Overarching principles and salient findings for inclusion in guidelines for power mobility use within residential care facilities

Mortenson, W. Ben; Miller, William C.; Boily, Jeanette; Steele, Barbara; Crawford, Erin M.; Desharnais, Guylaine

doi:10.1682/jrrd.2005.01.0031

Cited by 34 publications

(28 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…To determine suitability, prescribers frequently relied on informal and formal assessments of various client attributes, including cognition, vision, hearing, and perception-tests that may have reinforced their expert knowledge but, as some prescribers noted, may also have lacked predictive validity (Mortenson et al, 2005(Mortenson et al, , 2006. Given cognitive and workload demands, prescribers may have used age-based heuristics-that is, problem-solving shortcuts-to help them to make provision decisions quickly and efficiently.…”

Section: Deciding Who Should Be Entitledmentioning

confidence: 99%

“…One descriptive study of scooter prescribers in the Netherlands provided insight into how health care professionals struggled to balance their responsibility to recommend devices on the basis of predetermined criteria with their desire to act in what they perceived as their clients' best interests (Jörg, Boeije, & Schrijvers, 2005). Using a multi-method approach that included a variety of stakeholders (Mortenson et al, 2005(Mortenson et al, , 2006, residential care prescribers developed powered mobility safety guidelines, which indicated that prescribers were aware of the benefits of powered mobility use by residents but also wanted to mitigate the potential harm to users and to others in their facilities.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Prescribers’ Experiences With Powered Mobility Prescription Among Older Adults

Mortenson

Clarke

Best

2013

The American Journal of Occupational Therapy

View full text Add to dashboard Cite

Despite the potential benefits of powered mobility, many older adults do not have access to this technology. To date, few studies have explored how prescribers make decisions regarding provision of powered mobility. Therefore, we undertook a qualitative study to develop a better understanding of prescribers' attitudes toward and practices with older adult candidates for powered mobility devices. Our analysis of 10 in-depth interviews identified three main themes: (1) "Deciding who should be entitled" explored how therapists decided who should have access to powered mobility, (2) "power wheelchair negotiation" described the discord between clients and therapists that became apparent during this process, and (3) "practical considerations" revealed how contextual factors shaped the provision of powered mobility. The findings suggest that the ways in which powered mobility is funded, provided, and accommodated should be improved so that more older adults have access to these devices and can use them to their full potential. MeSH TERMSattitude of health personnel; decision making; health policy; prescriptions; professional-patient relations; wheelchairs The use of powered mobility devices such as power wheelchairs and scooters has been associated with increased mobility, enhanced participation in daily activities, decreased pain and discomfort, and improved health-related quality of life (Auger et al., 2008).

show abstract

Section: Deciding Who Should Be Entitledmentioning

confidence: 99%

mentioning

confidence: 99%

Prescribers’ Experiences With Powered Mobility Prescription Among Older Adults

Mortenson

Clarke

Best

2013

The American Journal of Occupational Therapy

View full text Add to dashboard Cite

show abstract

“…Personalized driving training (Hall, Partnoy, Tenenbaum, & Dawson, 2005), driving performance assessments (Dawson, Chan, & Kaiserman, 1994), and risk management strategies and institutional driving guidelines (Mendoza et al, 2003;Mortenson et al, 2006) are currently applied to minimize unsafe power wheelchair operation and maintain mobility independence in institutional settings. However, these interventions do not always address residents' need for self-mobility, especially in circumstances when driving abilities are marginal or deteriorate and use of power wheelchairs is restricted.…”

Section: Literature Review Current Interventionsmentioning

confidence: 99%

Evaluation of a Contact Sensor Skirt for an Anti-Collision Power Wheelchair for Older Adult Nursing Home Residents With Dementia: Safety and Mobility

Wang

PEng

Holliday

et al. 2011

Assistive Technology

View full text Add to dashboard Cite

We studied an anti-collision power wheelchair's ability to enable safe, independent mobility in nursing home residents with dementia. The device had a contact sensor skirt that compensated for drivers' absent or delayed responses to obstacles. Safety observations were tracked during device use. In six single-subject studies, distances traveled by residents in manual and anti-collision wheelchairs were compared. Two residents could use the device: One resident's mobility and well-being improved; the other thought it was unhelpful. Another resident with potential for use did not like its usability, speed, and appearance. For two other residents, the device did not compensate for decreased initiation, motor planning, and awareness of obstacles above the sensors. Another resident was withdrawn because of verbal aggression. Interviews and focus groups revealed the device's usefulness. Perceptions of safety were mixed. Further work should improve environmental coverage, sensor skirt reliability, and safety; match technology to the needs of a wider range of residents; and enhance usability, functionality, and acceptance.

show abstract

“…39 Power mobility use may also act as a subtle proxy for higher level executive function that our measure of cognition was too crude to discern. Although there are safety concerns associated with the use of power mobility, 5,40 anti-collision power wheelchairs are currently under development for use in these settings. 41 Unlike previous research, 11 SIT scores were not significant independent predictors of mobility.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Mobility Among Wheelchair Using Residents in Long-Term Care

Mortenson

Miller

Oliffe

2011

Archives of Physical Medicine and Rehabilitation

Self Cite

View full text Add to dashboard Cite

Objective-The purpose of this study was to identify predictors of mobility among long term care residents who use wheelchairs as their main means of mobility. Based on the Matching Person to Technology Model, we hypothesized that wheelchair-related, personal and environmental factors would be independent predictors of mobility.Design-Cross-sectional study. Setting-Eleven long term residential care facilities in the Lower Mainland of British Columbia, CanadaParticipants-The study included 268 residents: 149 self-responding residents and 119 residents who required proxy respondents. Interventions-Not applicable.Main outcome measures-Mobility was measured using the Nursing Home Life Space Diameter. Standardized measures of personal, wheelchair-related and environmental factors were administered and socio-demographic data were collected as independent variables. Preliminary analyses of these data are part Dr. Mortenson's doctoral thesis. Financial disclosureWe certify that no party having a direct interest in the results of the research supporting this article has or will confer any benefit on us or on any organization with which we are associated. We certify that all financial and material support for this research are clearly identified in the title page of the manuscript. CIHR Author Manuscript CIHR Author Manuscript CIHR Author ManuscriptResults-Independent mobility decreased as the distance from the resident's room increased: 63% of participants were independently mobile on their units, 40% were independently mobile off their units within the facilities and 20% were independently mobile outdoors. For the total sample, the significant predictors of mobility, in descending order of importance, were wheelchair skills (including the capacity to engage brakes and manoeuvre), functional independence in activities of daily living, having four or more visits per week from friends or family and use of a power wheelchair. This regression model accounted for 48% of variance in mobility scores.Conclusions-Limited independent mobility is a common problem among facility residents. Residents may benefit from interventions such as wheelchair skills training or provision of powered mobility but the effectiveness of these interventions needs to be evaluated.

show abstract

Overarching principles and salient findings for inclusion in guidelines for power mobility use within residential care facilities

Cited by 34 publications

References 13 publications

Prescribers’ Experiences With Powered Mobility Prescription Among Older Adults

Prescribers’ Experiences With Powered Mobility Prescription Among Older Adults

Evaluation of a Contact Sensor Skirt for an Anti-Collision Power Wheelchair for Older Adult Nursing Home Residents With Dementia: Safety and Mobility

Predictors of Mobility Among Wheelchair Using Residents in Long-Term Care

Contact Info

Product

Resources

About