Power Mobility and Safety Concerns
Power mobility allows those who are in long-term care in their everyday activities and leisure pursuits. The devices can also pose security concerns that need to be addressed.
The majority of participants choose to adopt a teleological perspective and allow all residents the chance to try a device, rather than restrict residents with certain diagnosis that could be viewed as a prejudicial risk management.
Mobility
A power mobility device enables people who are disabled to move around their community or home and engage in daily activities that are otherwise unavailable to them. However, these devices could also be a danger to the person using them and also to other people who share their environment or space. 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 in Vancouver Coastal Health Authority conducted qualitative interviews with residents about their power mobility use. The objective was to establish an environment that allowed for a client-centered power movement prescription. The findings revealed four main themes: (1) the meaning of power mobility, (2) learning the rules of the road, (3) red flags concerning safety, and (4) solutions.
Power mobility can dramatically improve the quality of life for those who have limited mobility, allowing them to participate in a range of daily living activities, at home as well as in the community (Brandt, 2001; Evans, 2000). Participation in self-care or leisure activities, as well as productive ones is crucial for physical and mental health for older adults, and for those with progressive diseases power mobility can be the opportunity to keep participating in these vital activities.
Most participants found it not acceptable to remove a resident's chair, as this would cause a major disruption in their life story or path and prevent them from pursuing the same activities they used to do prior to their disease progression. This was especially true for those in the Facility 1 who were capable of maintaining their chairs for short durations and were forced to rely on others to push them around the facility.
Another potential solution was reducing the speed at which some residents drove their chairs, however this led to a variety of concerns, including a lack of privacy and the impact on other residents in the community. The most drastic solution to security concerns was to take away a resident's wheelchair.
Safety
Power mobility lets people move more freely. They can also participate in a broader range of activities and run errands. With greater mobility comes a higher chance of accidents. These incidents can result in serious injuries for a few. It is crucial to think about the safety of your clients prior to recommending power mobility.
The first step in assessing security is to determine if your client is able to safely operate their power wheelchair or scooter. Depending on the severity of their disability and current health, this may require a physical examination by a doctor or occupational therapist, and having a conversation with a mobility specialist to determine whether a specific device is appropriate for them. In some instances your client will require a vehicle lift to be able to load and unload the mobility device at their home, workplace or community.
greenpower scooter of safety is learning the rules of the road. This involves sharing space with other pedestrians, wheelchair users, and drivers of trucks, cars or buses. This was a theme that was mentioned by most participants in the study.
Some people learned to drive their wheelchairs on sidewalks instead of driving through busy areas or on curbs (unless the wheelchair was specifically made for this purpose). For others this meant driving more slow in a crowded area and watching out for pedestrians.
The final and least desired alternative was to take away the chair of a person. This was viewed as a double punishment: losing independent mobility and preventing access to facilities and community activities. This was the viewpoint of the majority of participants who were able to remove their chairs and included Diane and Harriet.
Other suggestions made by the participants included educating other residents, family members and staff on the proper operation of power mobility. This could include teaching the basics of driving (such as using the right side of a hallway) and encouraging residents to practice driving techniques while out, and assisting them in understanding how their actions can affect other people's mobility.
Follow-Up
A device that is powered by electricity can have a profound impact on a child's ability to function and be a part of life. There is little research into the experiences children go through when they first learn to utilize these devices. This study employs an approach that is pre-post to study the effects of six months' experience with one of the four early power mobility devices on children in the school age group with severe cerebral palsy (CP).
We conducted qualitative interviews with 15 parents, as well as pediatric occupational and physical therapists. Thematic analysis revealed three main themes. The first theme, 'Power for mobility The theme described the ways that using the power of a device affected more than just motor skills. The experience of learning to drive a powered mobility device is often an emotional and transformative one.
The second theme, 'There's no such thing as a cookbook,' revealed that learning to use the power mobility device was an individualized process that developed over time in a cyclical manner. The therapists were asked to decide what was appropriate based on each child's abilities and requirements. During the training phase and after, therapists had to be patient with children as well as parents. A number of parents and therapists emphasized the need to assist families celebrate successes and problem-solve challenges associated with the training process.
The third theme, "Shared space", looked at how the use of a power device can impact other people's lives and interactions. The majority of the participants in this study felt that people should always show consideration for other people when using their mobility device. This was particularly true when driving on public roads. Participants also said that they've seen instances where someone else's property was damaged due to the use of a motorized device or a person had suffered injuries from a driver who failed to yield the right of way.
Overall, the results of this study suggest that short-term power mobility and socialization training is possible for preschoolers with CP in certain classroom settings. Future research should be focused on the effectiveness of training and outcomes of this type of intervention for children with CP. This should hopefully result in the development of more uniform training protocols for this population.