Power Mobility and Safety Concerns
Power mobility allows individuals who are in long-term care in their routine activities and leisure pursuits. These devices also raise safety concerns, which must be addressed.
Rather than exclude residents who have certain diagnoses from use of power mobility that could be considered prejudicial risk management, most participants chose to take a teleological approach and let all residents try out the device.
Mobility
A power mobility device enables people who are unable to move around their homes or communities and participate in daily living activities that would otherwise be not accessible to them. These devices pose a risk not only to the individual using them, but also to those who are in their environment. Occupational therapists need to carefully evaluate the safety needs of each client to make the best recommendations regarding powered mobility.
In power mobility scooter (von Zweck, 1999), OTs from three residential care facilities within the Vancouver Coastal Health Authority conducted qualitative interviews with residents about their use of power mobility. The goal was to create an environment that allowed for a client-centered power movement prescription. The findings revealed four main themes: (1) power mobility meaning, (2) learning road rules, (3) red flags - safety concerns, and (4) solutions.
Power mobility can greatly improve the quality of life for those who are mobility-challenged by giving them the opportunity to participate in a variety of daily living activities, both at home and in the community (Brandt, 2001; Evans, 2000). Participation in self-care or leisure activities, as well as productive ones is essential to mental and physical health for older adults, and for a lot of people with progressive diseases power mobility can be the opportunity to keep participating in these vital activities.
The participants felt it was inconvenient to remove a resident's wheelchair in order to alter their life's story and progression, and prevent them from performing the same activities that they were doing before their condition worsened. This was especially the case for those in Facility 1, who had been able to maintain their power chairs for short durations and were dependent on others to help them move around the facility.
Another option is to limit the speed at which residents drive their chairs. However, this could raise a number issues such as privacy and the impact on the rest of the community. The most drastic solution to safety concerns was to remove the wheelchair from a resident's.
Safety
Power mobility allows those with disabilities to move more freely, participate in a wider variety of activities, and even do the errands. However, with increased freedom of movement comes a greater risk for accidents. These accidents could result in serious injuries for some. This is why it is crucial to think about the security of your client before recommending that they utilize power mobility.
First check whether your client is able to safely use their scooter or power chair. Depending on their impairment and current health, this may involve a physical evaluation by a physician or occupational therapist, or a discussion with a mobility specialist to determine whether a specific device is appropriate for them. In some cases, a vehicle lift will be necessary 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 pedestrians, wheelchair users and drivers of buses or cars. Most participants in the study have mentioned this issue.
Some people learned to drive their wheelchairs on sidewalks instead of driving in the midst of crowds or on curbs (unless the wheelchair was specially made for this purpose). Others drove more slowly and looked out for pedestrians in an area that was crowded.
The most popular and least desired option of removing the wheelchair of a person was viewed as a double punishment: losing independence in mobility and hindering them from taking part in activities with the community or at facilities. Diane and Harriet among others were among the participants who had their chairs removed.
Other suggestions made by participants included educating other residents as well as family members and staff on the proper operation of power mobility. This could include teaching the basics of driving (such as the correct side to walk on in the hallway), encouraging the residents to practice driving skills when they go outside and helping them recognize how their behavior affects the mobility of others.
Follow-Up
A child's ability and willingness to participate in life can be greatly affected by a power mobility device. However, very there isn't much research about the experience of children who are learning to use this equipment. This study uses the post-previous method to analyze the effects of 6 months of use with one of the 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 along with occupational and physical therapists for children. Thematic analysis revealed three main themes. The first theme, 'Power for mobility', described how using an electric device impacted more than just the child's motor skills. Learning to drive a mobility device was often an emotional and transformative journey for the participants.
The second theme, 'There's no such thing as a recipe book,' showed that learning to utilize a power mobility device was an individualized process that developed over time in a cycle. Therapists were required to determine what was realistic depending on the individual's capabilities and needs. In the post-training and training phases, therapists were expected to be patient with children and parents. Parents and therapists alike described the need to help families celebrate their achievements and solve problems associated with the process of training.
The third theme called 'Shared space', explored how the use of a power device could influence other people's lives and interactions. The majority of participants in this study felt that a person must be mindful of other users when using a mobility device. This was particularly relevant when driving on roads that are public. Several participants also noted that they've encountered instances where another'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.
Overall, the results 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 be focused on the effects of training and results of this kind of intervention for children with CP. This will hopefully result in the development of more standard training protocols for this population.