Wheelchair mobility among facility residents: Perils, pitfalls and promises (original) (raw)
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Wheelchair Use by Ambulatory Nursing Home Residents
Journal of the American Geriatrics Society, 1986
In a survey of wheelchair USE in two nursing homes, the authors found a substantial number of cognitively intact nursing home residcrits who walked, but who also used a wheelchair. Using chart review and interviews with the residents, it was found that multiple physical factors, including pain, strength, endurance, vision and balance, and multiple social and environmental factors, including the fear of fallincy, were related to the resident's decision to use a wheelchair as an alternative means of mobility. A physical examination focused on aspects of mobility was M obility problems in the elderly are gaining increasing recognition as major factors in disability associated with aging. Nearly every area of function (eg, socialization, ability to obtain food, and sense of wellbeing) can be affected by mobility disorders. Further, persons with significant pre-existing mobility problems form a significant proportion of the more than 170,000 elderly persons who suffer hip fractures each year.' In most environments there are major barriers to the use of the wheelchair by persons who have difficulty walking. Nursing homes in contrast represent an environment in which wheelchair use is sometimes the norm and where there are usually minimal barriers to the use of the wheelchair as an alternative means of mobility. A series of informal observations of walking be-From The Center for Aging Studies and Services,
Intelligent power wheelchair use in long-term care: potential users' experiences and perceptions
Disability and rehabilitation. Assistive technology, 2016
Long-term care (LTC) residents with cognitive impairments frequently experience limited mobility and participation in preferred activities. Although a power wheelchair could mitigate some of these mobility and participation challenges, this technology is often not prescribed for this population due to safety concerns. An intelligent power wheelchair (IPW) system represents a potential intervention that could help to overcome these concerns. The purpose of this study was to explore a) how residents experienced an IPW that used three different modes of control and b) what perceived effect the IPW would have on their daily lives. We interviewed 10 LTC residents with mild or moderate cognitive impairment twice, once before and once after testing the IPW. Interviews were conducted using a semi-structured interview guide, audio recorded and transcribed verbatim for thematic analyses. Our analyses identified three overarching themes: (1) the difference an IPW would make, (2) the potential ...
Older adults' use of, and satisfaction with, electric powered indoor/outdoor wheelchairs
Age and Ageing, 2007
Background: research documenting the experiences of electric powered indoor/outdoor wheelchair (EPIOC) users has generally failed to take into account the specific needs and concerns of older adults. This study sought to qualitatively examine the older EPIOC users' satisfaction with the chair and service providers. Method: eight women and nine men aged between 60 and 81 (mean 69) years were recruited through a specialist wheelchair service database. All had severe mobility disabilities. Analysis was performed using a qualitative framework approach. Results: participants reported a variety of EPIOC uses, including shopping and some social contact. Moderate satisfaction with the chair was reported. Use was compromised by indoor and outdoor environmental barriers; and the chair not meeting users' needs. Accidents were rare, but many users still experienced insecurity in the chair. High levels of satisfaction with the service were reported, although concern was expressed over length of waiting times. Conclusions: EPIOCs proved useful to most older people with disabilities. However, even those who were satisfied reported only moderate use of the chair outdoors. Limited use related to an infrequent need for outings, outdoor barriers, feelings of insecurity over chair safety and lengthy waiting times for chair delivery and required modifications. Service providers should be aware that older EPIOC users may require extra support and the provision of timely adjustments to increase chair use.
Trials, 2013
Background: Many older adults rely on a manual wheelchair for mobility but typically receive little, if any, training on how to use their wheelchair effectively and independently. Standardized skill training is an effective intervention, but limited access to clinician trainers is a substantive barrier. Enhancing Participation in the Community by Improving Wheelchair Skills (EPIC Wheels) is a 1-month monitored home training program for improving mobility skills in older novice manual wheelchair users, integrating principles from andragogy and social cognitive theory. The purpose of this study is to determine whether feasibility indicators and primary clinical outcome measures of the EPIC Wheels program are sufficiently robust to justify conducting a subsequent multi-site randomized controlled trial. Methods: A 2 × 2 factorial randomized controlled trial at two sites will compare improvement in wheelchair mobility skills between an EPIC Wheels treatment group and a computer-game control group, with additional wheelchair use introduced as a second factor. A total of 40 community-dwelling manual wheelchair users at least 55 years old and living in two Canadian metropolitan cities (n = 20 × 2) will be recruited. Feasibility indicators related to study process, resources, management, and treatment issues will be collected during data collection and at the end of the study period, and evaluated against proposed criteria. Clinical outcome measures will be collected at baseline (pre-randomization) and post-intervention. The primary clinical outcome measure is wheelchair skill capacity, as determined by the Wheelchair Skills Test, version 4.1. Secondary clinical outcome measures include wheelchair skill safety, satisfaction with performance, wheelchair confidence, life-space mobility, divided-attention, and health-related quality of life.
Physical therapy, 2014
Self-efficacy has important implications for health and functioning in people with limited mobility. However, the influence of self-efficacy on mobility in adults who use wheelchairs has yet to be investigated. The study objective was to: (1) estimate the direct association between wheelchair use self-efficacy and life-space mobility and (2) investigate an indirect effect through wheelchair skills. This was a cross-sectional study. Participants (N=124) were adults who use a wheelchair, live in the community, and were 50 years of age and older (X̅=59.67, range=50-84), with at least 6 months of experience with manual wheelchair use; 60% were men. The 20-item Life-Space Assessment, the 65-item Wheelchair Use Confidence Scale, and the 32-item Wheelchair Skills Test-Questionnaire were used to measure life-space mobility, self-efficacy, and wheelchair skills, respectively. Self-efficacy had a statistically significant association with life-space mobility (nonstandardized regression coeffi...
Demographic profile of older adults using wheeled mobility devices
2011
The purpose of this study was to determine whether the use of wheeled mobility devices differed with respect to age, gender, residential setting, and health-related factors among older adults. A total of 723 adults ageing 60 and older are representing three cohorts, from nursing homes, the Center for Assistive Technology, and the wheelchair registry from the Human Engineering Research Laboratories. Wheeled mobility devices were classified into three main groups: manual wheelchairs, power wheelchairs, and scooters. Our results found factors including age, gender, diagnosis, and living settings to be associated with differences in use of manual versus powered mobility devices. Differences in use were also noted for subtypes of manual (depot, standard, and customized) and powered (scooter, standard, and customized) mobility devices, on demographic, living arrangements, and healthrelated factors. Consideration of demographic, health-related, and environmental factors during the prescription process may help clinicians identify the most appropriate mobility device for the user.
Characterization of Power Wheelchair Use in the Home and Community
Archives of Physical Medicine and Rehabilitation, 2008
Objective: To characterize the use of power wheelchairs and to determine if multiple measures of mobility and occupancy jointly provide a more comprehensive picture of wheelchair usage and daily activity in full-time power wheelchair users than daily distance alone. Design: Prospective observational study. Setting: Subjects' everyday mobility was measured in their homes and communities for 2 weeks, and prompted recall interviews were conducted by phone.