Power Mobility and Safety Concerns
Power mobility enhances participation in daily activities and recreational pursuits for individuals in long term care. The devices can also create safety concerns, which must be addressed.
The majority of participants opt to adopt a teleological view and give all residents the chance to test the device, instead of restrict residents with certain diagnosis, which could be considered an unfair risk management.
Mobility
A power mobility device allows people with limited ability to move about their homes or communities and participate in daily living activities that are otherwise unavailable to them. However, these devices could also be a danger to the person who uses them, and also to other people who are in their space. Occupational therapists must carefully evaluate the safety needs of each client to provide the most appropriate recommendations for 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 aim was to develop an environment that allowed 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 greatly improve the quality of life for those with limited mobility by allowing them to participate in a range of daily living activities both at home and in the community (Brandt 2001; Evans, 2000). Self-care, productive and recreational occupations are vital for mental and physical health of the elderly. For many with chronic illnesses, power mobility can be a means to participate in these essential activities.
The participants felt it was inconvenient to remove a wheelchair from a resident's home in order to alter their life's story and progression and stop them from performing the same things they were doing before their condition advanced. This was particularly the case for those in the Facility 1, who had been able to maintain their chairs for short durations and were dependent on others to move them around the facility.
Another option is to slow down the speed at which some residents drive their chairs. However it could create various issues like privacy and the impact on the rest of the community. In the end, taking away the chair of a resident was thought to be the most drastic and least preferred solution to safety concerns.
Safety
Power mobility allows disabled people to move more freely and take part in a wider variety of activities, and even complete around. With greater mobility comes a higher risk of accidents. For some, these accidents could result in serious injuries to themselves or others. It is important to think about the safety of your clients before suggesting power mobility.
The first step in determining safety is to determine whether your client can safely operate their power wheelchair or scooter. go green mobility scooters could involve an examination of the physical by a doctor or occupational therapist or a mobility specialist, based on the nature of your client's impairment and their current health. In some instances the use of a vehicle lift may be necessary to allow for your client to unload and load their mobility device at home or in the community at work.
Understanding the rules of road safety is an additional aspect of safety. This includes sharing space with pedestrians, other wheelchair users, and drivers of cars, trucks or buses. This topic was mentioned by the majority of participants in the study.
Some people learned to drive their wheelchairs along sidewalks instead of driving in busy areas or on curbs (unless the wheelchair was specifically designed for this). For others, it meant driving more slowly in a busy environment and watching out for pedestrians.
The last and least preferred option of removing the wheelchair of a person was viewed as a double punishment that would result in the loss of mobility, and also preventing them from participating in community and facility activities. This was the opinion of the majority of participants who were able to remove their chairs, including Diane and Harriet.
Other ideas suggested by participants included educating residents, family members and staff about the safety of power mobility. This could include teaching basic driving skills (such as the right side to walk on in the hallway), encouraging the residents to practice driving techniques when they leave, and helping them understand how their behavior affects other people's mobility.
Follow-Up
The capacity and willingness of a child to participate in life can be greatly affected by a power mobility device. There isn't much research on the experience that children experience when they learn to make use of these devices. This study employs a post-previous design to examine the effects of 6 months of experience with one of the four early mobility devices on a group of school-aged children of children suffering from severe cerebral palsy (CP).
We conducted interviews in qualitative format with 15 parents, along with occupational and physical therapists for children. Thematic analysis identified three main themes. The first, 'Power in mobility,' explained the ways in which a powered device changed more than just locomotor abilities. The experience of learning how to drive a motorized mobility device can be an emotional and transformative one.
The second theme, 'There's no such thing as a cookbook,' revealed that the process of learning to use the power mobility device was an individualized process that unfolded over time in a cyclical manner. Therapists were tasked with unearthing what was realistic for the individual child's needs and abilities. During the training phase, and afterwards, therapists needed to be patient with children and parents. Many parents and therapists mentioned a need to help families celebrate their successes and solve problems that arise from the process of training.
The third theme called 'Shared space was a look at how the use of an electric device can affect the lives of other people and their interactions. The majority of the participants in this study believed that it is important to be mindful when using a power mobility device. This was particularly relevant when driving on roads that are public. Many participants also reported that they had encountered situations in which someone else's property was damaged by the use of a power mobility device, or when a person was injured due to a driver who not yielded right-of-way.
The results of this study indicate that power mobility and socialization training for preschoolers with CP can be conducted in certain classroom environments. Future research should continue to investigate the effectiveness of training and outcomes of this type of intervention for young children with CP. This could lead to more standardized training protocols for children suffering from CP.