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Mobility Issues and Limitations in Aged Care

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Published: 07 July 2021

There are many considerations to keep in mind when caring for a resident who lives with impaired or limited mobility.

Why is Mobility Important?

Mobility is closely tied to our sense of independence, but also our social connectedness, activity and security (Health.Vic 2015a). A person's wellbeing can be considerably compromised by a mobility restriction.

Mobility issues become more of a concern with age, and in many cases, older adults must face a period of adjusting from complete independence to suddenly relying on others for even minor tasks, such as brushing their teeth or basic grooming.

Mobility impairment can range from limitations of stamina to total paralysis (DRES 2011).

Often, a lack of functional mobility can contribute to health issues such as falls, incontinence and malnutrition (Health.Vic 2015a).

Mobility issues and limitations are directly tied to the Aged Care Quality Standards: Standard 5: Organisation’s Service Environment.

mobility issues limitations aged care two women walking one uses a mobility aid or walking frame
Mobility is closely tied to our sense of independence, but also our social connectedness, activity and security.

The Effects of Facilitating Mobility and Self-Care

By encouraging and helping a patient to achieve or regain mobility, the risk of the following decreases:

  • Depression
  • Delirium
  • Malnutrition
  • Falls and fall-related injuries
  • Loss of confidence due to fear of falling.

(Health.Vic 2015a)

The Effects of Long-Term Bed Rest Due to Mobility Restriction

In a situation in which drastically reduced mobility results in bed rest, there is a heightened risk of additional health complications:

Cardiovascular

  • Postural hypotension
  • Reduced aerobic capacity.

Respiratory

  • Reduction in arterial oxygen level
  • Increased potential for atelectasis.

Musculoskeletal

  • Reduced muscle mass
  • Reduced muscle strength
  • Muscle shortening
  • Joint contractures
  • Reduced bone density
  • Increased risk of falls/injury
  • Pain.

Gastrointestinal

  • Constipation
  • Malnutrition.

Genitourinary

  • Continence issues.

Skin

  • Breakdown in skin integrity.

Psychological

(Health.Vic 2015a)

What is ‘Functional Mobility’?

Functional mobility is the capacity to move from one position to another, enabling participation in everyday life.

Functional mobility includes:

  • Bed mobility
  • Transfers
  • Walking
  • Wheelchair mobility
  • Accessing toilets
  • Getting in and out of a car
  • Driving and taking public transport.

(Health.Vic 2015b)

Mobility restrictions and the use of gait aids can significantly impact a person’s ability to access their home and local area. This can cause difficulty maintaining and initiating social connections within their community (Health.Vic 2018).

Mobility Aids

types of mobility aids
Mobility aids are equipment that facilitates movement for someone who would otherwise be unable or limited in their attempt to move, participate in, or carry out a task.

Read: Understanding Mobility Aids

Mobility aids are pieces of equipment that facilitate movement for people who would otherwise be unable or limited in their attempt to move, or participate in or carry out a task. Mobility aids include:

  • Wheelchairs
  • Walking frames
  • Ramps
  • Shower chairs
  • Splints
  • Braces
  • Home oxygen services.

(Better Health Channel 2019)

Tips for Looking After a Resident with a Mobility Impairment

There are small changes that can be made to help a resident living with a mobility restriction to move around. These include:

  • Ensuring you know the resident’s capacity (i.e. whether they can get out of bed on their own, how far they are able to walk, whether they need assistance)
  • Always ensuring mobility aids are correctly adjusted to suit the resident
  • Ensuring any tripping hazards such as furniture, mats and power cords are cleared from walkways. There should be enough unobstructed space for residents to move around safely, including those who use mobility aids
  • Ensuring the resident’s bed is a suitable height
  • Ensuring mobility aids are able to fit through walkways
  • Looking out for wet or uneven flooring
  • Regularly checking mobility aids for damage (protruding or missing screws, split or loose hand grips, worn rubber tips etc.)
  • Ensuring the resident’s footwear is well-fitting, flat and non-slip.

(SA DoH 2019; CEC 2016, 2017; Ausmed 2020)

Exercise

Exercise programs can be delivered in individual or group settings and may include strength, balance, functional retraining and aerobic exercises. Group classes facilitate social interaction and may help counteract the loneliness of isolation (Health.Vic 2015c).

The exercise undertaken by older people with mobility limitations does not need to be strenuous. Research has shown that even minor increases in movement can make a difference in physical ability and prevent the likelihood of falls in people over the age of 65 (Aged Care Guide 2015).

Recommend that, if they are able to, residents incorporate balance and strength training into their daily routines – examples include taking the stairs more often and balancing on one leg while brushing their teeth (Aged Care Guide 2015).

Informed by rigorous study, this approach to exercise has been shown to reduce falls by more than 30% (Aged Care Guide 2015).

Another way of exercising is through incidental activity - physical activity that occurs as part of a daily routine. Examples include:

  • Getting out of bed
  • Walking to the toilet
  • Getting dressed
  • Eating meals outside of bed
  • Showering and grooming.

(Health.Vic 2015c)

As well as facilitating exercise, incidental activity is also beneficial in encouraging self-care (Health.Vic 2015c).

These activities can be performed with supervision or assistance if required (Health.Vic 2015c).

Illustration of women in a pool doing strength exercises as a group for increased mobility
Limited mobility can be navigated through accessible home environments, support and exercise programs.

Falls Prevention

Every year, one in three older adults experience a fall (Aged Care Guide 2015). From 2017 to 2018 alone, over 128 000 older adults were admitted to the hospital after a fall (AIHW 2021).

Falls in older adults are a major concern associated with disability, institutionalisation, mortality and socioeconomic burden (Waldron, Hill & Barker 2012).

In older adults, as many as 30% of falls cause moderate to severe injuries, for example, lacerations, hip fractures and head trauma, resulting in an increased risk of premature death (Waldron, Hill & Barker 2012).

A fear of falling may additionally lead to an avoidance of daily activities, social isolation or reduced quality of life (Waldron, Hill & Barker 2012).

Despite this, falls are often preventable (Aged Care Guide 2015).

Read: Falls Prevention

Conclusion

A mobility impairment has the potential to severely impact the wellbeing of an individual through isolation, fear of falling, increased bed-rest and dependency on others for simple tasks. Limited mobility can be navigated through accessible home environments, support and exercise programs.

Additional Resources


References

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