September 2011 – Mobility Issues Concerning Aging Adults

Older adults nordic walking
Mobility represents a challenge to an older adult’s independence and autonomy. Mobility can be on several levels:
1) How does the older adult ambulate in the home?
2) How does the older adult move around the community?
3) How does the older adult perform when driving?
Several factors can come into play. When people age, it affects them physically, mentally and emotionally. Physically, eyesight may begin to decline especially if they have problems with cataracts, glaucoma or macular degeneration. They may not respond as quickly to braking situations or recovering from a near-fall. How do they walk? Is it slow and lumbering or brisk and sure? Gait is very predictive of longevity. If they are shuffling, it may indicate an impending health condition that needs the attention of a physician. If there is an infection in the body such as a Urinary Tract Infection, it can manifest as if they have dementia. However, once they are treated and the infection is gone, they are back to normal. During the infection, they can experience delirium. This would definitely affect their ability to function behind the wheel of a car.
Many older adults are taking medications. These medications can impact their ability to think and react behind the wheel. Mentally, dementia can cause confusion in a situation which requires a quick response. At 85, 50% of older adults experience some form of dementia. Older adults who have been diagnosed by a physician as having dementia or Alzheimer’s should be assessed regarding their ability to drive. Dementia can also impact balance and coordination which puts the individual at higher risk for falls. Emotionally, if they are feeling confused, they will be defensive, paranoid and angry. They feel vulnerable. They need to feel that someone is looking out for them and that they are still valued and in control of their lives. Give them choices when dealing with situations so that they feel more in control.
Women are more likely statistically to stop driving before they became a hazard on the road. Men are more likely to continue driving past the time that they should have stopped. There is a lot of denial in families and the individual about their abilities. They still picture themselves as the robust person they have always been and they are unable to see how the changes are impacting them. It is somewhat like a frog in boiling water. If the frog is placed in the water while it is being heated, he will not realize it is too hot until it is too late. The same is true of dementia. It is the obligation of family and friends to observe and point out the changes because the individual will not recognize that they are taking place.
What can families do to be proactive? Put together a plan to help the individual with their mobility. Do they need medical aids to help them get around? i.e. cane, walker, wheelchair? Do they need to strengthen their muscles through walking, exercise or physical therapy? Do they need someone to drive them around to their appointments? Are there services that are able to deliver to the home? For instance, pharmacies, grocers and many other retailers will deliver for a fee. Some doctors will make home visits as will beauticians, foot doctors, nurses and laundry services. Do they need help with bill paying? Talk about what will make their life continue to function with the proper supports.
You may also want to check if they are able to get in and out of the home on their own in case of emergency. Is someone else able to get into their home if there is a problem? Do they have their emergency contacts, doctors, pharmacy and hospital posted in a prominent place. Would a lockbox be appropriate for enabling someone to enter their home in case they are unable to get to the door? Check into technology that can be used to track medication usage and mobility patterns so that in the event of a fall, emergency services will be called immediately.
Mobility is a huge issue which cannot be addressed completely in a short newsletter. However, to find out more about assessing mobility, go to University of Missouri St. Louis Gerontology Program,meusert@umsl.edu or go to National Association of Professional Geriatric Care Managers, to find a geriatric care manager in your location to help you to assess mobility and develop a plan.
Visit Caring for Mom Together to find out more about caregiving for an aging adult. Diane Keefe is writingBlueprint for Care to assist caregivers in understanding the issues, services and resources available to them while caregiving for an older adult. Diane is a professional Geriatric Care Manager and is writing this from the experience she had while managing older adult care in her Geriatric Care Management practice.

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