Living on the margins of care: A scoping review of factors which influence wheelchair provision for older people in Irish nursing homes.

Background: The importance of appropriate wheelchair and seating provision cannot be underestimated (Gowran 2012). Older adults form the largest user group of wheeled mobility devices (Karmarkar et al 2012) and in nursing homes wheelchairs are often used as the primary means of mobility among residents (Mortenson et al 2012). According to Gavin-Dresechnack et al (2010) eighty percent of residents spend time sitting in a wheelchair every day. Despite this there appears to be no guidelines which influence wheelchair provision in this setting leading to poor use of wheelchairs. Objectives: The aim of this scoping study is to inspect the extent, range and nature of evidence available and factors which influence wheelchair provision in nursing homes. Methods: A methodological framework developed by Arksey & O’Malley (2002) for conducting a scoping study has been used to guide this research. Results: Appropriate wheelchair selection is an important factor for resident’s quality of life and participation in meaningful occupation. Irish policies which outline standard of care and practice in nursing homes are significantly undeveloped. Conclusion: This scoping study has found that systematic, organisational and interactional factors influence wheelchair provision in nursing homes. In Ireland, poor access to occupational therapy services for residents in these settings has potentially adverse effects on the implication of the provision of suitable wheelchairs services.