Power Mobility and Safety Concerns
Power mobility allows those who are in long-term care in their daily activities and leisure pursuits. The devices can also create safety risks, which need to be addressed.
Most participants chose to adopt a teleological perspective and give all residents the chance to test a device, rather than exclude those with specific diagnosis which could be considered a prejudicial risk management.
Mobility
A power mobility device is an option for those with limited mobility to move around in their community or home, and to participate in activities of daily living that they may not be able to participate in. However, these devices may also pose a risk to the person using them and also to other people who share their environment or space. Occupational therapists should carefully consider the safety requirements of each client before making recommendations regarding powered mobility.
In green power scooters conducted by OTs in three residential care facilities of the Vancouver Coastal Health Authority, qualitative interviews were conducted with residents to determine 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 significantly increase quality of life for people who have limited mobility, allowing them to participate in a range of daily life activities, at home as well as in the community (Brandt, 2001; Evans, 2000). Self-care, productive and recreational jobs are essential for the mental and physical health of people who are older. For many who suffer from chronic illnesses, power mobility allows them to take part in these important activities.
It was considered unacceptable by the participants to take away a wheelchair, as this would disrupt their life story and trajectory and stop them from performing the same things they were doing before their condition worsened. This was particularly applicable to those in the Facility 1 who had been able use their power chairs for a short time and now relied on others to push them.
Another option is to reduce the speed at which some residents drove their chairs, but this raised a number of concerns, including privacy issues and impact on other people in the community. Ultimately, removing the chair of a resident was deemed the most drastic and least desirable solution to security concerns.
Safety
Power mobility allows disabled people to move around more easily and take part in a wider range of activities and do errands. However, with greater mobility comes a greater chance of accidents. For some, these incidents could cause serious injuries to themselves and others. This is why it is crucial to consider the safety of your client before suggesting that they utilize power mobility.
First check if your client is able to safely operate their power chair or scooter. This may include an assessment of physical health by a physician or occupational therapist or a mobility specialist, based on the nature of your client's disability and their current health. In some instances the use of a vehicle lift may be required to allow for your client to load and unload 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 other wheelchair users, pedestrians, and drivers of buses or cars. The majority of participants in the study mentioned this theme.
Some people learned to drive their wheelchairs along sidewalks instead of driving through crowded areas or on curbs (unless the wheelchair was specially designed for this). Others drove slower and paid attention to pedestrians in an area that was crowded.
The final and least popular option, which was to remove a person's wheelchair, was seen as a double whammy that would result in the loss of mobility and preventing them from taking part in the activities of the community and facilities. This was the viewpoint of most participants who were able to remove their chairs among them Diane and Harriet.
Other solutions that were suggested by the participants included educating other residents staff, family members and other residents about the safety of power mobility. This could include teaching driving basics (such as which side to walk on in a hallway) as well as encouraging residents to practice driving skills when they leave and helping them be aware of how their actions affect other people's mobility.
Follow-Up
The ability of a child and their willingness to take part in the world can be greatly affected by a device for power mobility. However, little research has been done on the experience of children learning to use this device. This study employs an approach that is post-previous to study the effects of 6 months of experience with one of four early mobility devices on a group of school-aged children of children who suffer from severe cerebral Palsy (CP).
We conducted qualitative interviews with 15 parents and also occupational and physical therapists for children. Thematic analysis identified three main themes. The first theme, 'Power for Mobility explained how the use of a powered device affected more than just locomotor abilities. Learning to drive a power mobility device can be an emotional, transformative experience for those who participated.
The second theme 'There's no recipe book' showed that learning how to utilize an equipment for mobility was a process that unfolded in a cyclical manner over time. Therapists were asked to decide what was appropriate in light of the child's capabilities and needs. In the initial phase of training and after, therapists had to be patient with children and parents. Therapists and parents alike spoke of the need to assist families celebrate their successes and address issues related to the training process.
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 it is important to be considerate when using a power device. This was especially true when driving in public areas. Participants also said that they've witnessed situations where property of someone else's was damaged due to the use of a power mobility device, or a person has been injured by a driver who didn't yield the right of way.
The results of this study suggest that power mobility and socialization training for preschoolers with CP can be done in a variety of classroom settings. Future research should continue to investigate the effects of training and results of this type of intervention for children with CP. This could eventually lead to more standard training protocols for children suffering from CP.