UBC Faculty Research and Publications

Ready to Roll? Mortenson, Ben 2009

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Ben Mortenson, BScOTMSc, Phd CandidateDr. Bill MillerDr. John OliffeDr. Catherine BackmanReady to Roll? Understanding Activity, Mobility and Life Satisfaction among Residents Who Use WheelchairsBackgroundWheelchairs and Residential CareFacility 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 poorPhase 1: Exploratory StudyGoals1. To explore what life is like for residents who use wheelchairs as their primary means of mobility. 2. 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 2Cross-Sectional StudyGoalsTo identify factors that enabled1. Mobility,2. Social Activity3. Life Satisfactionof residents who use wheelchairs as their primary means of mobility.Facilities{ 11 extended/multilevel care facilities in the Lower Mainland of British Columbiaz had over 100 residents who used wheelchairsWho We Included{ primary means of mobility{ >2 hours per day{ speak English{ > 60{ lived in facility/used a wheelchair >1 monthResidents{ Cognitively competent and non-competent (via proxy respondents){ 55% took part in the studyOutcomes We MeasuredMobility  (places went, how often, and how independent)Social Participation (how often they did formal and informal activities)Life SatisfactionPerson{ Cognition{ Depressive symptoms{ Age { Health{ Etc.Wheelchair Factors{ Wheelchair skills{ Type of wheelchair{ Need for seating interventionz Sliding, discomfort, skin ulcers etc.{ Restrainedz Seat belt can’t be releasedz Chair can’t be propelledEnvironmental Factors{ Facility Satisfaction{ Perceived barriers to participation{ Visits from friends and familyData Collection{ Family members usually acted as proxies (67%)Results/DiscussionFacility 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 symptomsMobilityMobility ResultsVSPredictors of Mobility{ Wheelchair skills{ Power wheelchair{ Visits from friends and family{ Facility >physiotherapyParticipation/Life Satisfaction ResultsActivityParticipation/Life Satisfaction ResultsFood CarePredictors of Participation{ Mobility{ DepressionPredictors of Life Satisfaction{ Depression{ Facility SatisfactionSummarySuggestions1. Need to address wheelchair appropriateness issues for most residents2. Need to evaluate the use of restraintsSuggestions3. Wheelchair skills training, increased provision of power mobility to facilitate mobility?4. Better foodSuggestions5. Better staffing levels generally6. Better backfill for recreational staffing7. Changes to the way care is delivered8. Addressing mood problems among residentsAcknowledgementsAcknowledgements{ All of the residents, family members and staff.AcknowledgementsRecently graduated Masters of Occupational Therapy students { Sneha Shankar, Justin, Wallace, Tamara Van Dyke, Brianne Vetter, Anna Rancourt, and Kerstin CrosthwaiteResearch 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 ChanAcknowledgements� Strategic Training Fellowship in Rehabilitation Research from the CIHR Musculoskeletal and Arthritis Institute � CIHR and Michael Smith Foundation for Health Research Fellowships� Canadian Occupational Therapy FoundationAcknowledgements� CIHR seed grant� Canadian Occupational Therapy Foundation� BC Network for Aging ResearchQuestions?{ bmortens@interchange.ubc.ca

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