The experiences of using an anti-collision power wheelchair for three long-term care home residents with mild cognitive impairment

Abstract

Purpose. Presented are three case analyses of long-term care home residents with cognitive impairment who tested an anti-collision power wheelchair. We discuss technology design and research implications for this population.

Method. Case studies involved 371 h of participant observation and 7 h of open-ended interview with residents (n = 3), family members (n = 3) and clinical staff (n = 11). Thematic analysis generated themes related to technological, psychological and social aspects of residents' inclination and disinclination towards power mobility use.

Results. Themes examined the discordance between others' and residents' reports of anti-collision power wheelchair use; a facet of response bias; unanticipated implications for independence and dependence; and implications of device design for self-presentation.

Conclusions. Technology alone is insufficient to help residents to fully benefit from the autonomy that a wheelchair intervention can provide: close attention is required to the social and organisational factors of institutional life. For technology to be acceptable, the design must meet the functional and aesthetic needs of users. Considerations in the design of future power wheelchairs for residents with cognitive impairment include capabilities to drive on uneven surfaces, effort-reducing driving modes, improved user interface usability, and acceptable driving speed, size and appearance.

Keywords:

• Mobility
• dementia
• nursing home
• independence
• social isolation
• assistive technology design

Declaration of interest: There are no relationships between any of the study participants and the investigators. The Rocket™ power wheelchair was donated in kind by Nimble Inc. with no contracts or agreements made on the outcomes of research or commercialisation of products. This project was funded by a Canadian Institutes of Health Research Operating Grant (Funding Reference Number MOP 57696) and by Toronto Rehabilitation Institute. Funding for the first author was provided by a Canadian Institutes of Health Research Canada Graduate Scholarship Master's Award, an Ontario Graduate Scholarship, Toronto Rehabilitation Institute and the University of Toronto. The second author gratefully acknowledges support from a Canadian Institutes of Health Research New Investigator Award (MSH - 87726, 2009-2014). Toronto Rehabilitation Institute receives funding under the Provincial Rehabilitation Research Program from the Ministry of Health and Long-Term Care in Ontario. Equipment and space have been funded, in part, with grants from the Canada Foundation for Innovation and the Province of Ontario. The views expressed do not necessarily reflect those of the Ministry.

Note

1. In the interests of maintaining anonymity of the study participants, all names of participants referred to here are pseudonyms.

Acknowledgements

The authors wish to thank the residents and staff at the facility where the study was conducted. They are grateful to Gerry Griggs, Adam Sobchak, Alysia Lau, Elaine Lau, AlHassan Aly, and Trisha Orzech for their assistance with the project, and Karen-Lee Miller for her constructive and insightful comments. The first author wishes to thank Drs. Alex Mihailidis, Anne Carswell and Gary Naglie for their ongoing guidance and support.