Dysmobility/Immobility
Mobility is of significance importance to those in older age groups participate in exercise, explorations and pleasure allows opportunity for maintaining independence. Mobility is essential to the health and well-being of the older person. The incidence of problems associated with mobility increases with age. A number of chronic diseases predispose the older person to dysmobility.
Impacts:
• rapid cardiac and muscular deconditioning
• decreased ability to carry out everyday activities affects lifestyle, independence
• risk factor for decreased health status
• impaired mobility risk factor for falls
• instability and loss of confidence
• dependence (maybe institutionalisation)
• social impacts
Potential consequences of long term immobility and bed rest:
Pressure ulcers; stiffness and loss of muscle strength; constipation; urinary tract infections; malnutrition; orthostatic hypotension; hypothermia; deep vein thrombosis; pulmonary embolus; osteoporosis; contractures; depression
Most common causes (usually multifactorial):
• rheumatogical (eg rheumatoid arthritis, osteoarthritis, fibromyalgia)
• stroke
• osteoporosis fracture
• falls
• sensory deficits (vision and hearing)
• foot problems (painful feet impediment to mobility)
Patients with mobility problems are common in podiatric practice – ie due to dysmobility unable to reach feet for self care. Often can have risk factors (eg vascular disease; anticoagulant therapy; oedema) that puts them at greater risk from inappropriate/injudicious foot care.
Management of immobility:
Exercise (can reverse most of adverse consequences); prompt rehabilitation; anticoagulants; lower extremity elastic stockings; adequate nutrition and hydration; daily toileting routine; frequent body repositioning; physical therapy; attention to psychological and social needs.
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