Mobility Problems for Older Adults
Guess the hottest trend in mobility? It's not what you think.
Harvard Medical School's Health blog says the hottest trend in mobility now is not a smartphone app or wireless gadget. That's right. It's the kind of movement pattern that lets people do what they need to do: walk and move.
Mobility gets people through the day; to the bed in our room, the pantry in the kitchen, to the toilet in the bathroom.
The flexible movement even helps people get in and out of a chair, shop at the local market and join friends for lunch.
Mobility is a Big Issue
As people age, mobility declines.
The psychological and physical consequences are detrimental, and they lead to isolation and depression.
The list goes on," says geriatrician Dr. Suzanne Salamon, an instructor at Harvard Medical School. "If you're unable to get out then you can't go shopping, you can't go out with your friends to eat dinner or go to the movies, and you become dependent on other people to get you places. So you become a recluse, you stay home, you get depressed."
With immobilization comes incontinence because you can't get to the bathroom, you can develop urinary infections, skin infections.
Read the full Harvard blog article on Mobility.
To assess whether you have mobility issues, the University of Alabama researchers suggest answering these two questions:
- For health or physical reasons, do you have difficulty climbing ten steps or walking one-quarter of a mile?
- Have you modified the way you climb ten steps or walk a quarter of a mile, because of underlying health or physical reasons?
Study by the Journal of the American Medical Association
Referencing a study by JAMA (Journal of the American Medical Association), its findings clarify that the most common risk factors for mobility impairment are:
- Older age,
- Little physical activity,
- Strength or balance impairment,
- Chronic diseases such as diabetes or arthritis.
The JAMA study points to tools that help assess mobility in the ambulatory setting. One is physical therapy because physical therapists can assess mobility limitations and develop remedial or function-enhancing interventions.
It's surprising, but few studies support therapeutic exercise to improve mobility limitation. There is strong evidence that supports resistance and balance exercises for developing mobility-limiting physical weakness and balance disorders. Assessing a patient's physical environment and the patient's ability to adapt to it using mobility devices is critical. Read the JAMA study on Improve Mobility.
Since osteoarthritis is the most prevalent form of arthritis in the United States, affecting over 20 million adults. More than half of all people age 65 and over have evidence of osteoarthritis. It is the leading cause of disability in this age group. (Source: Agency for Healthcare Research and Quality)
It's no wonder that 70% of the Residential Care Facilities reported 10% of the residents confined to a bed or chair and 12% of facilities say 11-24% confined to a bed or chair.
Mobility Devices Used
Over 6.8 million individuals in the U.S., living outside of institutions, use assistive devices to help them with movement. Out of all who use an assistive device:
- 1.7 million individuals use a wheelchair or scooters for mobility (90% use manual wheelchairs).
- The remaining 5.1 million individuals use other mobility devices; canes, crutches, and walkers.
Canes are by far the most widely used mobility devices:
- 4.8 million Americans use them, or 70 percent of mobility device users.
- Walker use reported by 1.8 million persons and crutches used by 566,000 persons.
41% of the Residential care facilities reported that 10% or less of the residents use a wheelchair or electric scooter to get around. And 20% of facilities say 24-49% of residents use a wheelchair or electric scooter to get around in the facility
Mobility and Aging
Movement relates to body changes due to aging and shows up in muscle loss, loss of muscle strength and function, stiffer and less mobile joints (inflexibility), and gait changes affecting balance.
Restricted movement affects performing all activities of daily living (ADLs). Elderly patients are also at increased risk for the complications of immobility.
The number of residents in residential care facilities with mobility issues is high. The CDC found that 40% of services said 10% or less of residents currently receive assistance in transferring in and out of bed or a chair. And 18% of facilities say 25-49% or less of residents now receive assistance in moving in and out of bed or a chair.
Mobility and Osteoarthritis
Because Osteoarthritis causes stiffness in the joints, some physical devices and treatments can help. As people get older, the bone cartridge wears down. The joints and the tissues around the joints become inflamed.
