Advocates say more wheelchair training needed for N.S. occupational therapists

Andrew Jantzen uses a wheelchair to get around, but he's never received adequate training on how to use it.

"A lot of the day-to-day stuff was just never introduced to me. It was a little strange going out into the world," said Jantzen, who has been using a power wheelchair for the past few years. 

He's not alone.

Jantzen is the regional co-ordinator at Tetra Society of North America, an organization that helps build assistive devices for people in need, such as devices that help people communicate, eat or make mobility easier.

He said from what he's heard, many people in the province are not receiving the training they need to learn important wheelchair skills, like navigating icy or bumpy terrains in a safe way.

A lot of what he learned about wheelchair skills and taking care of a wheelchair was from friends and peers.

For example, someone advised him that Ziploc bags make a great covering and can help to protect important controls on his power wheelchair.

"This is a whole new thing, a whole new way of navigating," he said. "I learned pretty quickly that it's common knowledge — there's not a lot of training available through [occupational therapists]."

Occupational therapists are healthcare professionals who specialize in helping people solve problems that interfere with their ability to do the things such as getting dressed, eating, participating in the community and sports. 

They work in a variety of settings, from private practices to hospitals and rehab centres.

Dr. Lee Kirby, head of the wheelchair research team at Dalhousie University in Halifax, said many occupational therapists in the province and across the globe feel unprepared to offer wheelchair training skills to patients.

Kirby, who is also a rehabilitation medicine physician at the Nova Scotia Rehabilitation and Arthritis Centre, recently completed a survey that looked at the practices of Nova Scotia occupational therapists when it comes to wheelchair skills training.

He said 73.5 per cent of respondents stated they found wheelchair training skills to be an important part of occupational therapy, yet only one third of them said they felt adequately prepared to offer that type of training to people in wheelchairs as well as their caregivers. 

The survey, distributed with the help of the Nova Scotia College of Occupational Therapists, heard from 110 occupational therapists.

Kirby, who is also a professor at Dalhousie's division of physical medicine and rehabilitation, is also working on a new survey with input from 35 countries. He said so far, the findings appear to be similar.

He said the survey was helpful in identifying the barriers occupational therapists face when it comes to feeling comfortable with wheelchair skills training. He hopes more education will be implemented in schools and on the job.

Brendan Elliott, a spokesperson for the Nova Scotia Health Authority, said in an email that the authority is not aware of any complaints from patients or staff in regards to a lack of wheelchair skills training.

But Elliott said the authority has implemented its own survey for occupational therapists at the Nova Scotia Rehabilitation and Arthritis Centre in Halifax on their wheelchair practices to better understand what is happening at the centre and whether local practices reflect the findings of Kirby's research.

"We will be creating action plans based on what is happening at the rehab centre, including looking at simplifying documentation and staff education and training, if required," said Elliot, noting occupational therapists are employed in all four zones health zones.

He said the authority also recently implemented focus groups with occupational therapists and occupational therapist assistants to better understand the results of the survey, however there have been delays in that research because of the third wave of COVID-19.

Adequate education needed

Cher Smith, an occupational therapist with Capital Health Nova Scotia, said she hopes Kirby's research brings more awareness to the issue.

"Throughout Nova Scotia, it would be great if everyone at the same level of competency and comfort in providing that training to people of all different types," said Smith, who helped develop the content of the survey.

"It's a combination of the school providing adequate education and enough practice in that area as well as having access to training."

Kirby said he's concerned people who use wheelchairs won't get access to the training they need, something that could discourage them from living a full life.

"This whole notion of people thinking about wheelchairs as something they're afraid of or they don't want to be confined to a wheelchair ... those are really very negative stereotypes that don't really correspond to the reality," said Kirby.  

"Often in rehabilitation, we can't change what happen to the person, but the big difference between where they are and where they can be often comes through assistive technology like wheelchairs."