Special Section: Senior Mobility

Embracing the New: Strategies that Can Help

The aging process causes changes in strength, stamina, range of motion and flexibility, vision, hearing and other physical conditions. Today’s seating & mobility technology can help to maintain independence, but persuading seniors to try it — or to change from the assistive technology they’ve used for years — can be a battle.

Jay Brislin, MSPT, is the VP of Quantum Rehab.

“When you’re looking at the baby boomer generation — which is now getting into that geriatric population — they weren’t really exposed to medical or mobility devices when they were younger,” he notes. “That was almost taboo. Now they’re getting to the age where they may need some of this equipment, and that’s not something they necessarily want to be seen in. So you may end up having people that are using canes when they should be using walkers, or using walkers when they technically should be using a manual wheelchair.”

That same sort of compensation is also seen among some consumers who have used assistive technology for years, but are now experiencing physical changes related to aging.

Russ Rolt, ATP, is VP of sales & business development for Active Controls.

“For the average senior, any change is difficult,” he says. “Th ey don’t want to move, they don’t want a new environment. They’re comfortable with things how they are. For a lot of them, the perception of relying on a power chair is that they are lesser, that they are reduced in their level of function. And they fight that tooth and nail.

“How many people do we see struggling to push manual wheelchairs because their perception is a manual wheelchair user is less disabled than a power chair user? We as providers know that’s not true, and many people are far more functional and a lot more able with the use of power mobility than they are with manual chairs.”

That may be the case, but convincing seniors to give new mobility devices a try can still be challenging. Here are some ways that clinicians and providers can try to make senior clients feel more comfortable about starting a transition.

Can You Preserve Something That’s Familiar?

One of the more difficult technology transitions for consumers is moving from a scooter to a power wheelchair.

“The big issue you see with an older population is balance,” Brislin says. “Most scooters, regardless of whether they’re three wheeled or four wheeled, require a little more balance as well as quite a bit more hand-eye coordination. On a scooter, you’re actually performing two functions to drive. You’re pushing the accelerometer as well as turning the tiller left or right. The combination of those two requires a lot of cognition, and it requires a lot of quick hand-eye coordination, too.”

Power wheelchairs may be the better option for seniors with balance issues, or those who need to perform power-assisted weight shifts via tilting because, for instance, they lack the strength or flexibility to do weight shift s independently.

But while changing from scooter to power chair, is it possible to preserve some familiar part of the equation — such as the type or location of the driving controls?

“If they’re transitioning from scooter to power chair, they’ve become very comfortable and reliant on something in front of them that they lean on, that they reposition with,” Rolt says, referring to the centralized location of scooter tillers.

Rolt’s company, Active Controls, manufactures tiller-style controls that can be used to operate power chairs — so he has a direct interest in accommodating seniors who prefer using tillers to drive. But he also rightly points out that a lifetime of using automotive steering wheels and bicycle handlebars have ingrained the concept of “centralized driving controls” in seniors’ minds.

“It’s a radical departure from that to driving with a joystick on an armrest,” Rolt says. “Number one, it’s not right in front of you, where everything has been. Number two, it’s not a concept you’ve used if you don’t have an Xbox.”

For some seniors, maintaining some familiarity with the driving controls — whether that means using a tiller or centrally locating a joystick — may help reduce the learning curve and help them feel comfortable and in control more quickly aft er transitioning to a power chair.

Can You Observe the Situation First?

It’s natural to want to jump in and suggest new technology right away — especially when a problem is apparent.

But when working with seniors, Brislin suggests, taking a more gradual approach may be smarter — because, for one thing, the ATP is likely to be younger than the client he or she is trying to help.

“The last thing anybody wants is somebody much younger telling us what to do,” Brislin says.

Rather than immediately telling the client what needs to happen — i.e., that getting a wheelchair seems medically justified at this point in life — try asking some questions and observing the scene.

“See what things they like, but that they’re not doing,” Brislin says. “You can also get that information by talking to their loved ones. Then you’re able to get some buy-in by saying, ‘If we get you this (wheelchair), you could do some of these things.”

Brislin also suggests talking with the client and with caregivers or family members separately, and then bringing the two accounts together, may help ATPs get a more accurate picture of everyday challenges. And clients may also get a realistic look at how family members are impacted when changes in physical condition make a mobility product obsolete.

“If you get each person’s perspective and bring them together and talk about both of those perspectives, you can start having people realize, ‘Maybe I am putting too much strain on my spouse,’” Brislin says. “If the person who needs the mobility device is reluctant to change, trying to point out some of the things (a new mobility device) would allow their spouse to do certainly is another avenue to take.”

Can You Make the Vehicle More Attractive?

Beauty is in the eye of the beholder; so is convenience and, to some extent, efficiency. Making a scooter or power chair more attractive — in physical appearance or in its ability to perform very beneficial services — can help the vehicle to “sell” itself.

Brislin says accessories such as baskets, cup holders and cell phone holders can make help make seniors feel better about their new equipment. On the clinical end, positioning components and alternative drive controls, he says, “help people conserve energy and be as independent as possible.”

Clients can be told, he adds, that such options “help conserve your energy for things that you want to use it for, not things you have to use it for.”

Can You Give Them a Preview of Their Success?

Nothing breeds success like success, as the saying goes, so try telling senior clients about other consumers you’ve worked with who are doing well (without divulging private details, of course).

“Success stories are huge,” Brislin says. “Anytime you can bring up success stories you may have had with other people in similar situations, it can be a much easier transition.”

Another version of this: Asking seniors to try the equipment and report back. Brislin suggests saying to clients, “Try this for a week, and let me know how much better you feel. Let me know how much more energy you have. Let me know how much easier it is to do whatever tasks (that are currently difficult).”

Th at perspective can help clients to move forward with new equipment, whether they’re using assistive technology for the first time or changing the type of mobility equipment they’ll use.

Says Brislin: “You’re able to show somebody that with Product A, five years ago they could do these 10 things. They can do half of those now. But Product B opens up the opportunity to do all 10 of those things again. It’s not really what they’re using, it’s that what they’re using is allowing them to accomplish the same goals.”

This article originally appeared in the July 2012 issue of Mobility Management.

About the Author

Laurie Watanabe is the editor of Mobility Management. She can be reached at lwatanabe@1105media.com.

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