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Hunter S1, Divine A1, Johnson A1, Hill K2, Wittich W3, Holmes J4
1University of Western Ontario, Health & Rehabilitation Sciences, London, Canada, 2Curtin University, Health & Rehabilitation Sciences, Perth, Australia, 3University of Montreal, Ecole de Optometrie, Montreal, Canada, 4University of Western Ontario, Occupational Therapy, London, Canada
Background: Gait, balance and mobility problem are common and progressive in people with Alzheimer's disease (AD). The provision of a mobility aid is often a first line rehabilitation strategy. Older adults indicate that stigma and a sense of loss and debility are associated with mobility aid use. People living with AD experience personal and social stigma associated with the disease itself. The addition of a mobility aid may increase negative emotional responses that influence willingness to use the mobility aid. In addition, characteristics of cognitive impairment itself may make the use of a mobility aid challenging. However, the self-perceptions and challenges of aid use have not been evaluated in people living with AD and their caregivers.
Purpose: The purpose of this study was to,
1) to identify perceptions of people with mild-to-moderate AD and their caregivers on mobility aid use, and
2) identify barriers to the use of the equipment in a safe and independent manner.
Methods: Semi-structured interviews (n=12 dyads) were conducted with persons living with AD (PLWAD) using a mobility aid (2 cane, 10 4-wheeled walker) and their caregiver. Inductive content analysis was used to identify themes.
Results: Four themes emerged.
1) A lack of health-care professional involvement: Most equipment was provided by non-medical people (e.g., family).
2) Paradoxical beliefs about need for training: Caregivers and PLWAD felt little formal training was required. However, neither group knew the features of the walker (e.g., brakes, adjustability) and reported equipment use that was unsafe (e.g., using it in the folded position).
3) Caregiver oversight for use of aid: Caregivers ensured the PLWAD used the aid, set the brakes and they assisted with physically manoeuvring the aid.
4) The concept of self: The maintenance of independence at home was very important to the PLWAD.
Conclusion(s): Lack of health-care involvement created knowledge deficits and unsafe practices which may lead to falls. The caregiver oversight was extensive and masked barriers to use by PLWAD, as they had little opportunity to be independent.
Implications: The findings highlight the educational and training needs of both PLWAD and caregivers. The need for health-care service providers in the provision of and training in the proper use of the mobility aid may improve safe use of the equipment and reduce the potential for falls.
Keywords: Gait, cognition, Alzheimer's disease
Funding acknowledgements: This study was supported by an Alzheimer´s Association Research Grant (AARG-16-440671).
Purpose: The purpose of this study was to,
1) to identify perceptions of people with mild-to-moderate AD and their caregivers on mobility aid use, and
2) identify barriers to the use of the equipment in a safe and independent manner.
Methods: Semi-structured interviews (n=12 dyads) were conducted with persons living with AD (PLWAD) using a mobility aid (2 cane, 10 4-wheeled walker) and their caregiver. Inductive content analysis was used to identify themes.
Results: Four themes emerged.
1) A lack of health-care professional involvement: Most equipment was provided by non-medical people (e.g., family).
2) Paradoxical beliefs about need for training: Caregivers and PLWAD felt little formal training was required. However, neither group knew the features of the walker (e.g., brakes, adjustability) and reported equipment use that was unsafe (e.g., using it in the folded position).
3) Caregiver oversight for use of aid: Caregivers ensured the PLWAD used the aid, set the brakes and they assisted with physically manoeuvring the aid.
4) The concept of self: The maintenance of independence at home was very important to the PLWAD.
Conclusion(s): Lack of health-care involvement created knowledge deficits and unsafe practices which may lead to falls. The caregiver oversight was extensive and masked barriers to use by PLWAD, as they had little opportunity to be independent.
Implications: The findings highlight the educational and training needs of both PLWAD and caregivers. The need for health-care service providers in the provision of and training in the proper use of the mobility aid may improve safe use of the equipment and reduce the potential for falls.
Keywords: Gait, cognition, Alzheimer's disease
Funding acknowledgements: This study was supported by an Alzheimer´s Association Research Grant (AARG-16-440671).
Topic: Older people; Neurology
Ethics approval required: Yes
Institution: University of Western Ontario
Ethics committee: Health Sciences Research Ethics Boards
Ethics number: 108430
All authors, affiliations and abstracts have been published as submitted.
