Powered Mobility Devices inside Residential Aged Care: inspiring occupational therapists to advocate autonomy and mitigate misadventure.

ABSTRACT

Background:

Powered wheelchairs and mobility scooters, collectively powered mobility devices (PMD), are highly valued by older Australians, including those in residential aged care, to facilitate community and personal mobility at the onset of mobility decline.  A PMD is a proven enabler, preserving activity levels, restoring self-esteem, and promoting wellbeing.  Supporting participation in activities of choice is fundamental to the aged care standards and this choice often includes using a PMD.  The number of PMDs in residential aged care is expected to grow proportionally with that of the wider community, as are incidents causing injury.  An incident is defined as any collision, tip or fall connected with the use of a PMD.

The challenge for the Australian residential aged care sector is to embrace increasing demand for autonomy via PMD use, whilst maintaining a safe living and working environment for all stakeholders in an equitable manner.  Occupational therapy theoretical frames of reference provide guidance to address all components of this multi-stakeholder occupational performance challenge, to achieve balance and wellbeing.  This first part of a four-part research program aimed to examine the number and circumstances around PMD related incidents within an aged care provider group, contributing evidence for subsequent comparison with the literature and review of assessment tools used by occupational therapists.

Method:

A retrospective cohort study was conducted.  Incident reports were used to determine the number and circumstances around PMD related incidents across 33 facilities over a 12-month period. Follow-up data were collected 9-12 months later.

Results:

Although no fatalities were recorded as a direct result of PMD use, analysis of the data found sufficient collisions, tips and falls to raise concern.  Only one third of residents were still using their PMD at follow-up, the remainder having died or discontinued use due to failing skills.  Examination of the circumstances around incidents highlighted trends or ‘red flags’, justifying further study of the assessment tools used within residential aged care services to determine resident ability to commence, continue or cease PMD use.

Conclusion:

Based on this study, it is estimated that thousands of incidents with potential for injury, fatality, litigation or loss of income occur annually within Australian residential aged care facilities.  Illuminating the potential risk will enable a considered review of the supports needed to promote safe PMD use in residential aged care and mitigate risk for all stakeholder groups within these environments.

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