When asked about locomotion or movement, helping the resident walk or wheel him/herself around the facility, 40% of facilities say 10% or less of residents require assistance. 19% reported 75% or less of residents need help with locomotion or movement. (Source: 2010 CDC Survey)
Since cartilage pads the ends of the bones in your joints and when it wears down it causes uneven surface that irritates and in the end the bones rub together. Without the protective cartilage, the bones become damaged.
In the residential care facilities surveyed by CDC, residents have trouble walking: 34% of the residents can't walk a quarter-mile (about three city blocks). And that 21% of the residents have very difficult time walking a quarter-mile, and only 16% of the residents do not find difficulty walking a quarter-mile.
CDC asked about stair climbing: Without assistance and equipment, how difficult is it for residents to walk up ten steps without resting? Residential care facilities reported that 29% of the residents cannot walk up ten steps at all. And that 19% have a very difficult time walking up ten steps, and 19% do not have any difficulty.
CDC wanted to know if residents had trouble standing for a period of time. They asked residential care facilities: Without assistance and without equipment, how difficult is it for residents to stand or be on feet for about two hours? 37% of residents cannot stand on be on their feet for two hours at all, and 23% have a very difficult time standing on their feet for two hours, and 10% do not have any difficulty standing on their feet.
Facilities also reported that residents have difficulty sitting for about two hours or more. Here are the stats: 64% of the residents have no difficulty sitting for 2 hours, 5% of the residents find very difficult to sit for 2 hours, and 3% can't do it at all.
Stooping and Bending
Problems with stooping, bending and kneeling: How difficult is it for residents to stoop, bend, or kneel? 15% of the residents do not have difficulty stooping, kneeling and bending, 22% of the residents find it very difficult to accomplish the physical movements, and 21% cannot stoop, bend and kneel at all.
How difficult is it for residents to reach up over head? 38% have no difficulty reaching over the head, while, 9% find it very difficult, and 7% can't do it at all.
Mobility and Arthritis
Arthritis may affect one joint like the hand or finger, rheumatoid arthritis usually happens symmetrically; affecting both wrists, both hands, both knees, and both ankles and feet.
Residential care facilities reported to CDC that 61% of the residents do not find any difficulty in using the fingers to grasp, 4% have a very difficult time grasping with the fingers and 2% cannot use fingers to grasp or handle small objects at all.
Lifting and Carrying
Activities like lifting and carrying up to 10 lbs are difficult for residents. Residential care facilities reported that 13% of the residents do not have any trouble carrying 10 lbs at all, 19% of the residents find carrying 10 lbs very difficult, and 28% can't do it at all.
Push and Pull Issues
When asked how difficult is it for residents to push or pull a large object like a living room chair, 8% of the residents do not find it hard at all to push an object, 19% find it very difficult to do the task, and 43% cannot push a large object at all.
About Mobility Scooters and Power Chairs
Using a Mobility Scooter in Assisted Living
Electric mobility scooters and power chairs are popular choices for today's assisted living residents. They make it easier for active seniors to go on shopping trips, visit neighbors, enjoy the outdoors and complete common daily tasks. While assisted living facility residents may not need around the clock care, they may still have trouble getting around. Some may suffer from a physical condition or disability while others find that the body's aging process has limited their abilities.
Scooters can Help Residents be More Independent
Mobility scooters are a relief to assisted living residents who want independence. Today, scooters are available with a number of options. They can accommodate people of every shape and size and go at varying speeds. Mobility scooters are capable of helping seniors with limited disabilities get around more easily and safely than if they tried to do it on their own.
Most models work easily in an assisted living setting. Some features of mobility scooters include a comfortable headrest, the ability to move between 4 and 8 miles per hour, and emergency brakes and lighting. Because scooters are electrically powered, they are a safe, quiet, and environmentally friendly mobility option for seniors in assisted living residences.
There is no need to gas up a mobility scooter. However, when deciding on the right scooter, you should consider the type of battery and the amount of use you can get from a single charge. Additional batteries can always be purchased for backup too.
