Power Mobility and Safety Concerns
Power mobility allows those who are in long-term care to take part in their routine activities and leisure pursuits. However, the devices can also cause safety issues that must be addressed.
The majority of participants choose to adopt a teleological perspective and give all residents the opportunity to test devices, not to exclude those with specific diagnoses, which could be considered a risk management decision that is prejudicial.
Mobility
A power mobility device allows people who are unable to move about their home or community and take part in daily activities that would otherwise be unavailable to them. These devices could cause danger not only to the individual using them, but also to other people who are in their 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 about their use of power mobility. The aim was to create a framework for client-centered power mobility prescribing. The findings revealed four main themes: (1) the meaning of power mobility, (2) learning the rules of the road, (3) red flags concern about safety and (4) solutions.
Power mobility can improve the quality of life for individuals with mobility limitations. This is due to the fact that it allows them to take part in daily activities at home and in the community. Self-care, productive and recreational occupations are vital for physical and mental well-being of older adults. For many who suffer from chronic illnesses, power mobility can be a means to participate in these essential activities.
The majority of participants felt it was unacceptable to take away the chair of a resident, since this would cause a major interruption to their life or trajectory and essentially prevent them from pursuing the same activities they had been doing before the progression of their illness. This was particularly true for those in Facility 1 who were capable of maintaining their power chairs for short durations and were forced to rely on other residents to help them move around the facility.
Another option is to slow down the speed at which some residents drive their chairs. However this could cause various issues like privacy and the impact on the rest of the community. Ultimately, removing a resident's chair was considered the most drastic and least desired solution to safety concerns.
Safety
Power mobility allows people to move more easily. They can also participate in a wider range of activities and do errands. However, with increased mobility comes a higher risk of accidents. These accidents can cause serious injuries for some. It is essential to consider the security of your clients prior to suggesting the use of power mobility.
The first step in assessing safety is to determine if your client can safely operate their power scooter or power chair. Based on the nature of their condition and their the state of their health, this could require a physical examination by a doctor or occupational therapist, or a discussion with a mobility expert to determine whether a specific device is suitable for them. In certain situations the use of a vehicle lift may be required to allow for your client to unload and load their mobility device at home, in the community or at work.
Knowing the rules of road safety is another aspect of safety. This includes sharing space with other pedestrians, wheelchair users and drivers of trucks, cars or buses. A majority of the participants have mentioned this issue.
For some it required learning to use their wheelchairs on sidewalks, instead of driving through crowded areas or over curbs (unless specifically designed for doing this). For others, it meant driving more slowly in a busy environment and keeping an eye out for pedestrians.
The most popular and least desired option of removing the wheelchair of a person was seen as a double punishment: losing independence in mobility, and also preventing them from taking part in activities with the community or at facilities. This was the view of the majority of participants who were able to remove their chairs among them Diane and Harriet.
The participants also suggested that residents, family members, and staff be informed about the proper use of power mobility. This could include educating residents on the basics of driving (such as using the correct side of the hallway) as well as encouraging residents to practice driving strategies when they leave and helping them to understand how their actions can affect other people's mobility.
Follow-Up
A device that is powered by electricity can significantly impact the ability of a child to function and be a part of life. Yet My Mobility Scooters has been done on the experience of children who learn to use this equipment. This study employs an approach that is post-previous to study the effects of 6 months of use with one of four early mobility devices on a school-aged group of children who suffer from severe cerebral palsy (CP).
We conducted interviews in qualitative format with 15 parents and also pediatric occupational and physical therapists. Thematic analysis revealed three main themes. The first theme, 'Power for mobility explained the ways that using a powered device affected more than just locomotor abilities. Learning to drive a mobility device can be a transformative, emotionally charged journey for the participants.
The second theme , 'There's no recipe book' showed that learning how to utilize a mobility device was a process that developed in a way that was cyclical over time. The therapists were asked to determine what was realistic depending on the individual's capabilities and requirements. During the training phase, and afterwards, therapists needed to be patient with children and parents. Therapists and parents alike emphasized the need to help families celebrate their accomplishments and resolve issues that arise from the process of training.
The third theme, "Shared space", looked at how the use of an electric device can affect other people's lives and interactions. The majority of the participants in this study believed that people should be considerate when using a power device. This is especially important when driving in public spaces. Participants also said that they've witnessed situations in which property belonging to someone else had been damaged by the use a power mobility device or a person had been injured by a motorist who did not yield the right of way.
Overall, the results of this study suggest that short-term power mobility and socialization training appears feasible for preschoolers with CP in certain classroom settings. Future research should be focused on the training and outcomes of this type of intervention for young children with CP. This should hopefully result in the development of more standardized training protocols for this group.