Independence is important in having quality of life for many individuals. The more physical activity the individual has, the health of the individual is improved. As we increase in our years older adults will all experience a reduction in mobility. Many individuals experience changes of gait, strength, and balance. This loss can interfere with daily functioning from getting out of bed, self-care, and being independent. Overall health can decline as physical activity declines, decrease of socialization, increase falls, diabetes, and other comorbidities that would decline the quality of life.
One of the main concerns of decreased mobility is the increase chance of a fall. Falls happen when gait is sluggish or when there is an off balance. This can lead to injury and hospitalization. There are many resources available to assist with mobility. Different walking aids from canes to walkers if used correctly can help increase safety and mobility. With Medicare they will assist with pay for a mobility aid. One of the more common items in the home that causes falls is rugs. Many do not have a non-slip back and will get tangled easily and cause a fall. One of the remedies is to go through the home and remove rugs or make sure that they have nonskid on the bottom. For example, a 80-year-old male patient admitted to home health care post hospitalization new on coumadin lives alone had no aids to assist and multiple rugs throughout house, and nutrition is poor. Nurse noted gait is unsteady and using items around house to steady. The nurse explained the risk of rugs and benefits of getting a rolling walker, and balanced diet based on coumadin diet with increase of calcium. He had concerns over price. The nurse explained with insurance DME would be at no cost and was able to get a walker and with consent agreed to take out some of the rugs. Home health was provided for a time to help stabilize him after hospital stay and reduce readmission. Patient was also evaluated and ordered to get physical therapy on board to assist with increasing mobility to help maintain independence Physical therapy has been found to be a large factor to decrease fall recurrence (Attar, et al.,2021). A dietitian was brought on board to help with diet. Improving calcium and protein intakes by using dairy foods is a readily accessible intervention that reduces the risk of falls and fractures commonly occurring in aged patients (Iuliano, et al., 2021). In the upcoming months he was eventually discharged from home health with a rolling walker, strength increased, and a more balanced diet. These interventions have helped him stay more independent longer and safer.
References
Attar, M., Alsinnari, Y. M., Alqarni, M. S., Bukhari, Z. M., Alzahrani, A., Abukhodair, A. W., & Jastaniah, N. A. (2021). Common types of falls in the elderly population, their associated risk factors and prevention in a tertiary care center. Cureus, 13(5).
Iuliano, S., Poon, S., Robbins, J., Bui, M., Wang, X., De Groot, L., & Seeman, E. (2021). Effect of dietary sources of calcium and protein on hip fractures and falls in older adults in residential care: cluster randomized controlled trial. BMJ, 375.
Discussion 2:
Reduced mobility in the elderly can significantly affect the lives they live. Reduced mobility is associated with an increase in falls and injuries, hospitalizations, disease, cognitive decline, and even death (Shafrin, et al., 2017; NIH, 2020). Without the ability to function independently older adults have difficulty visiting friends and family and doing activities that they enjoy, such as biking or golfing (NIH, 2020). A lack of independence and the consequences of reduced mobility can result in isolation & depression (NIH, 2020).
This population is prone to unsteadiness while walking and performing tasks, such as bathing, so I would be concerned about their risk of falls (HiAF, n.d.; NIH, 2020). Another concern is that they may no longer be able to care for beloved pets or may not be able to keep a pet due to the potential for trip and fall injuries. Finally, I would be concerned that without an improvement in their mobility it may become necessary for them to move out of their own home and into that of a relative or even potentially into a nursing facility.
One very common intervention in helping people with reduced mobility related to weakness or unsteadiness get around is to encourage the use of mobility devices such as a cane, walker, rollator, wheelchair, or mobility scooter (NIH, 2020). The use of a cane, walker, and rollator also provides the additional benefit of physical activity, or enabling exercise, which is another useful intervention for those with reduced mobility issues as participating in regular physical activity or exercise has been shown to decrease the risk of major mobility disability in older adults (NIH, 2020).
Resources
Health In Aging Foundation (HiAF). (n.d.). Caregiver guide: Mobility problems. American Geriatrics Society. https://www.healthinaging.org/tools-and-tips/caregiver-guide-mobility-problems
National Institutes of Health (NIH). (2020). Maintaining mobility and preventing disability are key to living independently as we age. U.S. Department of Health & Human Services. https://www.nia.nih.gov/news/maintaining-mobility-and-preventing-disability-are-key-living-independently-we-age
Shafrin, J., Sullivan, J., Goldman, D., Gill, T., & Ginsberg, S. (2017). The association between observed mobility and quality of life in the near elderly. PLoS One, 12(8), p. e0182920. https://doi.org/10.1371/journal.pone.0182920
Nursing of Family
Disuccion 1:
1. Describe conversations you are aware of that have an ongoing pattern (maybe the way you talk to a friend, or a conversation you have heard between co-workers, or conversations you have heard between a nurse and patient). What you are looking for is an ongoing communication pattern. Describe the repetitive pattern you see and give an example of a conversation.
2.
a. Looking back ongoing conversations growing up between children and parents in my parents were more under the dysfunctional patterns when it came to certain areas of communication. My family consists of Hispanic and Caribbean decent and in the islands certain topics were sought to be off topic. These topics include sexual habits and financing.
b. Another ongoing communication pattern I have noticed when speaking to friends, co workers and patient is described under the functional pattern. This is open areas of communication and self-disclosure. Having mutual respect for each other’s feelings, thoughts, and concerns (Friedman et. Al, 2003).
3. What are the patterns you see? What is the dynamic or ongoing behaviors?
a. The patterns I see are both functional and nonfunctional. The ongoing behaviors are being able to express one’s feelings effectively but also growing up the ongoing behaviors were seen as opposite. They were avoiding meaningful conversation by having “chitchat” conversations.
3. How can you use this insight to alter how you interact with patients? How does it help you to notice the ways your patient interacts with others?
a. Growing up this way has impacted how I interact with patients. When I first became a nurse, I had to get comfortable talking about these topics with patients, but also having my cultural background has benefitted me. It has benefitted me by being able to understand culture norms of other similar cultural backgrounds.