Power Mobility and Safety Concerns
Power mobility can enhance participation in daily activities and recreational pursuits for individuals in long term care. However, these devices can also pose safety risks that need to be addressed.
Instead of excluding residents with a specific diagnosis from the power mobility option, which may be considered risk management prejudicial, most participants preferred to take an approach based on teleology and let everyone try out the power mobility device.
Mobility
A power mobility device allows those who are disabled to move around their community or home and engage in daily activities that might otherwise be not accessible to them. These devices pose a risk not only to the person using them but also to others who share their space or the space. Occupational therapists should carefully consider the safety needs of each client prior to making recommendations on powered mobility.
In an exploratory study conducted by OTs at three residential care facilities of the Vancouver Coastal Health Authority, qualitative interviews were conducted with residents to assess their power mobility use. The aim was to develop a framework that would allow the use of power mobility that is centered on the needs of the client. The results revealed four major themes: (1) power mobility meaning, (2) learning road rules, (3) red flags security concerns and (4) solutions.
Power mobility can dramatically improve the quality of life for individuals who have limited mobility, permitting them to take part in a range of daily life activities, both at home and in the community (Brandt, 2001; Evans, 2000). Participation in self-care or leisure activities, as well as productive ones is essential for physical and mental health of older adults, and for many people with progressive diseases, power mobility offers a way to continue participating in these important activities.
Most participants found it unacceptable to remove the chair of a resident, since this would cause a major interruption to their life or path and prevent them from continuing to engage in the same activities they had been doing before their illness progressed. This was especially relevant for those in Facility 1 who were only allowed to use their power chairs for a brief period and were now reliant on others to push them.
Another possible solution is to limit the speed at which some residents drove their chairs, however this raised a number of 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 desirable solution to safety concerns.
Safety
Power mobility allows those with disabilities to move around more easily and take part in a wider range of activities and run around. However, with increased mobility comes a higher risk of accidents. These incidents can result in serious injuries for some. It is essential to consider the safety of your clients before recommending power mobility.
The first step in determining safety is to determine whether your client is safe to operate their scooter or power wheelchair. Based on the severity of their impairment and the state of their health, this could involve a physical assessment by a physician or occupational therapist, and an interview with a mobility expert to determine if a specific device would be appropriate for them. In some cases, your client will need a lift for their vehicle to be capable of loading and unloading the mobility device at workplace, home, or community.
Another aspect of safety is learning the rules of the road. This includes sharing space with other pedestrians, other wheelchair users, and drivers of cars, trucks or buses. green mobility scooters of the participants mentioned this theme.
Some people learned to drive their wheelchairs along sidewalks instead of driving in busy areas or on curbs (unless the wheelchair was designed to be used in this way). For others this meant driving more slowly in a busy environment and watching out for people walking.
The last and least popular option was to remove a person's chair, which was viewed as a double punishment loss of mobility independent and preventing access to facilities and community activities. Diane and Harriet, among others, were among the participants who were stripped of their chairs.
The participants also suggested that family members, and staff members be trained on the safe use of power mobility. This could include teaching the fundamentals of driving (such as driving on the right side of the hallway) as well as encouraging residents to practice driving techniques when they leave and helping them understand how their behavior can influence other people's mobility.
Follow-Up
A power mobility device can significantly impact a child's ability to function and take part in life. However, very little research has been done about the experience of children who are learning to use this equipment. This study employs a pre-post design to examine the effects of six months' experience using one of four early power mobility devices on the children in school with severe cerebral palsy (CP).
We conducted interviews in qualitative format with 15 parents along with occupational and physical therapists who work with children. Thematic analysis revealed three key themes. The first, 'Power in Mobility explained the ways in which powered devices changed more than just motor skills. The experience of learning to drive a motorized mobility device is often an emotional and transformative experience.
The second theme, 'There's no such thing as any cookbook,' revealed that learning to utilize a power mobility device was an individualized process that evolved over time in a cyclical fashion. Therapists were required to discover the most appropriate solution for each child's needs and capabilities. Through the training and post-training phases, therapists were required to be patient with children and parents. Parents and therapists alike described the need to help families celebrate their successes and address issues related to the process of training.
The third theme, 'Shared space', explored the ways in which using a power device could influence other people's lives and interactions. The majority of participants in this study believed a person should always show consideration for other people when using their mobility device. This is especially applicable when driving on public roads. Participants also mentioned that they've seen instances in which property belonging to someone else had been damaged by the use of a motorized device, or a person has suffered injuries from a driver who failed to yield the right of way.
Overall, the findings of this study suggest that short-term power mobility and socialization training appears feasible for preschoolers with CP in certain classroom environments. Future research should be focused on the training and outcomes of this type of intervention for young children with CP. This should hopefully lead to the development of more standardized training protocols specifically for this group of children.