Sneha Shankar, W. Ben Mortenson, Justin Wallace; Taking Control: An Exploratory Study of the Use of Tilt-in-Space Wheelchairs in Residential Care. Am J Occup Ther 2015;69(2):6902290040. https://doi.org/10.5014/ajot.2014.013565
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© 2021 American Occupational Therapy Association
Tilt-in-space (TIS) wheelchairs are common in residential care, but little empirical evidence exists regarding how they are used by residents and staff in these settings. As part of a larger study exploring the use of wheeled mobility in these facilities, we conducted a substudy to examine how TIS wheelchairs are used in practice and to explore the experiences of the residents who use them. We conducted a series of three participant observations and interviews with 6 residents or their family members and interviewed 10 staff. Our analysis identified taking control as the main overarching theme, subsuming two subthemes: promoting comfort and mobilizing to participate. Findings suggest that power TIS wheelchairs enable user control, whereas manual TIS wheelchairs promote staff control. These findings illustrate how TIS wheelchairs may enable or inhibit occupational engagement and suggest that vigilance is necessary to prevent their use as a restraint.
I tell them, “Tilt the chair way back so that I can lay right back,” because it’s important that here in the back there not be any gap, because if there is, my feet are going to slip down, and that contributes more to spasms; the legs and feet get tired.
Resident abilities need to be carefully considered with the provision of TIS.
Vigilance is necessary to ensure manual TIS wheelchairs enable rather than prevent occupational engagement in residential care settings.
Power TIS enables greater occupational engagement for residents.
Additional resources, including increased staffing and provision of additional education opportunities, are needed to ensure that the devices are used and monitored correctly and that residents have better access to devices and training.
Given the limited funding that is available for power TIS, residents need monetary support to have improved access to these devices.
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