Power Mobility and Safety Concerns
Power mobility improves participation in daily activities and recreation for those in long term care. These devices also raise safety risks, which need to be addressed.
Instead of excluding power electric scooter who have certain diagnoses from use of power mobility, which may be considered prejudicial risk management, most participants chose to take a teleological approach and let all residents try out the power mobility device.
Mobility
A power mobility device allows those with limited ability to move about their homes or communities and engage in daily activities that might otherwise be not accessible to them. However, these devices may also pose a risk for the person using them, and other people who are in their space. Occupational therapists need to carefully evaluate the safety needs of each client to make the most appropriate recommendations for powered mobility.
In an exploratory study carried out by OTs at three residential facilities of the Vancouver Coastal Health Authority, qualitative interviews were conducted with residents to assess the extent to which they used power mobility. The objective was to develop a framework for client-centred power mobility prescribing. 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 significantly increase quality of life for those with limited mobility by permitting them to take part in a variety of daily living activities, both at home and in the community (Brandt 2001; Evans, 2000). Participation in self-care as well as leisure and productive occupations is essential to mental and physical health for older adults, and for a lot of people who are suffering from progressive illnesses power mobility can be an opportunity to continue taking part in these vital activities.
Most participants found it unacceptable to take away the resident's chair since it would result in a significant disruption in their life story or path and prevent them from continuing with the same activities they had been doing before their illness progressed. This was especially true for those in Facility 1, who had been able to maintain their power chairs for short durations and were forced to rely on other residents to push them around the facility.
Another option is to limit the speed at which some residents drive their chairs. However it could create various issues like privacy and the impact on the rest of the community. Ultimately, removing green energy mobility scooters was considered the most drastic and least preferred solution to security concerns.
Safety
Power mobility allows disabled people to get around more freely and take part in a wider range of activities and run errands. However, with greater freedom of movement comes a greater chance of accidents. For some, these accidents could result in serious injuries to themselves or others. It is essential to consider the safety of your clients prior to recommending the use of power mobility.
The first step in assessing security is to determine if your client can safely operate their power scooter or power chair. This could involve a physical assessment by a doctor or occupational therapist or a mobility specialist, based on the nature of your client's disability as well as their current health. In some instances, a vehicle lift will be required to make it possible for your client to unload and load their mobility device at home, in the community or at work.
Another aspect of safety is to learn the rules of the road. This involves sharing space with other pedestrians, other wheelchair users and drivers of trucks, cars or buses. This topic was mentioned by most participants in the study.
For some this, it required learning to use their wheelchairs on sidewalks, instead of driving through areas that were crowded or over curbs (unless specifically designed for doing such). For others, it meant driving more cautiously in a noisy environment and keeping an eye out for pedestrians.
The final and least popular option of removing a person's wheelchair, was seen as a double whammy that would result in the loss of mobility, and also preventing them from participating in activities with the community or at facilities. Diane and Harriet among others were among those who had their chairs removed.
Other ideas suggested by participants included educating residents, family members and staff about the safety of power mobility. This could include teaching the basics of driving (such as which side to walk on in the hallway), encouraging the residents to practice driving skills when they go outside and helping them be aware of how their actions affect the mobility of others.
Follow-Up
The ability of a child and their willingness to take part in the world can be greatly affected by a device for power mobility. Yet there isn't much research on the experiences of children who learn to use this equipment. This study employs an approach that is pre-post to study the impact of six months of experience using one of 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 as well as occupational and physical therapists who work with children. Thematic analysis revealed three main themes. The first theme, 'Power for mobility explained the ways that using an electric device impacted more than just the child's motor skills. The experience of learning to operate a powered mobility device is usually an emotional and transformative experience.
The second theme, 'There isn't any cookbook,' revealed that learning to utilize a power mobility device was a bespoke process that unfolded over time in a cyclical manner. Therapists were asked to decide what was appropriate based on each child's abilities and needs. In the post-training and training phases, therapists were expected to be patient with children and parents. Several parents and therapists described a need to help families celebrate their successes and solve problems that arise from the process of training.
The third theme"Shared space was a look at how the use of a power device could have an impact on the lives of others and how they interact. The majority of those who participated in this study felt that a person should always show consideration for other people when using their mobility device. This is especially relevant when driving on public roads. Participants also shared that they had seen situations where someone else's property had been damaged by the use of a power mobility device, or a person has been injured by a driver who did not yield the right of way.
The results of this study indicate that power mobility and socialization training for preschoolers with CP can be carried out in certain classroom environments. Future research should be focused on the effects of training and results of this type of intervention for children with CP. This will hopefully lead more standard training protocols for children suffering from CP.