Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-23T00:17:05.642Z Has data issue: false hasContentIssue false

Mobility and participation among ageing powered wheelchair users: using a lifecourse approach

Published online by Cambridge University Press:  24 September 2018

Delphine Labbé*
Affiliation:
Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada Rehabilitation Research Lab, Vancouver, Canada
W. Ben Mortenson
Affiliation:
Rehabilitation Research Lab, Vancouver, Canada Department of Gerontology, Simon Fraser University, Vancouver, Canada
Paula W. Rushton
Affiliation:
School of Rehabilitation, Université de Montréal, Montreal, Canada CHU Sainte Justine Research Center, Montréal, Canada
Louise Demers
Affiliation:
School of Rehabilitation, Université de Montréal, Montreal, Canada Centre de recherche de l'institut universitaire de gériatrie de Montréal, Montreal, Canada
William C. Miller
Affiliation:
Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada Rehabilitation Research Lab, Vancouver, Canada
*
*Corresponding author. Email: [email protected]

Abstract

About 65 million people use wheelchairs worldwide. Powered wheelchairs offer independent mobility for those who find it difficult to propel a manual wheelchair. Previous studies have described powered wheelchairs as a mixed blessing for the users in terms of usability, accessibility, safety, cost and stigma; however, few studies have explored their impact on mobility and participation over time. Therefore, as part of a larger longitudinal study, we used a combined retrospective and prospective lifecourse perspective to explore the experiences of older adult powered wheelchair users. Based on the interpretive description approach, 19 participants took part in a series of semi-structured interviews over a two-year period about their mobility, social participation and ageing process. The participants were powered wheelchair users, at least 50 years of age, recruited in Vancouver, Montreal and Quebec City (Canada). We identified three themes that highlighted how the powered wheelchair experience was integrated into the life continuum of the users. ‘It's my legs’ emphasised how powered wheelchairs are a form of mobility that not only enables users to take part in activities, but also impacts their identities, past and present. ‘Wheels of change’ explored the dynamic nature of powered wheelchair use and changes related to ageing. ‘Getting around’ illustrated how users’ mobility was affected by the interaction with their physical and social environments. Developing public policies to advance social and environmental changes could help countries to ensure equity of access and social inclusion of those ageing with disabilities.

Type
Article
Copyright
Copyright © Cambridge University Press 2018

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Present address: Department of Occupational Science and Occupational Therapy, University of British Columbia, Vancouver, Canada

