Power Mobility and Safety Concerns
Power mobility allows people 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.
Rather than exclude residents who have certain diagnoses from power mobility option as it could be viewed as risk management that is prejudicial, the majority of participants preferred to take a teleological approach and let all residents test the power mobility device.
Mobility
A power mobility device allows people with limited ability to move about their community or home and participate in daily living activities that might otherwise be unavailable to them. These devices could pose a risk not only for the person who uses them but also to others who share their space or environment. Occupational therapists need to carefully examine each client's safety requirements to make the most appropriate recommendations regarding powered mobility.
In an exploratory study (von Zweck 1999), OTs from three residential care facilities of the Vancouver Coastal Health Authority conducted qualitative interviews with residents regarding their power mobility use. The objective was to develop an approach to client-centered power mobility prescribing. The results revealed four major themes: (1) power mobility meaning, (2) learning road rules, (3) red flags security concerns and (4) solutions.
Power mobility can boost the quality of life for individuals with mobility limitations. This is because it allows them to take part in daily activities at home and within the community. Self-care, active and recreational occupations are vital for physical and mental well-being of the elderly. For many with advanced illnesses, power mobility allows them to take part in these important activities.
Participants found it unacceptable to remove a resident's wheelchair because it would alter their life's story and progression and hinder them from performing the same activities that they had prior to their illness progressed. This was especially relevant for those in the Facility 1 who were only allowed to use their power chairs for a short period of time and were now reliant on others to push them.
Another option is to reduce the speed at which residents drove their chairs, however this led to a variety of concerns, including privacy issues and the impact on other residents in the community. In the end, removing the chair of a resident was deemed the most drastic and least desired solution to safety concerns.
Safety
Power mobility allows those with disabilities to get around more freely, participate in a wider range of activities and run around. With the increased mobility comes an increased chance of accidents. For some, these incidents could cause serious injuries to themselves or others. This is why it is vital to consider the security of your client before recommending that they utilize power mobility.
First consider determining if your client can safely operate their power chair or scooter. Depending on the nature of their condition and their current health, this may involve a physical assessment by an occupational or physician therapist, and having a conversation with a mobility specialist to determine if a particular device is appropriate for them. In some instances the use of a vehicle lift may be required to allow for your client to load and unload their mobility device at home in the community, or at work.
Understanding the rules of road safety is an additional aspect of safety. This includes sharing space with pedestrians, other wheelchair users and drivers of cars, trucks or buses. The majority of participants in the study mentioned this theme.
green power mobility reviews to drive their wheelchairs on sidewalks instead of driving in the midst of crowds or on curbs (unless the wheelchair was specially made to be used in this way). Others drove more cautiously and looked out for pedestrians in an area that was crowded.
The final and least preferred option was to remove a person's chair, which was viewed as a double punishment: losing independent mobility and preventing access to facilities and community activities. This was the opinion of the majority of participants who had their chairs removed, including Diane and Harriet.
The participants also suggested that 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) as well as encouraging residents to practice driving skills when they leave and helping them to understand how their actions can affect the mobility of others.
Follow-Up
A device that is powered by electricity can have a profound impact on a child's ability to function and take part in life. There isn't much research on the experience that children go through when they first learn to utilize these devices. This study employs a pre-post design to examine the impact of 6 months of use with one of the four early power mobility devices on a group of school-aged children with severe cerebral palsy (CP).
We conducted interviews in qualitative format with 15 parents, and also pediatric occupational and physical therapists. Thematic analysis revealed three main themes. The first theme, 'Power for mobility explained the ways that using a powered device affected more than just motor skills. The experience of learning how to operate a powered mobility device is often an emotional and transformative one.
The second theme, 'There isn't a cookbook,' revealed that the process of learning how to use a power mobility device was a bespoke process that evolved over time in a cycle. Therapists were asked to decide what was appropriate based on each child's abilities and needs. Throughout the training and post-training phases, therapists were expected to be patient with children and parents. Parents and therapists alike described the need to assist families celebrate their achievements and resolve issues that arise from the training process.
The third theme, "Shared space", examined how the use of a power device can impact other people's lives and interactions. The majority of participants in this study believed that people should be considerate when using a power 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 through the use of the power mobility device or when a person was injured by a driver who failed to yield right-of-way.
The results of this study show that power mobility and socialization training for preschoolers with CP can be done in a variety of classroom settings. Future research should continue to study the training and results for this kind of intervention in children with CP. This will hopefully result in the development of more standardized training protocols for this group.