with severe cerebral palsy (CP).
Qualitative interviews were conducted with 15 parents as well as pediatric occupational and physical therapists. Thematic analysis revealed three main themes. The first theme, 'Power to move', described how using a powered device affected more than just motor skills. Learning to drive a mobility device was often an emotional, transformative journey for participants.
The second theme, 'There isn't a cookbook,' revealed that the process of learning to utilize the power mobility device was an individualized process that developed over time in a cycle. Therapists were charged with determining what was appropriate for each child's needs and abilities. Through the training and post-training phases, therapists were required to have patience with children and parents. Several parents and therapists described 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 the power device can affect other people's interactions and lives. The majority of the participants in this study believed that it is important to be mindful when using a device that is powered by electricity. This was especially true when driving in public areas. Participants also mentioned that they've witnessed situations where someone else's property was damaged due to the use of a power mobility device, or a person has suffered injuries from a driver who didn't yield the right of way.
The results of this study show that power mobility and socialization training for preschoolers with CP can be conducted in specific classroom environments. Future research should continue to investigate the training and outcomes for this kind of intervention in children with CP. This could lead to more standard training protocols for children who have CP.