References

Arim, R (2015) A Profile of Persons with Disabilities Among Canadians Aged 15 Years or Older, 2012 (Report No. 89-654-X). Ottawa: Statistics Canada.Google Scholar
Berger, RJ (2016) Recovery from spinal cord injury: a theorized life history. In Berger, RJ and Lorenz, LS (eds), Disability and Qualitative Inquiry: Methods for Rethinking an Ableist World, Vol. 5. London: Routledge, pp. 155174.CrossRefGoogle Scholar
Blach, Rossen C, Sørensen, B, Würtz, Jochumsen B and Wind, G (2012) Everyday life for users of electric wheelchairs – a qualitative interview study. Disability and Rehabilitation: Assistive Technology 7, 399407.Google Scholar
Bloomfield, BP, Latham, Y and Vurdubakis, T (2010) Bodies, technologies and action possibilities: when is an affordance? Sociology 44, 415433.CrossRefGoogle Scholar
Bourdieu, P (1984) Distinction: A Social Critique of the Judgement of Taste. Cambridge, MA: Harvard University Press.Google Scholar
Clarke, LH and Bennett, E (2013) ‘You learn to live with all the things that are wrong with you’: gender and the experience of multiple chronic conditions in later life. Ageing & Society 33, 342360.CrossRefGoogle ScholarPubMed
Darling, RB and Heckert, DA (2010) Orientations toward disability: differences over the lifecourse. International Journal of Disability, Development and Education 57, 131143.CrossRefGoogle Scholar
Disabled World (2017) Adaptive Driving: Vehicle Hand Controls and Products Information. Available at https://www.disabled-world.com/assistivedevices/automotive/.Google Scholar
Edwards, C and Imrie, R (2003) Disability and bodies as bearers of value. Sociology 37, 239256.CrossRefGoogle Scholar
Edwards, K and McCluskey, A (2010) A survey of adult powered wheelchair and scooter users. Disability and Rehabilitation: Assistive Technology 5, 411419.Google Scholar
Elder, GH and Giele, JZ (2009) Life course studies: an evolving field. In Elder, GH and Giele, JZ (eds), The Craft of Life Course Research. New York, NY: The Guilford Press, pp. 124.Google Scholar
Farbu, E, Gilhus, N, Barnes, M, Borg, K, De Visser, M, Driessen, A and Stalberg, E (2006) EFNS guideline on diagnosis and management of post-polio syndrome. Report of an EFNS task force. European Journal of Neurology 13, 795801.CrossRefGoogle ScholarPubMed
Flagg, JL (2009) Wheeled mobility demographics. In Bauer, E and Bunning, ME (eds), Industry Profile on Wheeled Mobility. Buffalo, NY: T2RERC, pp. 730.Google Scholar
Foucault, M (1982) The subject and power. Critical Inquiry 8, 777795.CrossRefGoogle Scholar
Frank, A, Neophytou, C, Frank, J and de Souza, L (2010) Electric-powered indoor/outdoor wheelchairs (EPIOCs): users’ views of influence on family, friends and carers. Disability and Rehabilitation: Assistive Technology 5, 327338.Google ScholarPubMed
Gibson, BE, Secker, B, Rolfe, D, Wagner, F, Parke, B and Bhavnit, M (2012) Disability and dignity-enabling home environments. Social Science & Medicine 74, 211219.CrossRefGoogle ScholarPubMed
Green, S, Davis, C, Karshmer, E, Marsh, P and Straight, B (2005) Living stigma: the impact of labeling, stereotyping, separation, status loss, and discrimination in the lives of individuals with disabilities and their families. Sociological Inquiry 75, 197215.CrossRefGoogle Scholar
Hall, SA (2009) The social inclusion of people with disabilities: a qualitative meta-analysis. Journal of Ethnographic & Qualitative Research 3, 162173.Google Scholar
Heitor, T, Medeiros, V, Nascimento, R and Tomé, A (2014) Investigating accessibility to achieve inclusive environments: the spatial experience of disability at a university precinct in Lisbon. In Langdon, PM, Lazar, J, Heylighen, A and Dong, H (eds), Inclusive Designing: Joining Usability, Accessibility, and Inclusion. New York, NY: Springer, pp. 93103.CrossRefGoogle Scholar
Hinojosa, R, Boylstein, C, Rittman, M, Hinojosa, MS and Faircloth, CA (2008) Constructions of continuity after stroke. Symbolic Interaction 31, 205224.CrossRefGoogle Scholar
Jensen, MP, Truitt, AR, Schomer, KG, Yorkston, KM, Baylor, C and Molton, IR (2013) Frequency and age effects of secondary health conditions in individuals with spinal cord injury: a scoping review. Spinal Cord 51, 882892.CrossRefGoogle ScholarPubMed
Jeppsson Grassman, E, Holme, L, Taghizadeh Larsson, A and Whitaker, A (2012) A long life with a particular signature: life course and aging for people with disabilities. Journal of Gerontological Social Work 55, 95111.CrossRefGoogle ScholarPubMed
Jeppsson Grassman, E and Whitaker, A (2013) Ageing with disability: an introduction. In Jeppsson, Grassman E and Whitaker, A (eds), Ageing with Disability: A Lifecourse Perspective. Bristol, UK: Policy Press, pp. 115.CrossRefGoogle Scholar
Kemper, A, Stolarick, K, Milway, J and Treviranus, J (2010) Releasing Constraints: Projecting the Economic Impacts of Increased Accessibility in Ontario. Toronto: Martin Prosperity Institute.Google Scholar
LaPlante, MP and Kaye, HS (2010) Demographics and trends in wheeled mobility equipment use and accessibility in the community. Assistive Technology 22, 317.CrossRefGoogle Scholar
Larsson, AT and Grassman, EJ (2012) Bodily changes among people living with physical impairments and chronic illnesses: biographical disruption or normal illness? Sociology of Health & Illness 34, 11561169.CrossRefGoogle ScholarPubMed
