Mobility Flashcards
sarcopenia,
a loss of muscle mass,
strength and endurance.
Bone density is a measure of
The amount of minerals in a bone
Severe injury
One that requires ‘medical attention, including a visit to
a physician, visit to an emergency department,
admission to hospital or immediate fall-related death’
Falls extend hospital stays by average of
10 days
Most common cause of injury in older adults
Falls
Falls cause how many deaths in older adults
6th leading cause
How many hip fracture patients never regain full function
50%
How many injry related hospitalizqations are falls
85%
How many LTC admissions are fall-related?
40%
Where do most falls occur
At home during ADLs
How many seniors hospitalized for hip fracture die within 1 year of hip fracture
25%
Length of hospital stay for fall has an average extra of ____ days
10
Behavioural risk for falls
History of falls
* Fear of falling
* Lack of physical activity
* Impaired safety awareness/ over
estimation of abilities
* Inappropriate use of adaptive
equipment
* Inappropriate footwear
* Substance misuse
* Poor nutrition/hydration
* Risk taking behavior
How does fear of falling affect walking
Not acting physiologically like normal seld, hesitant, ginger stepping, off balance etc.
SOCIOECONOMIC
Risk Factors
- Communication / language barriers
- Living alone
- Lack of support network
- Limited access to services /
transport - Costs (equipment, medication,
treatment, etc.) - Income level
- Education level
- Housing conditions
- Cultural factors
Biological risk factors for falls
- Impaired balance, mobility, muscle
strength, coordination - Cognition & Mood (e.g. memory
loss, delirium, agitation) - Syncope / dizziness
- Sleep disturbance / fatigue
- Vision/ hearing
- Age and gender
- Health conditions (cardio, resp,
neuro, musculoskeletal,
continence)
syncope
dizziness
Universal Falls Risk SAFE *** On the test
Safe environment (5 safety checks)
Assist with mobility (mobilize at LEASSt BID)
Fall and injury risk reduction
Engage [ateint and family/caregivier
Examples of Gait disorders
Ataxia, parkinsons, frail senior gait, hemiplegia, osteomalacia
Ataxia
Disorganized gait, staggering, sidestepping
Osteomalacia gait
(softening of bones due to Vit D
deficiency): Skeletal pain on weight bearing;
unstable waddling gait
Frail senior gait
Stooped posture, hip and
knee flexion, diminished arm swing, stiffness
in turning
Parkinsons gait typical
Propulsion gait
Osteoporis
Porous Bone
When the body loses too much bone or does not make enough bone
Silent disease
High risk of bone fracture
Osteopperosis affect on people
Affects 55% of peopel over 50
Can result in significant pain. loss of funciton
Non modifiable risk factors for osteoperosis
- Female gender
- Caucasian race
- Northern European ancestry
- Advanced age
- Family history of
osteoporosis - Previous fragility and > 40 yrs
of age
Prevenion and management of osteoperiosis
Must begin in childhood and teen years to continue
Osteoarthritis
Degenerative joint disease
Wear and tear damage over time causes loss of cartilage causing rough joints to rub
OA
Theory of multiple causation:
Infection, autoimmunity, genetic factors,
environmental factors, hormonal factors
Symptoms: pain, swelling, stiffness
\women affected more than men
Onset is gradual usually beginning in 40s
Rheumatoid arthritis
Autoimmune disease
Chronic progressive disease that is a systemic diseasee of the immune system
Msot common type of arthrisit
Damage to joints is due to
inflammation
Synovitis
(congestion/edema of
synovial membrane and joint capsule)
- Pannus formation
n (thickened layers of
granulation tissue that cover and
invade cartilage, destroy the joint
capsule)
Fibrous ankylosis
(fibrous invasion of
the pannus and scar formation that
occludes joint space)
Calcification
of fibrous tissue (total
ankylosis, immobilizing the joint)
RA is more common in women
2-3x
Symptoms of RA
worsens in the morning and
after long periods of inactivity
* Flare-up can last a few days to a few
months
Osteoarthritis vs RA
OA: Bone ends rub together bc of thinned cartilage
RA: Swollen inflamed synovial membrane and bone erosion
Onset of OA
Late life
Slow progression
Joints affected by OA
Asymmetrical
Wt bearing joints
RA onsetq
Any age
Rapid onset
Symmetircal distribution
Functional consequences of arthritis
QOL of life
More meds and side effects
Higher risk for complication
Arthritis Tylenol
Slow release tylonel
Nursing assessment for arthritis
Assess pain, mobility, evidence of
falls, psychosocial changes
* Need for mobilization aids
(canes, walkers, scooters and
wheelchairs)
* Assess baseline psychological
function within stages of the
disease
* Assess medication management
and side effects
Pharm interventions
Antiinflams
Anti-Rehuemtics and immunity suppressant
NSAIDS
Antibiotic
Non pharm arthritis interventions
Local (ice/ heat to joints and/ or limbs)
* Systemic (regular and sufficient sleep 8-10 hrs)
* Psychologic (stress reduction)
* PT: exercise, gross motor assistance
* OT: aids to living (larger handled utensils, zipper
pulls, bath bars, etc.), fine motor assistance
* Stress reduction: pet therapy, music therapy, art
therapy, meditation, prayer, gardening, deep
breathing, etc.
Parkinsons
Dopamine deficiency resulting in dopamine ACh imbalance
Lack of communication bw nerve cells
ACh acts to stimulate skeletal smooth and cardiac muscle contractions
Parkinsons more common in which sex
Men
Onset of parkinsosn
Onset most commonly at approximately 60
years, but can occur throughout the lifespan`
PD characterised by
Tremor
Rigidity + stooped posture
Bradykinesia (slow movement)* Hypophonia (lowered voice
volume)
* Micrographia (small, cramped
writing)
* Pain
* Depression and dementia are
common comorbidities
Neurodegeerative disease (PD_
Begins degeneration in the brain but progresses throught to the rest of the body
Wearing off effect
Parkinsons meds have short half life and thus are prescribed close together
Since there are intact neurons usually during parkinosns, the wearing off effect can be sudden and cause great anxiety to clients
Functional consequences of parkinsosn
- Disruption to quality of life related to work and
social/relational changes - Management of medication regime and side
effects - Higher risk for influenza, community acquired
pneumonia and poorer outcomes - Higher risk for falls
- Frequent hospitalizations
- Depression
Nursing assessment for parkinsons
Medication side effect (i/e/ Dyskenesia)
Assess mobility and provide aids
Assess patient’s understanding of disease
Psychosocial assessment
Therapy for PD
No cure for underlying pathology
(although gene therapy is being tested)
* Drugs + physiotherapy + exercise +
psychological support → provide
maximal symptomatic relief and permit
a near normal lifespan.
* Deep Brain Stimulation (DBS)
