Navigating uncharted territory: a qualitative study of the experience of transitioning to wheelchair use among older adults and their care providers.

Edward M Giesbrecht,Roberta L Woodgate,William C Miller

doi:10.1186/s12877-015-0092-2

Edward M Giesbrecht, Roberta L Woodgate + Show 1 more

Open Access

https://doi.org/10.1186/s12877-015-0092-2

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Abstract

BackgroundAn increasing number of older adults are procuring a wheelchair for mobility; however, the corresponding impact on related injuries, caregiver burden, and participation restriction is concerning. To inform the development of a wheelchair training program, we pursued a clearer understanding of the experience transitioning to wheelchair use for older adult users and their care provider.MethodsSix focus groups were conducted with older experienced wheelchair users (n = 10) and care providers (n = 4). Transcripts were analyzed using a Conventional Content approach; a coding framework enabled inductive theming and summary of the data.ResultsThree themes emerged from the user group: On My Own reflected both limited training and the necessity of venturing out, More Than Meets the Eye addressing barriers to use, and Interdependence between wheelchair users and the ambulatory community. Care provider responses fell into two themes: the All Encompassing impact of assumed responsibilities and Even the Best Laid Plans, where unpredictable and inaccessible environments sabotaged participation.ConclusionsThe transition from ambulatory to wheelchair mobility can feel like uncharted territory. Balanced support and appropriate mentorship are fundamentally important and real-world encounters optimize independence and proficiency with skills. The impact on care providers is extensive, highlighting the importance of skills training.

Highlights

An increasing number of older adults are procuring a wheelchair for mobility; the corresponding impact on related injuries, caregiver burden, and participation restriction is concerning
The wheelchair user experience Participants in the two user groups identified a variety of issues that had impacted their transition to wheelchair use, which are summarized in three overarching themes (Fig. 1)
Three participants shared similar experiences receiving some degree of wheelchair mobility skills training, such as Tim who said: “I came through [Rehabilitation Facility] and learned quite a bit from the staff but found that getting out at home and the park and other places, encountered things that I didn’t experience [in Rehab]”

Summary

Introduction

An increasing number of older adults are procuring a wheelchair for mobility; the corresponding impact on related injuries, caregiver burden, and participation restriction is concerning. To inform the development of a wheelchair training program, we pursued a clearer understanding of the experience transitioning to wheelchair use for older adult users and their care provider. The wheelchair is becoming an increasingly common assistive device for older adults. The risk of a disabling health condition increases and mobility is the most prevalent area of impairment among older adults in Canada [1]. A 2004 study reported that among multiple assistive device users, the manual wheelchair (MWC) was considered third most important, following eyeglasses and canes [2]. The number of wheelchairs provided to address mobility issues among older adults is rising.

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