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Care
Published in Henry J. Woodford, Essential Geriatrics, 2022
Mobility aids improve gait patterns by allowing the support of some body weight through the arms rather than the legs, which can protect a painful, weakened, or unstable joint. They tend to promote a more upright posture. Balance and confidence may also be helped. A wide range is available (seeFigure 2.2). The choice of which aid is most appropriate is usually based on individual preferences, ability and lifestyle, plus environmental factors at home. Physiotherapists often help in selecting the most appropriate walking aid. People may decline, or never use, aids that they feel stigmatise them as disabled. People with moderate to severe dementia can have difficulty learning how to use walking aids correctly and can forget to use them when mobilising.
Caring for people with impaired mobility
Published in Nicola Neale, Joanne Sale, Developing Practical Nursing Skills, 2022
Rowena Slope, Katherine Hopkinson
Commissioning for Quality and Innovation (CQUINs) require trusts to demonstrate improvement in a specified area of care, and in 2019, a Preventing Hospital Falls CQUIN was introduced to encourage trusts to focus their improvement efforts on the delivery of three high-impact actions for falls prevention in hospital (NHS England and NHS Improvement 2019). These were: Lying and standing blood pressure, as a drop in blood pressure on standing (orthostatic hypotension) is a common occurrence in acutely unwell hospitalised individuals and is a risk factor for falls (Windsor et al. 2016).No hypnotics or antipsychotics or anxiolytics given during stay OR rationale for giving hypnotics or antipsychotics or anxiolytics documented, as falls are associated with polypharmacy and psychotropic drug use.Mobility assessment documented within 24 h of admission to the inpatient unit identifying if walking aid required or not, and walking aid provided within 24 h of admission if required, as a lack of suitable mobility aid increases the risk of falling.
Incontinence
Published in Susan Carmody, Sue Forster, Nursing Older People, 2017
Nurses should also ensure that residents are using mobility aids appropriately. There are multiple benefits of improving mobility and increasing activity for residents. Improvement in incontinence problems is one such significant benefit.
Environmental barriers and housing accessibility problems for people with Parkinson’s disease: A three-year perspective
Published in Scandinavian Journal of Occupational Therapy, 2023
Nilla Andersson, Björn Slaug, Maria H. Nilsson, Susanne Iwarsson
Descriptive information (T1 and T2) included the variables gender, age, Parkinson’s disease duration, living alone or with a partner, see Table 1. The Hoehn and Yahr scale (HY, range I-V, higher = worse) was used to describe disease severity in ‘on-state’ [36]. Severity of motor symptoms was assessed with Part III of the Unified Parkinson’s Disease Rating Scale (UPRDS III, possible scores 0–108; higher = more motor symptoms) [37]. Global cognitive function was assessed by the Montreal Cognitive Assessment (MoCA, possible scores 0–30, higher = better cognitive function) [38]. The Parkinson’s Disease Activities of Daily Living Scale (PADLS) was used to describe difficulties and dependence in ADL (possible scores 1–5; higher = more problems) [39]. Mobility aids indoors were addressed with the variables any mobility device, cane/crutches, rollators, manual wheelchair or powered wheelchair. Housing was described by the variables: residential location (rural/semi-urban/urban), type of housing (apartment/housing/other), tenure of housing (privately owned/rental), housing adaptations (yes/no) and number of years lived in the same dwelling.
Can assessment of disease burden and quality of life based on mobility level in patients with end-stage cancer provide an insight into unmet needs? An exploratory cross-sectional study
Published in Physiotherapy Theory and Practice, 2023
Yeliz Bahar- Ozdemir, Sefik Kaya, Nalan Akgul- Babacan, Tugce Al, Ece Albayrak, Nilufer Coskun, Gulseren Akyuz
Activities of daily living (ADLs) consist of basic activities an individual should be able to perform on his/her own to be able to live independently in society. However, cancer and its treatment process can negatively affect patients’ ability to perform ADL performances, ultimately reducing their QoL. Fatigue, pain, depression, low aerobic capacity, and lack of strength related to cancer and its treatment are associated with decreases in physical function (Sheill, Guinan, Hevey, and Hussey, 2018; Zucchetti et al., 2018). During the terminal stage, there are conditions that result in more physical impairments and consequently, patients experience activity limitations and participation restrictions that may negatively affect their QoL. To overcome physical impairments, patients usually need to use mobility aids (MA) such as canes, crutches, walkers, rollers, or wheelchairs.
A theoretical framework for addressing fear of falling avoidance behavior in Parkinson’s disease
Published in Physiotherapy Theory and Practice, 2023
Merrill R. Landers, Maria H. Nilsson
An additional important treatment priority in this pattern is doing strength training and weight bearing exercises that are sufficient to improve bone health. Since people in this pattern are avoiding activity, it is possible, from a theoretical perspective, that their bone health may be less than ideal due to a lack of participation in physical activity. Additionally, as falling is one of the two main causes that hastens mortality in PD, it is important to prevent the consequences of a fall (e.g. bone fractures) in those who are at high risk for falling. Mobility aids or assistive devices (e.g. rolling walker or rollator) to decrease the risk should also be recommended for people in this pattern if it is appropriate. Moreover, there should be encouragement to use the mobility aid or assistive device to facilitate more participation in physical activity. That is, these devices should be used to help enable the person to increase their physical activity without increasing their fall risk. Lastly, as improvements in balance and gait are realized, there should be a concomitant increase in physical activity (i.e. decreased avoidance behavior). If avoidance behavior due to FOF persists despite improved gait and balance, a therapist-led, social cognitive theory (Bandura, 2004; Ellis and Motl, 2013) and/or cognitive behavioral therapy (CBT) strategy (Dobkin et al., 2019; Herning, Cook, and Schneider, 2005; Kraepelien et al., 2020; Reynolds et al., 2020) may be needed to increase self-efficacy and physical activity levels and to decrease cognitive and affective factors associated with the avoidance behavior.