Exploring the impact of wheelchairs on individuals in residential care : a two-phase, mixed-methods study

Wheelchairs are the primary means of mobility for most of the older adults living in residential care. Despite their intuitive benefits, little research has explored the outcomes of wheelchair use for facility residents. Therefore, a two-phase, mixed-methods project was undertaken. Phase 1: Exploratory Ethnographic Study. Objectives. 1. To explore the perceptions and experiences of facility life among residents who use wheelchairs as their primary means of mobility and to examine how wheelchairs are used in these settings. 2. To identify nondemographic factors that enable or curtail the mobility, participation and life satisfaction of these residents. Method. Sixteen residents from two facilities took part in participant observations, and these residents or surrogate family members completed a series of in-depth interviews. Results. We drew upon the work of Pierre Bourdieu to understand how wheelchairs and other forms of capital could either enable or curtail the things residents did and the places that they went. These findings emphasize the critical role that the facility environment plays in the lives of residents. This study identified a wide range of potential wheelchair-related, environmental, and personal factors related to resident’s mobility, participation, and life satisfaction. Phase 2: Quantitative Cross-sectional Study. Objective. To identify the predictors of mobility, participation and life satisfaction of residents who use wheelchairs as their primary means of mobility. Method. We conducted a cross-sectional study with 268 residents from 11 facilities. To measure independent and dependent study variables we administered standardized personal, wheelchair-related and environmental tools and collected socio-demographic and wheelchair equipment data. Results. Wheelchair skills (including the capacity to engage brakes and manoeuvre) were the most important independent predictors of mobility. Depression was the most important independent predictor of life satisfaction among self-responding and proxy subjects and of participation for self-responding subjects. For proxy subjects, mobility was the most important independent predictor of participation; and depression approached significance. Significance. The study findings emphasize the pivotal role that wheelchairs play in the lives of residents, reveal institutional practices that may curtail their mobility and participation, suggest potential policy and practice changes, and lay the groundwork for future research.Medicine, Faculty ofGraduat