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Power Mobility and Safety Concerns

Power mobility enhances participation in daily activities and recreation for those in long-term care. However, the devices could also pose safety risks that need to be addressed.

Rather than exclude residents with certain diagnoses from the use of power mobility as it could be viewed as prejudicial risk management, most participants chose to take an approach based on teleology and let all residents trial a device.

Mobility

A power mobility device provides a method for people with limited mobility to move around in their community or home, and participate in activities of daily living that they would not be able to participate in. These devices can pose a risk not only for the person who uses them, but also to those who share their space or surroundings. Occupational therapists must carefully assess the safety needs of each client before making recommendations on powered mobility.

In an exploratory study (von Zweck, 1999), OTs from three residential care facilities in Vancouver Coastal Health Authority conducted qualitative interviews with residents regarding their use of power mobility. The objective was to develop a framework for client-centred power mobility prescribing. The results revealed four major themes: (1) the meaning of power mobility, (2) learning the rules of the road, (3) red flags: concerns about safety and (4) solutions.

Power mobility can improve the quality of life of individuals with limited mobility. This is because it allows them to participate in daily activities at home and in the community. Self-care, active and recreational jobs are essential for the physical and mental health of people who are older. For many with advanced illnesses, power mobility allows them to take part in these vital activities.

It was considered unacceptable by the participants to remove a wheelchair from a resident's home because it would alter their life's narrative and direction, and prevent them from performing the same things that they did before their disease progressed. This was especially relevant to those in Facility 1 who were in a position to use 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 this could cause several issues, including privacy and the impact on the rest of the community. The most drastic solution to security concerns was to take away the wheelchair of a resident.

Safety

Power mobility allows people to move more freely. They can also participate in a greater variety of activities, and run errands. However, with greater freedom of movement comes a greater chance of accidents. These incidents can result in serious injuries for certain. It is crucial to think about the safety of your clients prior to recommending the use of power mobility.

First check if your client is able to safely use their power chair or scooter. Depending on the nature of their condition and their current health, this may involve a physical evaluation by a doctor or occupational therapist, or a discussion with a mobility specialist to determine whether a specific device would be appropriate for them. In some cases, a vehicle lift will 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 learning the rules of the road. This includes sharing space with other pedestrians, wheelchair users and drivers of trucks, cars or buses. green power electric mobility scooter of the participants mentioned this theme.

For some, this meant learning to drive their wheelchairs on sidewalks, instead of driving through areas that were crowded or over curbs (unless specifically designed to do this). Others drove more cautiously and kept an eye out for pedestrians in a crowded environment.

The final and least popular option of removing a person's wheelchair, was viewed 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 had their chairs removed among them Diane and Harriet.

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 fundamentals of driving (such as driving on the right side of a hallway) and encouraging residents to practice driving skills while out, and helping them understand how their behavior affects the mobility of others.

Follow-Up

A power mobility device can have a profound impact on the child's ability to function and be a part of life. There is little research on the experiences children go through when they first learn 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 group of school-aged children of children with severe cerebral palsy (CP).

Qualitative interviews were conducted with 15 parents and pediatric occupational and physical therapists. Thematic analysis identified three major themes. The first, 'Power in mobility,' explained the ways in which powered devices changed more than just motor skills. Learning to drive a power mobility device can be an emotional, transformative experience for those who participated.





The second theme 'There's no cookbook' revealed that learning how to make use of the mobility device was a process that developed in a way that was cyclical over time. Therapists were tasked with unearthing what was realistic for each child's needs and capabilities. In the post-training and training phases, therapists were also required to have patience with parents and children. Many parents and therapists mentioned the need to assist families celebrate their successes and solve problems that arise from the training process.

The third theme, "Shared space", examined 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 people should always be mindful when using a power device. This was especially relevant when driving on public roads. A few participants also mentioned that they've had to deal with situations where someone else's property was damaged due to the use of a power mobility device, or where a person was injured by a driver who failed to yield right-of-way.

The results of this study indicate that socialization and power mobility training for preschoolers with CP can be carried out in certain classroom settings. Future research should continue to examine the effectiveness of training and outcomes for this kind of intervention for children with CP. This could lead to the development of more uniform training protocols for this population.