Should nursing homes limit resident’s time in a wheelchair?

The News & Observer of Raleigh has an interseting article about the “new philosophy” of limiting or preventing nursing home residents from being in a wheelchair as long as the resident wants.

The article argues that older people’s health, mobility and self-image can suffer from too much time in wheelchairs. More than 24,000 North Carolina nursing home residents – about two-thirds of the total population – use wheelchairs as their main means of getting around.

Ways to limit unnecessary wheelchair use are part of a movement that gives priority to the well-being of residents and their caregivers, above the functions of the nursing home or convenience of the staff.

The Midwest-based group called GROW – Get Residents Out of Wheelchairs – has taken up the cause on a national level. The nonprofit urges nursing homes to help residents use regular chairs, couches, recliners when sitting “is considered the norm and socially accepted.” That includes for meals, TV watching, socializing with family and friends, and resting when tired.

Advocates acknowledge that wheelchairs have their uses for certain residents at certain times.
Advocates and academics say the downsides to spending too much time in a wheelchair are varied, but specific. They include a greater chance of pressure sores, significant discomfort and physical strain from operating chairs.

In addition, people in wheelchairs can be perceived as less able and are even spoken to differently in what becomes a self-perpetuating cycle of helplessness. Perhaps most importantly, loss of mobility can begin within a few days if someone starts using a wheelchair instead of walking.

Solutions are readily available in concept, but harder in reality. The GROW Coalition wants a requirement that nursing homes carry out a resident assessment before placing anyone in a wheelchair. In addition, lowered staffing ratios would let a center’s caregiver take more time with slow-moving residents.

Easier access to meals and other services should mean that more North Carolina nursing-home residents will be able to stay healthy and mobile.