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.”
