Mobility Issues and Limitations in Home Care

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Published: 07 July 2021

There are many considerations to keep in mind when caring for a client 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 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 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 client 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)

Mobility Limitations in the Home

A client living with reduced mobility may find it difficult to carry out simple tasks and participate in activities without assistance.

It is important to ensure their home environment allows them to live as independently as they would like to.

The following are recommended as basic aids to assist a client to live independently at home:

  • Cleaning and laundry aids
  • Kitchen and laundry fixtures
  • Can and jar openers
  • Preparing and cooking utensils
  • Customised scissors
  • Handrails
  • Shower rails
  • Ramps
  • Easy-use taps
  • Trays and over-bed tables
  • Reaching and turning aids
  • Walking and standing aids
  • Dressing and grooming aids
  • Remote control devices
  • Sitting and sleeping support
  • Slip-resistant mats and grip aids
  • Scooters and wheelchairs
  • Intercoms and emergency call systems.

(Better Health Channel 2015)

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 Client with a Mobility Impairment

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

  • Ensuring you know the client’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 client
  • Ensuring any tripping hazards such as furniture, mats and power cords are cleared from walkways. There should be enough unobstructed space for the client to move around safely, including when they are using a mobility aid
  • Ensuring the client’s bed is a suitable height
  • 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 client’s footwear is well-fitting, flat and non-slip.

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

Exercise

Exercise programs may include strength, balance, functional retraining and aerobic exercises (Health.Vic 2015c).

The exercise undertaken by people with mobility limitations does not need to be strenuous. Exercise can even be performed 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).

mobility issues limitations incidental activity exercise
Incidental activity such as getting dressed is a good way for people living with mobility impairments to exercise.

Falls Prevention

From 2017 to 2018 alone, over 222 000 people were admitted to the hospital after a fall (AIHW 2021).

It is important to note that most falls requiring hospitalisation are those that have occurred in the home (AIHW 2021).

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

Read: Minimising Falls Risk in the Home

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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