Power Mobility and Safety Concerns
Power mobility can enhance participation in daily activities as well as recreation for those in long-term care. However, the devices could also pose safety risks that must be addressed.
Most participants chose to adopt a teleological view and provide all residents with the chance to try a device, rather than exclude those with specific diagnosis which could be considered a prejudicial risk management.
Mobility
A power mobility device enables people who are disabled to move around their community or home and engage in daily activities that are otherwise impossible for them. However, these devices could also pose a risk to the person who uses them, and other people who are in their space. Occupational therapists must be aware of the safety requirements of each client prior to making recommendations regarding powered mobility.
In an exploratory study conducted by OTs at three residential facilities of the Vancouver Coastal Health Authority, qualitative interviews were conducted with residents to assess their use of power mobility. The aim was to create a framework for client-centered power mobility prescribing. 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 improve the quality of life for people who have mobility limitations. This is because it allows them to take part in daily activities at home and within the community. Participation in self-care as well as leisure and productive occupations is essential to mental and physical health for older adults and for a lot of people with chronic illnesses power mobility is the opportunity to keep participating in these vital 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 prevent them from doing the same things they were doing before their condition worsened. This was particularly true for those in the facility 1, who had been in a position to use their chairs for short durations and were dependent on others to help them move around the facility.
Another solution would be to slow down the speed at which residents drive their chairs. However this could cause 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 desired solution to security concerns.
Safety
Power mobility lets people move more easily. They are also able to participate in a broader range of activities, and do errands. With greater mobility comes a higher chance of accidents. These incidents can result in serious injuries for a few. It is essential to consider the security of your clients prior to suggesting power mobility.
The first step in determining security is to determine if your client is safe to operate their scooter or power wheelchair. This may include a physical assessment 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 your client may require a lift for their vehicle to be able to load and unload the mobility device at home, community or workplace.
Knowing the rules of road safety is a further aspect of safety. This involves sharing space with other pedestrians, other wheelchair users, and drivers of trucks, cars or buses. This topic was mentioned by most participants in the study.
Some people learnt to drive their wheelchairs along sidewalks instead of driving through crowded areas or on curbs (unless the wheelchair was designed for this purpose). For others this meant driving more slow in a crowded area and keeping an eye out for people walking.
The final and least desired option was to remove the chair of a person, which was seen as two-fold punishment loss of mobility independent and preventing access to facilities and community activities. Diane and Harriet, among others, were among the participants who had their chairs removed.
Participants also suggested that family members, and staff 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) as well as encouraging residents to practice driving techniques while outside, and helping them be aware of how their actions affect other people's mobility.
Follow-Up
A device that is powered by electricity can significantly impact a child's ability to function and take part in life. There has been little research into the experiences children have when learning to make use of these devices. This study employs a post-previous design to examine the effects of 6 months of using one of the four early mobility devices on a school-aged group of children with severe cerebral Palsy (CP).
green scooters were conducted with 15 parents as well as pediatric occupational and physical therapists. Thematic analysis revealed three main themes. The first, 'Power in Mobility explained how the use of a powered device changed more than just a child's motor skills. Learning to drive a mobility device can be an emotional, transformative journey for participants.
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. The therapists were asked to determine what was feasible based on each child's abilities and requirements. Through the training and post-training phases, therapists were also expected to be patient with children and parents. Therapists and parents alike spoke of the need to assist families celebrate their achievements and solve problems associated with the training process.
The third theme, 'Shared space was a look at the ways in which using an electric device can influence the lives of others and how they interact. The majority of participants in this study believed people must be mindful of other people when using their mobility device. This is particularly true when driving in public areas. Participants also said that they've seen instances in which property belonging to someone else was damaged due to the use a power mobility device or a person had been injured by a driver who didn't yield the right of way.
Overall, the findings of this study suggest that short-term power mobility and socialization training is feasible for preschoolers with CP in certain classroom environments. Future research should continue to investigate the training and outcomes for this kind of intervention in young children with CP. This should hopefully lead to the development of more standard training protocols specifically for this group of children.