As healthcare workers, we deal with patients every day that have mobility issues. We learn the proper ways to transfer patients from their beds to wheelchairs or commodes. Learning about mobility problems is such an integral part of what we do. Jessica, from Vive Health, wrote this article that is a great resource for us when learning about mobility issues in the elderly population.
Mobility Issues in Older Adults
As a nurse, you may encounter an array of mobility issues across a span of different kinds of patients. In fact, the most recent data from the Centers for Disease Control says that almost 40 million adults in the U.S. experience some degree of difficulty with physical functioning, with over 17 million reporting being unable to walk a quarter mile.
Common Pathologies That Affect Mobility
Some obvious injuries and diseases which affect mobility include spinal injuries and paralysis, cerebral palsy, muscular dystrophy, and amputation. Other conditions can also strongly contribute to mobility issues, these include:
- Degenerative disk disease
- Parkinson’s disease
- Multiple sclerosis
- Dementia and Alzheimer’s
- Some forms of cancer
- Bone or joint infection
While muscle loss and joint wear-and-tear is a natural part of aging, it’s important to remember that mobility issues aren’t necessarily inevitable for seniors. Researchers have found that lifestyle factors like low physical activity, older age, obesity, and impaired strength and balance increase risk for mobility problems down the line as do less obvious ones like smoking, drink alcohol, memory or thinking problems, or having feelings of depression.
Mobility issues can present in more ways than you may think and can affect everything from a patient’s ability to complete daily tasks (like getting dressed and going to the bathroom) to lowered health outcomes. A patient with early-stage mobility issues may not even use a walking aid, however, keeping an eye out for these common warning signs can help you work with their care team to take early action to delay any further disability.
Mobility problem warning signs include:
- Difficulty bearing weight on one or both legs
- Trouble balancing
- Avoiding the stairs
- Frequent falling
- Inability to stand up or walk for extended periods of time
- Trouble standing up or sitting down
- Skipping exercise
Harvard Medical School shares two important questions clinicians can ask seniors to illumine the extent of possible mobility issues they may have. They include:
Do physical or health reasons affect your ability to walk one-quarter of a mile or climb up 10 stairs?
Have underlying physical or health reasons caused you to modify the way you walk one-quarter of a mile or climb 10 stairs?
A care team can also “test” a patient’s mobility by witnessing the time and effort it takes a patient to stand up from a seated position, walk 10 steps, and return back to the chair and sit down. Researchers say moving slower than one yard per second when walking can indicate gait problems that need to be addressed.
What Are the Health Risks of Immobility?
Mobility issues seriously impact a person’s ability to exercise and stay active. In addition to weight gain or unhealthy weight loss, patients with mobility problems can experience circulation problems and edema, increased risk of falling, bone loss, muscle weakness, constipation, incontinence, pressure ulcers, and increased risk for kidney stones, pneumonia, and urinary tract infections among others.
Immobility indirectly affects emotional and mental health as well, limiting a patient’s ability to get out and about, interact with others, and seek fulfilling jobs or hobbies. Loneliness, social isolation, anxiety, anger, confusion, depression, and learned dependence can also cascade from mobility problems.
How Can Nurses Help?
For nurses who are working with older patients with mobility issues, keep these tips in mind:
Don’t associate a patient’s mobility problems with cognitive problems until you fully understand their diagnosis
Ask your patient or their caregiver before giving them assistance in regards to helping them mobilize (i.e. pushing their wheelchair)
Use transfer devices like gait belts, leg lifter straps, and hoya lifts to aid in moving them on and off the bed, on and off the toilet, etc.
If your patient is a wheelchair user, make an effort to squat or sit down when conversing so you are speaking with them at eye level (and not talking down to them)
When helping a patient with their mobility aid, listen to them for instructions and what they know is the most comfortable and efficient way to adjust or be moved
Be mindful of the extra time it takes an older adult with mobility issues to move, make a decision, or even talk
Encourage patients to keep moving, whether it’s doing seated chair exercises, getting outside for fresh air, or simply dancing in their bed to music
A 2013 clinical review published in the Journal of the American Medical Association focused on mobility limitations in older patients and how they can be addressed earlier in an ambulatory setting. The findings included recommendations for recognizing warning signs and referring patients to physical and occupational therapists who can help them regain some functioning and self-dependence.
Jessica Hegg is the content manager at ViveHealth.com. Avid gym-rat and nutrition enthusiast, she’s interested in all things related to staying active and living healthy lifestyle. Through her writing she works to share valuable information aimed at overcoming obstacles and improving the quality of life for others.