Löfqvist, C, Pettersson, C, Iwarsson, S and Brandt, A (2012) Mobility and mobility-related participation outcomes of powered wheelchair and scooter interventions after 4-months and 1-year use. Disability and Rehabilitation: Assistive Technology 7, 211218.Google ScholarPubMed
Martins, AC, Pinheiro, J, Farias, B and Jutai, J (2016) Psychosocial impact of assistive technologies for mobility and their implications for active ageing. Technologies 4, 19.CrossRefGoogle Scholar
Moll, LR and Cott, CA (2013) The paradox of normalization through rehabilitation: growing up and growing older with cerebral palsy. Disability and Rehabilitation 35, 12761283.CrossRefGoogle ScholarPubMed
Moll, LR, Cott, CA and Nixon, S (2016) Qualitative evidence in chronic, disabling conditions (childhood- or early-onset physical impairment). In Olson, K, Young, RA and Schultz, IZ (eds), Handbook of Qualitative Health Research for Evidence-based Practice. New York, NY: Springer, pp. 411425.CrossRefGoogle Scholar
Mortenson, WB, Oliffe, JL, Miller, WC and Backman, CL (2012) Grey spaces: the wheeled fields of residential care. Sociology of Health & Illness 34, 315329.CrossRefGoogle ScholarPubMed
Mortenson, WB, Hammell, KW, Luts, A, Soles, C and Miller, WC (2015 a) The power of power wheelchairs: mobility choices of community-dwelling, older adults. Scandinavian Journal of Occupational Therapy 22, 394401.CrossRefGoogle ScholarPubMed
Mortenson, WB, Demers, L, Rushton, PW, Auger, C, Routhier, F and Miller, WC (2015 b) Exploratory validation of a multidimensional power wheelchair outcomes toolkit. Archives of Physical Medicine and Rehabilitation 96, 21842193.CrossRefGoogle ScholarPubMed
Pettersson, C, Iwarsson, S, Brandt, Å, Norin, L and Månsson Lexell, E (2014) Men's and women's perspectives on using a powered mobility device: benefits and societal challenges. Scandinavian Journal of Occupational Therapy 21, 438446.CrossRefGoogle ScholarPubMed
Pettersson, C, Brandt, Å, Lexell, EM and Iwarsson, S (2015) Autonomy and housing accessibility among powered mobility device users. American Journal of Occupational Therapy 69, 19.CrossRefGoogle ScholarPubMed
Portacolone, E (2011) The myth of independence for older Americans living alone in the Bay Area of San Francisco: a critical reflection. Ageing & Society 31, 803828.CrossRefGoogle Scholar
Ripat, JD, Brown, CL and Ethans, KD (2015) Barriers to wheelchair use in the winter. Archives of Physical Medicine and Rehabilitation 96, 11171122.CrossRefGoogle ScholarPubMed
Roger, K, Wetzel, M, Hutchinson, S, Packer, T and Versnel, J (2014) ‘How can I still be me?’: strategies to maintain a sense of self in the context of a neurological condition. International Journal of Qualitative Studies on Health and Well-being 9, 23534.CrossRefGoogle ScholarPubMed
Salatino, C, Andrich, R, Converti, RM and Saruggia, M (2016) An observational study of powered wheelchair provision in Italy. Assistive Technology 28, 4152.CrossRefGoogle ScholarPubMed
Samuelsson, K and Wressle, E (2014) Powered wheelchairs and scooters for outdoor mobility: a pilot study on costs and benefits. Disability and Rehabilitation: Assistive Technology 9, 330334.Google ScholarPubMed
Shenton, AK (2004) Strategies for ensuring trustworthiness in qualitative research projects. Education for Information 22, 6375.CrossRefGoogle Scholar
Smith, EM, Giesbrecht, EM, Mortenson, WB and Miller, WC (2016) The prevalence of wheelchair and scooter use among community-dwelling Canadians. Physical Therapy 96, 11351142.CrossRefGoogle ScholarPubMed
Stenberg, G, Henje, C, Levi, R and Lindström, M (2016) Living with an electric wheelchair – the user perspective. Disability and Rehabilitation: Assistive Technology 11, 385394.Google ScholarPubMed
Sund, T, Iwarsson, S, Anttila, H and Brandt, Å (2015) Effectiveness of powered mobility devices in enabling community mobility-related participation: a prospective study among people with mobility restrictions. PM&R 7, 859870.Google ScholarPubMed
Thorne, S (2016) Interpretive Description: Qualitative Research for Applied Practice, 2nd edn. New York, NY: Routledge.Google Scholar
Torkia, C, Reid, D, Korner-Bitensky, N, Kairy, D, Rushton, PW, Demers, L and Archambault, PS (2015) Power wheelchair driving challenges in the community: a users’ perspective. Disability and Rehabilitation: Assistive Technology 10, 211215.Google ScholarPubMed
Verbrugge, LM and Yang, L-S (2002) Aging with disability and disability with aging. Journal of Disability Policy Studies 12, 253267.CrossRefGoogle Scholar
Ward, AL, Hammond, S, Holsten, S, Bravver, E and Brooks, BR (2015) Power wheelchair use in persons with amyotrophic lateral sclerosis: changes over time. Assistive Technology 27, 238245.CrossRefGoogle ScholarPubMed
Williams, E, Hurwitz, E, Obaga, I, Onguti, B, Rivera, A, Sy, TRL, Lee, Kr, Noon, J, Tanuku, D and Gichangi, A (2017) Perspectives of basic wheelchair users on improving their access to wheelchair services in Kenya and Philippines: a qualitative study. BMC International Health and Human Rights 17, 112.CrossRefGoogle ScholarPubMed
World Health Organization (2007) Global Age-friendly Cities: A Guide. Geneva: World Health Organization.Google Scholar
World Health Organization (2008) Guidelines on the Provision of Manual Wheelchairs in Less Resourced Settings. Geneva: World Health Organization.Google Scholar
Younger, M, Morrow-Almeida, HR, Vindigni, SM and Dannenberg, AL (2008) The built environment, climate change, and health: opportunities for co-benefits. American Journal of Preventive Medicine 35, 517526.CrossRefGoogle ScholarPubMed