UBC Faculty Research and Publications

Ready to Roll? Mortenson, Ben May 27, 2009

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Ready to Roll? Understanding Activity, Mobility and Life Satisfaction among Residents Who Use Wheelchairs Ben Mortenson, BScOT MSc, Phd Candidate Dr. Bill Miller Dr. John Oliffe Dr. Catherine Backman  Background  Wheelchairs and Residential Care  Facility Factors {  {  Poor equipment is common. Can cause discomfort, poor positioning and reduced mobility.  Problems with Social Participation {  {  Recreational programs Time spent doing little or no activity.  Quality of Life for Residents {  {  Residents often experience boredom, loneliness and helplessness. There is an assumption that it is unalterably poor  Phase 1: Exploratory Study  Goals 1.  2.  To explore what life is like for residents who use wheelchairs as their primary means of mobility. To understand how wheelchairs are used by residents, families and staff.  Means {  { {  Observations and interviews with 16 residents from two facilities Interviewed 10 staff Reviewed facility policies and procedures  Phase 2 Cross-Sectional Study  Goals To identify factors that enabled 1. Mobility, 2. Social Activity 3. Life Satisfaction of residents who use wheelchairs as their primary means of mobility.  Facilities {  11 extended/multilevel care facilities in the Lower Mainland of British Columbia z  had over 100 residents who used wheelchairs  Who We Included { { { { {  primary means of mobility >2 hours per day speak English > 60 lived in facility/used a wheelchair >1 month  Residents {  {  Cognitively competent and noncompetent (via proxy respondents) 55% took part in the study  Outcomes We Measured Mobility (places went, how often, and how independent) Social Participation (how often they did formal and informal activities) Life Satisfaction  Person { { { { {  Cognition Depressive symptoms Age Health Etc.  Wheelchair Factors { { {  Wheelchair skills Type of wheelchair Need for seating intervention z  {  Sliding, discomfort, skin ulcers etc.  Restrained z z  Seat belt can’t be released Chair can’t be propelled  Environmental Factors { { {  Facility Satisfaction Perceived barriers to participation Visits from friends and family  Data Collection  {  Family members usually acted as proxies (67%)  Results/Discussion  Facility Results  { {  100% had a least restraint policy 64% adopted the Eden alternative.  Participants •@150 competent residents and 120 proxy •Mostly female •Mid 80s •Manual wheelchairs •Almost have had serious depressive symptoms  Mobility  Mobility Results  VS  Predictors of Mobility { { {  {  Wheelchair skills Power wheelchair Visits from friends and family Facility >physiotherapy  Participation/Life Satisfaction Results  Activity  Participation/Life Satisfaction Results  Food  Care  Predictors of Participation { {  Mobility Depression  Predictors of Life Satisfaction { {  Depression Facility Satisfaction  Summary  Suggestions 1.  2.  Need to address wheelchair appropriateness issues for most residents Need to evaluate the use of restraints  Suggestions 3.  4.  Wheelchair skills training, increased provision of power mobility to facilitate mobility? Better food  Suggestions 5. 6.  7.  8.  Better staffing levels generally Better backfill for recreational staffing Changes to the way care is delivered Addressing mood problems among residents  Acknowledgements  Acknowledgements {  All of the residents, family members and staff.  Acknowledgements Recently graduated Masters of Occupational Therapy students { Sneha Shankar, Justin, Wallace, Tamara Van Dyke, Brianne Vetter, Anna Rancourt, and Kerstin Crosthwaite Research assistants { Chris Stellar, Kristina Smith; Lyndsay Martin, Jennifer Lee, Tristan Thomas, Chanudi Weerasinghe; Sarah Hamilton, Victor Tang, Bobby Lee, Silvana Doria, and Barinder Chauhan. Study Coordinator for Phase II { Elmira Chan  Acknowledgements ƒ Strategic Training Fellowship in  ƒ ƒ  Rehabilitation Research from the CIHR Musculoskeletal and Arthritis Institute CIHR and Michael Smith Foundation for Health Research Fellowships Canadian Occupational Therapy Foundation  Acknowledgements ƒ CIHR seed grant ƒ Canadian Occupational Therapy ƒ  Foundation BC Network for Aging Research  Questions?  {  bmortens@interchange.ubc.ca  


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