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Power Mobility and Safety Concerns

Power mobility can enhance participation in daily activities and recreational pursuits for individuals in long term care. These devices also raise safety concerns, which must be addressed.

Rather than exclude residents with a specific diagnosis from the power mobility option as it could be viewed as risk management that is prejudicial, the majority of participants chose to take an approach based on teleology and let all residents trial a device.

Mobility

A power mobility device allows people with limited ability to move about their home or community and take part in daily activities that would otherwise be not accessible to them. However, these devices can also be a danger to the person using them, as well as other individuals who share their environment or space. 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 in Vancouver Coastal Health Authority conducted qualitative interviews with residents regarding their power mobility use. The goal was to create an environment that allowed for a client-centered power movement prescription. 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 individuals with limited mobility. This is because it lets them participate in daily activities at home and in the community. Participation in self-care as well as leisure and productive occupations is crucial to physical and mental health of older adults, and for those who are suffering from progressive illnesses power mobility is an opportunity to continue taking part in these important activities.

The majority of participants felt it was unacceptable to remove a resident's chair, as this could cause a huge disruption in their life story or trajectory and essentially prevent them from continuing to engage in the same activities they used to do prior to their illness progressed. This was particularly true for those in the Facility 1, who had been able to maintain their green power scooter chairs for brief periods of time, but were forced to rely on others to help them move around the facility.

Another option is to reduce the speed that residents drive their chairs. However this could cause 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 a resident's wheelchair.

Safety

Power mobility power allows people to move more freely. They are also able to participate in a greater variety of activities and run around on their own. With greater mobility comes a higher risk of accidents. These incidents can result in serious injuries for some. It is crucial to consider the security of your clients prior to recommending power mobility.

First consider determining if your client is able to safely operate their power chair or scooter. This could include an examination of the physical by a physician or occupational therapist, or a mobility specialist, based on the nature of your client's disability as well as their current health. In certain situations it is necessary to have a vehicle lift. be necessary to allow for your client to unload and load their mobility device at home, in the community or at work.

Learning the rules of road safety is a further aspect of safety. This includes sharing space, with other pedestrians, wheelchair users, and drivers of buses or cars. This topic was mentioned by a majority of participants in the study.

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 purpose). Others drove more cautiously and kept an eye out for pedestrians in a crowd.

The final and least popular option that was to take away a person's wheelchair, was viewed as a double whammy that would result in the loss of mobility, and also preventing the person from participating in activities with the community or at facilities. Diane and Harriet among others were among the participants who were stripped of their chairs.

The participants also suggested that residents, family members, and staff members be trained on the safe use of power mobility. This could include teaching the basics of driving (such as using the correct side of the hallway), encouraging residents to practice driving skills when they leave and assisting them in understanding how their actions can affect the mobility of others.

Follow-Up

A power mobility device can have a profound impact on the ability of a child to function and take part in life. Yet little research has been done about the experience of children who are learning to use this device. This study uses a pre-post design to examine the impact of six months of experience with one of the four early power mobility devices on the children in school with severe cerebral palsy (CP).

Qualitative interviews were conducted with 15 parents as well as pediatric occupational and physical therapists. Thematic analysis revealed three major themes. The first theme, 'Power for Mobility The theme described how using the power of a device affected more than just locomotor abilities. The experience of learning how to drive a powered mobility device can be an emotional and transformative experience.

The second theme , 'There's no recipe book' revealed that learning to utilize an equipment for mobility was a process that unfolded in a continuous manner over time. Therapists were asked to determine what was feasible based on each child's abilities and requirements. In the initial phase of training and afterwards, therapists needed to be patient with children and parents. Parents and therapists alike described the need to assist families celebrate their accomplishments 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 lives and interactions. The majority of those who participated in this study believed that one must be mindful of others when using their power mobility device. This is especially important when driving in public areas. A few participants also mentioned that they've encountered situations where someone else's property was damaged due to the use of an electric power scooters mobility device, or where a person was injured by a driver who not yielded the right-of-way.

The results of this study suggest that power mobility and socialization training for preschoolers with CP can be done in certain classroom environments. Future research should continue to investigate the training and outcomes for this type of intervention in children with CP. This will hopefully result in the development of more uniform training protocols for this group.