There are several key benefits of using a mobility scooter in an assisted living facility:
- Stay independent longer: One of the main reasons seniors choose assisted living is because it allows them to keep their independence. A mobility scooter has the same effect by making it easier for you to get to the restroom on your own or visit a neighbor without calling for assistance.
- Prevent falls: Broken hips and major bruises are a real concern for seniors. Scooters provide mobility without the risk of injury, so you can still get out and visit friends or enjoy the grounds without being worried that you will lose your balance and fall.
- Avoid hospital visits: If you enjoy your independence, the last thing you want is an extended hospital stay. Also to relying on doctors and nurses for every aspect of your care, you have the little privacy, and the cost of a hospital visit is astronomical. Staying seated while you move around helps you stay accident and injure free.
Even if you are not already living in assisted care, a mobility scooter can help you get around more easily at your own home. Then, if you need assisted living later, you can always bring your mobility scooter along to maintain your active lifestyle and independence.
There are lots of options available for those interested in purchasing an electric mobility scooter. In many cases, seniors and the disabled qualify for financial assistance. That means you are able to get a scooter at little or no cost.
Mobility Scooters 101
What are mobility scooters and where can I use them?
Mobility scooters are electric powered chairs designed to help disabled individuals and seniors get around more easily and stay more active. Different models are available and used in the home, apartment, or assisted living residence.
How much do they cost?
The price of a mobility scooter is determined by a number of factors. Some cost several hundred dollars while others may cost one or two thousand dollars. In many cases, people who need mobility devices can receive a mobility chair at little or no cost to them. Private insurance or government health benefits may pay most or all of the fees associated with your mobility device.
What about Medicare?
Medicare does cover costs of Mobility Scooters for some Medicare does cover the costs of mobility scooters for seniors and the disabled. However, in order to qualify for assistance you must be able to prove that you have a legitimate medical need for the scooter. In addition, the primary use for the equipment must be for helping you get around your home. Basically, this means that Medicare won't buy you a mobility scooter just because you think it would be convenient to help you get from your apartment to the grocery store.
Use the following steps to make sure that Medicare covers your costs. You should speak with a professional for help complying with all of the requirements:
Do not order a mobility scooter before your attending physician has prescribed the medical equipment for you. It's not a good idea to make a buy before you see your doctor.
Your doctor must show and document that you have a medical need for the mobility scooter. You will also need a dated and signed written prescription for the mobility device.The order or prescription needs are given to the retailer before Medicare bills for the product. Your supplier needs to keep the prescription in their files.
In some cases procedures may vary, particularly if you get Medicare through HMO or PPO Medicare Medical Advantage Plan. Follow the steps for your specific plan, and call a customer service representative to detailed instructions on getting your mobility scooter covered.
How do I know if I need a mobility scooter?
Power scooters can help seniors in a number of ways. If you suffer from poor balance, are prone to falls and accidents, disabled, or have difficulty getting out of bed or getting up from a seated position a power scooter can help you get around your home more easily.
Power scooters are also beneficial for seniors who are recovering from an illness or who are undergoing rehabilitation after a surgery. They make it possible for seniors to remain active without putting additional strain on their bodies or risking additional injuries or further complications.
Mobility Devices such as Scooters & Wheelchairs Help Seniors
Seniors commonly suffer from a number of age-related conditions like arthritis, Parkinson's disease and osteoporosis which can limit an individual's mobility. For lots of seniors simply sitting at home or staying in bed all day, isolated from the rest of the world, is unacceptable. There are several different options available for seniors to improve mobility whether they need help getting around at home, an assisted living facility, or a skilled nursing care residence.
Seniors are often forced to live on a limited income, so cost is an important consideration in choosing a mobility scooter or other device. Check with your insurance representative to find out what products are covered under your policy. You may find that the cost for scooters and chairs is minimal. If you need help determining which kind of device is right for you, consult your physician or physical therapist. See if you qualify for a mobility scooter at little or no cost to you.
