Power Mobility and Safety Concerns
Power mobility allows individuals who are in long-term care in their everyday activities and leisure activities. However, the devices can also cause safety issues which need to be addressed.
Rather than exclude residents with a specific diagnosis from the power mobility option as it could be viewed as risk management prejudicial, most participants chose to take the teleological approach and let everyone test a device.
Mobility
A power mobility device provides a method for people with limited mobility to move about their home or community, and to participate in everyday activities that they might not otherwise be able to participate in. These devices can cause danger not only for the person who uses them but also to others who share their space or the space. Occupational therapists should carefully consider the safety needs of each client before making recommendations on powered mobility.
In a study that was conducted 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 a framework for client-centered power mobility prescribing. The results revealed four main themes: (1) the meaning of power mobility, (2) learning the rules of the road, (3) red flags: concerns about safety and (4) solutions.
Power mobility can boost the quality of life for individuals with limited mobility. This is because it allows them to participate in everyday activities at home and within the community. Participation in self-care or leisure activities, as well as productive ones is essential to physical and mental health of older adults, and for many people with chronic illnesses, power mobility offers a way to continue participating in these important activities.
electric wheel scooter felt it was inconvenient to remove a resident's wheelchair, as this would disrupt their life's story and progression and stop them from doing the same activities that they had prior to their illness progressed. This was especially applicable to those in Facility 1 who had been able use their power chairs for a short period of time and were now reliant on others to push them.
Another option is to reduce the speed at which residents drove their chairs, however this could have raised issues, such as a lack of privacy and the impact on other residents in the community. Ultimately, removing the chair of a resident was thought to be the most drastic and least preferred solution to safety concerns.
Safety
Power mobility allows people to move more freely. They can also take part in a wider range of activities, as well as do the errands. With greater mobility comes a higher chance of accidents. These accidents can cause serious injuries for certain. This is why it is important to consider the safety of your client before recommending that they use a power mobility.
The first step in assessing safety is to determine if your client is able to safely operate their power scooter or power chair. This could include a physical assessment by a physician or occupational therapist, or a mobility specialist, based on the nature of your client's impairment and their current health. In some instances your client may require an automobile lift to be able to load and unload the device at their home, workplace or community.
Understanding the rules of road safety is an additional aspect of safety. This includes sharing space with other wheelchair users, pedestrians and the drivers of cars or buses. This topic was mentioned by the majority of participants in the study.
For some this, it required learning to drive their wheelchairs on sidewalks instead of driving through areas that were crowded or over curbs (unless specifically designed for doing so). Others drove more slowly and kept an eye out for pedestrians in a crowd.
The final and least preferred alternative was to take away a person's chair, which was seen as two-fold punishment: losing independent mobility and preventing access to facilities and community activities. This was the opinion of the majority of participants who had their chairs removed and included Diane and Harriet.
Other ideas suggested by the participants included educating other residents as well as family members and staff on the safe operation of power mobility. This could include teaching basic driving skills (such as the right side to walk on in a hallway) and encouraging residents to practice driving skills while outside, and helping them recognize how their behavior affects other people's mobility.
Follow-Up
A power mobility device can profoundly affect a child's ability to function and participate in life. There isn't much research on the experience that children go through when they first learn to use these devices. This study uses the post-previous method to analyze the effects of six months of experience with one of four early mobility devices on a group of school-aged children of children who suffer from 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, 'Power in mobility,' described the ways in which a powered device changed more than just locomotor abilities. Learning to drive a mobility device was often a transformative, emotionally charged journey for participants.
The second theme , 'There's no recipe book' showed that learning to make use of an equipment for mobility was a process that took place in a way that was cyclical over time. The therapists were asked to decide what was appropriate depending on the individual's capabilities and requirements. Throughout the training and post-training phases, therapists were required to be patient with parents and children. Parents and therapists alike described the need to help families celebrate their accomplishments and address issues related to the training process.
The third theme, 'Shared space', explored the ways in which using an electric device can have an impact on the lives of other people and their interactions. The majority of the participants in this study believed that one should always show consideration for other people when using their mobility device. This is especially important when driving in public areas. Participants also said that they've witnessed situations where someone else's property was damaged due to the use of a motorized device or a person had been injured by a driver who didn't yield the right of way.
Overall, the results of this study suggest that short-term socialization and power mobility training appears feasible 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 more standard training protocols for children who have CP.