Clinically Speaking: The Impact of Power Mobility on ADLs

As a clinician, having the opportunity to work for a manufacturer of power mobility products causes you to look at a power chair from the manufacturer’s standpoint, where the emphasis is on making sure that a power chair is safe, functional, aesthetically pleasing, and of the highest quality. My occupational therapy background naturally causes me to look at a power chair and ask how it will impact clients’ activities of daily living (ADLs).

Sizing Up a Daily Routine
Everyone gets up in the morning and begins their daily routines, but many times it is something that we all take for granted. As an example, I wake up and take a shower, put in my contact lenses, put on make-up and blow-dry my hair. I go into the kitchen to make coffee. I get my toddler up and dressed for the day and get him breakfast. Next, everything gets packed into the car. I strap my son into the car seat, drop him off at my parents’ house and then head off to work.

Until I wrote that all down, I did not realize how many steps are really involved in my own morning routine. That is why it is so important to ensure that every step in a client’s daily routine, no matter how minor, is taken into consideration during the evaluation of a client for a mobility system.

When trying to determine what power chair is going to work best for your client, it is important to discuss what activities take place in their typical day. Do they have children? Do they work? What type of work do they do? Do they live alone or have a caregiver? Do they drive? Will they be using their power wheelchair outside? This information should all be gathered during the initial evaluation process.

Once these questions are answered, it can be determined what base and seating system would be the most appropriate for the client based on their lifestyle and medical requirements. Here’s a look at some of the important ADLs that should be considered.

Grooming, Bathing, Dressing & Toileting
Providing a home assessment prior to prescribing a power wheelchair for a client is crucial. Although you may think that this is a given, I have heard many scenarios over the last few years where a client has received a power chair that doesn’t make sense in their own home. They are unable to turn within their bathroom, pass through doorways, or even transfer to the toilet because of improper seat-to-floor height. Imagine how that would impact your client’s life.

Remember, typically, funding sources look at funding a power chair for in-home use. This area may be the single most important factor affecting a client’s satisfaction with their power chair and their perception of the product as a solution to their mobility needs. If your client could not partake in the above-mentioned ADL’s during their typical daily routine, they could feel that their power wheelchair is not useful and abandon the mobility system altogether.

Eating & Cooking
Many homes and apartments require a client to travel through several rooms to gain access to the kitchen. Make sure your client will be able to get from room to room safely and that they can get through all doorways. Remember, not every doorway in the house is the same width.

If your client enjoys cooking, it may be important to discuss the option of adding a power elevating seating system to their power chair. This type of seating system gives them the ability to become level with or have the ability to access their countertops, stove, sink and cabinets.

Work & Work Spaces
The appropriate power chair will also have an impact on the type of work your client does.
Depending on their level of injury and their job requirements, they may need to interact with their computer through their power chair. In this case, the proper electronics become essential to their ability to do their job effectively. Some work places can have limited space, so overall power chair size and turning radius are important considerations. Some clients may live close to their workplace and may consider driving their power chair to work on a daily basis. If that is the case, you’ll want to consider a motor package with higher speeds, batteries that hold a longer charge, and assess tire sizes and overall suspension options to create the best system possible to meet their needs.

Driving/Transportation
You also need to inquire how your client will get to various destinations throughout the day. Whether traveling to school, work or the grocery store, transportation is an important concern. If your client drives, consider whether their power chair will need to be accessible in their van and if any modifications would need to be done to their van to accommodate their new mobility system. Often this is something that is overlooked until after the evaluation process. Remembering this important step in an evaluation can eliminate potential problems down the road.

Child Care

If your client currently has young children, is expecting to have children or if they will be watching their grandchildren, you should take into consideration that this will be a very active time in their lives. You will need to make sure that your client can change or assist with changing a diaper, go to the kitchen to get a bottle, or even assist in the bathroom with potty training. A goal your client may have is to be involved in all of the ADLs of their children, and the right power mobility system is the best tool to help them to accomplish this goal.

A power mobility system is specifically designed to help your client lead the most independent lifestyle possible and to play a large role in their activities of daily living. Clients will always encounter obstacles or challenges throughout the day, just as you or I. But the appropriate power wheelchair can help them adapt within their environment and overcome these obstacles.

This article originally appeared in the Seating & Positioning Handbook: March 2009 issue of Mobility Management.

About the Author

Megan Kutch, MS, OT, is the Quantum sales manager for Pride Mobility Products Corp., Exeter, Pa. Megan can be reached via e-mail at mkutch@pridemobility.com or by calling (800) 800-8586.

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