Power Mobility and Safety Concerns
Power mobility improves participation in daily activities and recreation for those who are in long-term care. The devices can also create safety risks, which need to be addressed.
Rather than exclude residents who have certain diagnoses from use of power mobility that could be considered prejudicial risk management, most participants chose to take a teleological approach and allow all residents to test the device.
Mobility
A power mobility device is a way for people who are unable to move around their community or home, and to participate in everyday activities that they would not be able to perform. However, these devices may also pose a risk to the person using them and other people who are in their space. Occupational therapists should carefully consider the safety requirements of each client prior to making recommendations regarding 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 evaluate the extent to which they used power mobility. The objective was to establish a framework that could allow for a client-centered power movement prescription. The results revealed four major themes: (1) the meaning of power mobility, (2) learning the rules of the road, (3) red flags concerning safety, and (4) solutions.
Power mobility can significantly increase quality of life for individuals who are mobility-challenged by giving them the opportunity to participate in a variety of everyday living activities, at home as well as in the community (Brandt, 2001; Evans, 2000). Participation in self-care as well as leisure and productive occupations is vital to mental and physical health of older adults, and for many people who are suffering from progressive illnesses power mobility is the opportunity to keep participating in these important activities.
The participants felt it was inconvenient to remove a resident's wheelchair because it would alter their life story and trajectory and hinder them from engaging in the same things that they had prior to their illness progressed. This was particularly relevant to those in the facility 1, who had been capable of maintaining their power chairs for short periods of time and were forced to rely on others to move them around the facility.
Another option is to limit the speed at which residents drive their chairs. However, this could raise a number issues such as privacy and the impact on the rest of the community. The most drastic solution to security concerns was to take away the wheelchair of a resident.
Safety
Power mobility allows those with disabilities to move around more easily, participate in a wider range of activities and run the errands. However, with increased mobility comes a greater chance of accidents. For some, these accidents could result in serious injuries to themselves and others. It is important to consider the safety of your clients prior to suggesting power mobility.
The first step in assessing safety is to determine if your client can safely operate their scooter or power wheelchair. This could involve a physical assessment by a doctor or occupational therapist, or a mobility specialist, based on the nature of your client's disability and their current health. In some cases it is necessary to have a vehicle lift. be necessary to allow for your client to load and unload their mobility device at home or in the community at work.
green mobility scooters of safety is to learn the rules of the road. This includes sharing space with other pedestrians, other wheelchair users and drivers of cars, trucks or buses. This was a theme that was mentioned by most participants in the study.
Some people learnt to drive their wheelchairs on sidewalks instead of driving in busy areas or on curbs (unless the wheelchair was designed for this purpose). For others it meant driving slow in a crowded area and watching out for people walking.
The last and least popular alternative was to take away the chair of a person, which was viewed as a double punishment that would result in losing mobility independently and preventing access to facilities and community activities. This was the opinion of most participants who were able to remove their chairs and included Diane and Harriet.
Other solutions that were suggested by participants included educating other residents as well as family members and staff on the proper operation of power mobility. This could include educating residents on the basics of driving (such as using the right side of a hallway), encouraging residents to practice driving skills when they go out and helping them understand how their behavior can influence other people's mobility.
Follow-Up
A device that is powered by electricity can have a profound impact on the ability of a child to function and participate in life. However, very there isn't much research on the experience of children who learn to use this equipment. This study uses a post-previous design to examine the effects of six months of using one of the four early mobility devices on a group of school-aged children of children suffering from severe cerebral palsy (CP).
Qualitative interviews were conducted with 15 parents and pediatric occupational and physical therapists. Thematic analysis revealed three main themes. The first theme, 'Power for Mobility', described how the use of an electric device impacted more than just the child's motor skills. Learning to drive a mobility device was often an emotional, transformative journey for the participants.
The second theme 'There's no cookbook' revealed that learning how to make use of a mobility device was a process that unfolded in a cyclical manner over time. Therapists were required to decide what was appropriate in light of the child's capabilities and requirements. During the training phase and following, therapists were required to be patient with children and parents. Therapists and parents alike emphasized the need to assist families celebrate their accomplishments and solve problems associated with the process of training.
The third theme, "Shared space", looked at how the use of the power device can affect other people's interactions and lives. The majority of the participants in this study believed that people should be mindful when using a power device. This is particularly true when driving in public spaces. A few participants also mentioned that they've encountered instances where another's property was damaged through the use of an electric mobility device, or when a person was injured by a driver who had failed to yield right-of-way.
Overall, the results of this study suggest that short-term power mobility and socialization training is possible for preschoolers with CP in certain classroom environments. Future research should continue to investigate the effects of training and results of this type of intervention for children with CP. This will hopefully result in the development of more standard training protocols specifically for this group of children.