Power Mobility and Safety Concerns
Power mobility allows those who are in long-term care in their daily activities and leisure pursuits. However, the devices can also pose safety risks that need to be addressed.
Most participants chose to adopt a teleological perspective and provide all residents with the chance to test a device, rather than exclude residents with specific diagnosis which could be considered a risk management decision that is prejudicial.
Mobility
A power mobility device enables people who are disabled to move around their home or community and engage in daily activities that are otherwise impossible for them. However, these devices may also be a danger to the person using them as well as other individuals who share their environment or space. Occupational therapists must carefully assess each client's safety needs to make the best recommendations regarding powered mobility.
In a study that was conducted by OTs at three residential care facilities of the Vancouver Coastal Health Authority, qualitative interviews were conducted with residents to determine the extent to which they used power mobility. mobility power was to develop a framework that would allow for client-centred power movement prescribing. The results revealed four major 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 greatly improve the quality of life for those who have limited mobility, allowing them to participate in a variety of daily life activities, both at home and in the community (Brandt 2001; Evans, 2000). Participation in self-care as well as leisure and productive occupations is essential for physical and mental health of older adults, and for those with progressive diseases, power mobility offers a way to continue participating in these vital activities.
Participants found it unacceptable to remove a wheelchair from a resident's home, as this would disrupt their life's narrative and direction and hinder them from performing the same things that they did before their disease worsened. This was especially relevant for those in Facility 1 who had only been in a position to use their power chair for a short period of time and were now reliant on others to push them.
Another solution would be to reduce the speed that residents drive their chairs. However this could cause a number issues such as privacy and the impact on the rest of the community. Ultimately, removing a resident's chair was considered the most drastic and least desirable solution to security concerns.
Safety
Power mobility lets people move more easily. They can also take part in a greater variety of activities and do the errands. However, with increased mobility comes a greater risk for accidents. These accidents can cause serious injuries for some. It is crucial to think about the safety of your clients before recommending the use of power mobility.
First, determine whether your client can safely operate their power chair or scooter. This could involve an assessment of physical health by a doctor or occupational therapist, or a mobility specialist, based on the nature of your client's disability as well as their current health. In some instances your client may require a lift for their vehicle to be capable of loading and unloading the device at their home, workplace or community.
Understanding the rules of road safety is another aspect of safety. This includes sharing space with other wheelchair users, pedestrians and drivers of cars or buses. This was a theme that was mentioned by the majority of participants in the study.
Some people learnt to drive their wheelchairs along sidewalks instead of driving through the midst of crowds or on curbs (unless the wheelchair was specially designed for this purpose). For others, it meant driving more cautiously in a noisy environment and keeping an eye out for pedestrians.
The final and least desired alternative was to take away the chair of a person, which was viewed as a two-fold penalty: losing independent mobility and preventing access to facilities and community activities. This was the opinion of the majority of those who had their chairs removed, including Diane and Harriet.
Participants also suggested that family members, and staff members be educated on the safe use of power mobility. This could include teaching the fundamentals of driving (such as driving on the right side of a hallway) as well as encouraging residents to practice driving strategies when they leave and helping them to understand how their actions can affect the mobility of others.
Follow-Up
A device that is powered by electricity can profoundly affect the child's ability to function and participate in life. However, very there isn't much research about the experience of children who learn to use this device. This study uses an approach that is pre-post to study the impact of six months' experience using one of four early power mobility devices on the children in school with severe cerebral palsy (CP).
We conducted qualitative interviews with 15 parents and also pediatric occupational and physical therapists. Thematic analysis identified three main themes. The first, 'Power in Mobility explained the ways in which powered devices changed more than just motor skills. The process of learning to operate a powered mobility device is usually an emotional and transformative one.
The second theme 'There's no recipe book' showed that the process of learning to utilize a mobility device was a process that developed in a cyclical manner over time. Therapists were asked to determine what was realistic based on each child's abilities and needs. Throughout the training and post-training phases, therapists were also expected to be patient with parents and children. Therapists and parents alike spoke of the need to help families celebrate their successes and address issues related to the process of training.
Finally, the third theme called 'Shared space The study explored the ways in which using a power device could affect other people's lives and interactions. The majority of those who participated in this study believed that people must always be considerate of other people when using their mobility device. This was especially true when driving on roads that are public. Many participants also reported that they've encountered situations where someone else's property was damaged by the use of a power mobility device, or when a person was injured by a driver who failed to yield right-of-way.
The results of this study indicate that socialization and power mobility training for preschoolers with CP can be done in certain classroom environments. The next research study should examine the effectiveness of 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 for this group.