Electric Mobility Scooters for Seniors
Although most electric scooters are designed to be used indoors, there are also models available to help you get around outside. Models are generally very simple to operate, so you don't have to be a technical wizard to operate them. If you are concerned about them fitting into tight spaces, check the measurements before you buy. While electric scooters are one of the most expensive options, most or all of the cost may be covered by your insurance company or government health care benefits.
Wheelchairs for Seniors
One of the biggest advantages of a wheelchair is its compact size and your ability to use them indoors and out. They are easy to fit into tight spaces like bathrooms too. While wheel chairs are also available in different models and sizes, if they are not motorized they are difficult for seniors to operate. They are a good option for seniors who do not need long-term mobility assistance.
Walkers for Seniors
Walkers are a low-tech option for seniors that come in a number of weights, styles, and sizes. They are extremely easily to transport. Walkers are typically very light and are usually made of aluminum and are collapsible. They can easily fit in the back seat or trunk of a car. A typical walker rolls on wheels and accessorize with baskets and other gadget holders. In order to get by with a walker, seniors must still be able to get up from bed or out of a chair with their own strength.
Walking Sticks and Canes for Seniors
The cheapest and probably the most common mobility options for seniors are walking sticks and canes. You can find models that are adjustable in height. When purchasing one of these devices, pay special attention to the amount of weight the cane will bear. In addition to adjustable models, you can also buy canes and walking sticks that customized and made to order. These devices require balance and some mobility independence.
For seniors in assisted living facilities and other settings, all of these options have the potential to increase mobility and independence.
5 Signs that You Need a Mobility Scooter
When caring for a loved one our trying to assess your own needs and limitations, it is difficult to determine when it's the right time to ask for a little extra help. Whether you are trying to decide about moving into an assisted living facility or you are wondering if memory troubles could be a sign of something more, it's always easier to decide the next best step with a helpful guide. See if you qualify for a mobility scooter at little or no cost to you.
For older adults and individuals who may have difficulty moving around on their own, a common question is, "How will I know when it's time to get a mobility scooter?"
These are five things to look for when deciding whether or not a mobility scooter is the right solution for you.
- Frequent Falls: If you are prone to falling, then your chances of breaking bones or sustaining other more serious injuries increases dramatically. A mobility scooter can make it possible for you to get around more safely whether you are at home, an assisted living residence, the store, or enjoying the outdoors.
- Difficulty Walking: Many elderly and disabled adults find walking is difficult. In some cases, walkers and canes don't provide adequate support. If you become confined to a chair or bed for several hours at a time each day, a mobility scooter may help you stay more active.
- Difficulty Getting Up: If you have difficulty getting out of bed or getting up from a seated position, you are more likely to stay immobile throughout the day. This can lead to pain, discomfort and even bed sores. Mobility scooters are beneficial for people in these situations, making it possible for them to get around without having to repeatedly ask for help getting out of their chair or out of bed.
- Problems With Balance: As adults age, poor balance can contribute to falls that lead to serious injuries and prolonged hospital visits. Scooters make it possible to move around and complete tasks and chores without having to worry about instability.
- Prolonged Recovery from Illness or Surgery: Medical conditions and major surgeries often require a lengthy recovery period. In lots of cases, it is unclear whether a person will be able to walk independently. Mobility scooters can provide recovering patients with the independence they need to stay active and avoid being confined to a bed for most of the day.
- Seniors often find that they are able to do less and less on their own. Mobility scooters can help reverse that loss of independence. When older adults are once again able to do more things for themselves, it can improve mood, mental health, and overall well-being.
If you think a mobility scooter is a good choice for you or a loved one, there are several different models available. Do your homework before you buy, because each model is designed according to different needs.
After seven years of helping her aging parents, Carol Marak has become a dedicated senior care writer. Since 2007, she has been doing the research to find answers to common concerns: housing, aging and health, staying safe and independent, and planning long-term.
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