Power Mobility and Safety Concerns
Power mobility allows those in long-term care to participate in their everyday activities and leisure pursuits. These devices also raise safety concerns, which must be addressed.
The majority of participants opt to adopt a teleological perspective and provide all residents with the opportunity to test the device, instead of exclude those with specific diagnoses that could be viewed as a prejudicial risk management.
Mobility
A power mobility device provides an option for those who are unable to move around their community or home, and participate in daily activities that they might not otherwise be able to perform. These devices could be a danger not just to the individual using them but also to others who are in their environment. Therapists in occupational therapy must assess each client's safety needs to provide the most appropriate recommendations for powered mobility.
In an exploratory study (von Zweck, 1999), OTs from three residential care facilities within the Vancouver Coastal Health Authority conducted qualitative interviews with residents about their power mobility use. The objective was to establish an environment that allowed the use of power mobility that is centered on the needs of the client. The results revealed four major themes: (1) power mobility meaning, (2) learning road rules, (3) red flags - safety concerns, and (4) solutions.
Power mobility can improve the quality of life of those who have limited mobility. This is due to the fact that it allows them to take part in everyday activities at home and within the community. Participation in self-care as well as leisure and productive occupations is crucial to mental and physical health of older adults, and for a lot of people who are suffering from progressive illnesses, power mobility offers a way to continue participating in these vital activities.
Participants found it unacceptable to take away a wheelchair because it would alter their life's story and progression, and prevent them from doing the same things that they had prior to their illness advanced. This was especially relevant to those in the facility 1, who had been capable of maintaining their chairs for short periods of time, but were dependent on others to push them around the facility.
Another option is to slow down the speed at which some residents drive their chairs. However electric power scooters could cause various issues like privacy and the impact on the rest of the community. In the end, removing the chair of a resident was deemed the most drastic and least desirable solution to safety concerns.
Safety
Power mobility allows people with disabilities to get around more freely and take part in a wider range of activities and run errands. However, with greater mobility comes a higher risk of accidents. For some, these accidents could cause serious injuries to themselves or others. This is why it is vital to consider the safety of your client prior to suggesting they utilize power mobility.
The first step in determining security is to determine if your client is able to safely operate their scooter or power wheelchair. Based on the severity of their impairment and the state of their health, this could involve a physical evaluation by a physician or occupational therapist, as well as a discussion with a mobility specialist to determine whether a specific device would be appropriate for them. In some cases 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.
Knowing the rules of road safety is a further aspect of safety. This includes sharing space with other pedestrians, wheelchair users, and drivers of trucks, cars or buses. The majority of participants in the study mentioned this theme.
For some this, it meant learning to drive their wheelchairs on sidewalks, instead of driving through areas that were crowded or over curbs (unless specifically designed for doing so). For others, it meant driving more cautiously in a noisy environment and keeping an eye out for pedestrians.
The most popular and least desired option that was to take away the wheelchair of a person was viewed as a double punishment that would result in the loss of mobility and hindering them from taking part in activities with the community or at facilities. This was the opinion of the majority of those who had their chairs removed and included Diane and Harriet.
The participants also suggested that family members, and staff members be educated on the safe use of power mobility. This could involve teaching the basics of driving (such as using the right side of a hallway) as well as encouraging residents to practice driving techniques while out, and assisting them in understanding how their actions can affect the mobility of others.
Follow-Up
The capacity and willingness of a child to be a part of the world can be greatly affected by a device that can power them. There is little research into the experiences children go through when they first learn to use these devices. This study employs a post-previous design to examine the effects of six months of using 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 along with pediatric occupational and physical therapists. Thematic analysis revealed three main themes. The first theme, 'Power to move', described how using a powered device affected more than just the child's locomotor skills. Learning to drive a mobility device can be an emotional and transformative journey for the participants.
The second theme, 'There isn't a recipe book,' showed that the process of learning to utilize a power mobility device was an individual process that developed over time in a cyclical manner. Therapists were required to decide what was appropriate depending on the individual's capabilities and needs. In the initial phase of training and following, therapists were required to be patient with children as well as parents. Parents and therapists alike described the need to assist families celebrate their accomplishments and resolve issues that arise from 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 those who participated in this study felt that a person should always show consideration for other people when using their mobility device. This is especially true when driving on roads that are public. Participants also shared that they've seen instances in which property belonging to someone else had been damaged by the use of a power mobility device or a person had been injured by a driver who failed to yield the right of way.
The results of this study indicate that power mobility and socialization training for preschoolers with CP can be carried out in certain classroom settings. The next research study should investigate the training and outcomes for this type of intervention for children with CP. This will hopefully result in the development of more standardized training protocols specifically for this group of children.