Power Mobility and Safety Concerns
Power mobility allows people who are in long-term care to take part in their daily activities and leisure activities. However, the devices could also cause safety issues that must be addressed.
Rather than exclude residents who have certain diagnoses from use of power mobility as it could be viewed as risk management that is prejudicial, the majority of participants opted to adopt a teleological approach and let all residents try out the power mobility device.
Mobility
A power mobility device is a way for people with limited mobility to move around their home or community, and to participate in everyday activities that they may not be able to participate in. These devices can pose a risk not only to the person using them, but also to those who share their space or surroundings. Occupational therapists must carefully assess each client's safety needs to make the best suggestions regarding powered mobility.
In an exploratory study (von Zweck 1999), OTs from three residential care facilities in Vancouver Coastal Health Authority conducted qualitative interviews with residents regarding their use of power mobility. The goal was to develop a framework for client-centered power mobility 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 enhance the quality of life of people with mobility limitations. This is because it allows them to participate in everyday activities at home as well as in the community. Participation in self-care, productive and leisure occupations is crucial to mental and physical health for older adults and for a lot of people who are suffering from progressive illnesses power mobility is a way to continue participating in these important activities.
The participants felt it was inconvenient to remove a wheelchair from a resident's home in order to alter their life story and trajectory and hinder them from doing the same activities that they were doing before their condition progressed. This was particularly true for those in the Facility 1 who had only been in a position to use their power chair for a brief period and were now reliant on others to push them.
mymobilityscooters.uk is to limit the speed at which some residents drove their chairs, however this raised a number of issues, such as privacy issues and impact on other people in the community. The most drastic solution to safety concerns was to get rid of a resident's wheelchair.
Safety
Power mobility allows people to move around more freely. They can also take part in a wider range of activities and run the errands. However, with increased mobility comes a greater risk for accidents. For some, these incidents could result in serious injuries to themselves or others. It is important to think about the safety of your clients prior to suggesting the use of power mobility.
The first step in determining safety is to determine whether your client is able to safely operate their power wheelchair or scooter. Based on their condition and their current health, this may involve a physical evaluation by a doctor or occupational therapist, as well as a discussion with a mobility expert to determine if a specific device would be appropriate for them. In some instances your client will require an automobile lift to be able to load and unload the mobility device at their home, community or workplace.
Another aspect of safety is learning the rules of the road. This includes sharing space, with other wheelchair users, pedestrians, and drivers of buses or cars. The majority of participants in the study discussed this topic.
For some, this meant learning to use their wheelchairs on sidewalks, instead of driving through busy areas or over curbs (unless specifically designed to do such). Others drove slower and looked out for pedestrians in a crowded environment.
The last and least preferred option that was to take away a person's wheelchair, was viewed as a double punishment: losing independence in mobility, and also preventing them from participating in activities with the community or at facilities. Diane and Harriet, among others, were among the participants who were stripped of their chairs.
Other suggestions made by the participants included educating other residents, family members and staff on the proper operation of power mobility. This could include teaching basic driving skills (such as which side to walk on in the hallway) and encouraging residents to practice driving while outside and helping them be aware of how their actions affect the mobility of other people.
Follow-Up
The ability of a child and their willingness to take part in the world can be profoundly affected by a power mobility device. There has been little research on the experiences children experience when they learn to utilize these devices. This study uses a post-previous design to examine the effects of six months of using one of four early mobility devices on a group of school-aged children of 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 key themes. The first theme, 'Power for mobility', described how the use of an electric device impacted more than just the child's motor skills. The process of learning to operate a powered mobility device can be an emotional and transformative experience.
The second theme , 'There's no recipe book' showed that learning to make use of a mobility device was a process that unfolded in a continuous manner over time. Therapists were asked to decide what was appropriate depending on the individual's capabilities and requirements. Through the training and post-training phases, therapists were required to be patient with children and parents. Therapists and parents alike emphasized the need to help families celebrate their successes and solve problems associated with the training process.
The third theme, 'Shared space', explored how the use of devices that power us can influence the lives of others and how they interact. The majority of participants in this study believed that it is important to be considerate when using a power device. This was particularly true when driving on roads that are public. 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 in which an individual was injured due to a driver who failed to yield 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 environments. Future research should continue to examine the effectiveness of training and outcomes for this kind of intervention for children with CP. This will hopefully lead to the development of more standard training protocols specifically for this group of children.