Power Mobility and Safety Concerns
Power mobility allows people who are in long-term care in their routine activities and leisure pursuits. These devices also raise security concerns that need to be addressed.
Instead of excluding residents with a specific diagnosis from the use of power mobility that could be considered risk management prejudicial, most participants preferred to take the teleological approach and let all residents try out a device.
Mobility
A power mobility device allows those who are disabled to move about their home or community 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 other people who share their space or environment. Occupational therapists should carefully consider the safety needs of each client before making recommendations about powered mobility.
In an exploratory study (von Zweck 1999), OTs from three residential care facilities of the Vancouver Coastal Health Authority conducted qualitative interviews with residents regarding their power mobility use. The goal was to create a framework that would allow for a client-centered power movement prescription. greenpower mobility scooter 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 improve the quality of life for individuals who have limited mobility. This is because it lets them participate in everyday activities at home and within the community. Participation in self-care or leisure activities, as well as productive ones is crucial to physical and mental health of older adults, and for many people who are suffering from progressive illnesses power mobility is a way to continue participating in these important activities.
It was considered unacceptable by the participants to remove a resident's wheelchair in order to alter their life's story and progression, and prevent them from engaging in the same activities that they did before their disease progressed. This was especially true for those in the Facility 1 who had been allowed to use their power chairs for a short time and now relied on others to push them.
Another possible solution is to limit the speed at which some residents drove their chairs, but this led to a variety of concerns, including a lack of privacy and the impact on other residents in the community. The most drastic solution to safety concerns was to get rid of the wheelchair of a resident.
Safety
Power mobility allows people to move around more freely. They can also take part in a greater variety of activities, as well as run around on their own. However, with increased freedom of movement comes a greater chance of accidents. For some, these incidents could result in serious injuries to themselves or others. This is why it is important to think about the safety of your client before recommending that they utilize power mobility.
First consider determining whether your client can safely operate their power chair or scooter. Depending on the severity of 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 cases the use of a vehicle lift may be necessary to allow for your client to unload and load their mobility device at home in the community, or at work.
Another aspect of safety is knowing the rules of the road. This includes sharing space with pedestrians, wheelchair users, and drivers of trucks, cars or buses. This was a theme that was mentioned by the majority of participants in the study.
For some this, it required learning to use their wheelchairs on sidewalks, instead of driving through areas that were crowded or over curbs (unless specifically designed to do so). For others it meant driving slow in a crowded area and watching out for people walking.
The most popular and least desired option that was to take away the wheelchair of a person was viewed as a double whammy: losing independence in mobility and hindering them from participating in community and facility activities. Diane and Harriet among others were among the participants who had their chairs removed.
The participants also suggested that residents, family members, and staff members be educated on the safe use of power mobility. This could include teaching the basics of driving (such as which side to walk on in a hallway) and encouraging residents to practice driving techniques when they go outside and assisting them to be aware of how their actions affect the mobility of others.
Follow-Up
A power mobility device can significantly impact the ability of a child to function and take part in life. There is little research on the experiences children experience when they learn to make use of these devices. This study employs a pre-post design to examine the impact of six months' experience with one of four early power mobility devices on children in the school age group with severe cerebral palsy (CP).
Qualitative interviews were conducted with 15 parents and children's occupational and physical therapists. Thematic analysis identified three major themes. The first, 'Power in Mobility,' described the ways in which a powered device changed more than just motor skills. Learning to drive a mobility device was often a transformative, emotionally charged journey for the participants.
The second theme, 'There isn't a recipe book,' showed that learning to utilize the power mobility device was a bespoke process that unfolded over time in a cyclical manner. Therapists were asked to determine what was feasible based on each child's abilities and needs. In the initial phase of training and after, therapists had to be patient with children and parents. Therapists and parents alike emphasized the need to assist families celebrate their achievements and resolve issues that arise from the process of training.
The third theme, "Shared space", explored how the use an electric device can affect other people's interactions and lives. The majority of those who participated in this study felt that a person must be mindful of others when using their power mobility device. This is especially relevant when driving on roads that are public. Several participants also noted that they've encountered situations where someone else's property was damaged by the use of an electric 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 power mobility and socialization training for preschoolers with CP can be carried out in certain classroom settings. The next research study should study the training and results for this kind of intervention in children with CP. This could eventually lead to more standardized training protocols for children suffering from CP.