Week 9: Mobility

Question 1

Fall Facts

Answer 1

• falls are the most common cause of injury and the 6th leading cause of death (85% of injury r/t hospitalizations)
• 40% of LTC admissions are fall related
• 95% of hip fractures are due to falls
• 50% of those with hip fractures never regain pre-fall function
• 24% of seniors hospitalized with hip fractures die within the first year
• most falls occur at home while doing ADL due to the combined effect of multiple risk factors

Question 2

Mobility risk factors

x4

Answer 2

-Behavioural

–environmental

• socioeconomic
• biological

Question 3

Risk factor

(Behavioural)

(x10)

Answer 3

• dementia, delirium
• medications / polypharm
• substance abuse
• history of falls
• fear of falling
• lack of PA
• impaired safety awareness / over estimation of abilities
• inappropriate use of adaptive equip (ex cane)
• poor nutrition / hydration
• risk taking behaviours

Question 4

Risk Factor

(Socioeconomic)

(x9)

Answer 4

• communication and language barriers
• living alone
• lack of support network
• income level
• limited access to services and transport
• housing level
• housing conditions
• cultural factors
• costs (equip, meds, treatments)

Question 5

Risk Factors

(Environmental)

(x9)

Answer 5

• weather
• clutter
• stairs
• tripping hazards
• slippery surfaces
• poor lighting
• use of restraints
• lack of hand railings / safety equip
• poor building design

Question 6

Risk Factors

(Biological)

(x7)

Answer 6

• impaired balance, mobility, muscle strength, coordination
• cognition and mood (memory loss, delirium, agitation)
• syncope / dizziness
• sleep disturbances
• vision / hearing
• age and gender
• health conditions (cardioresp, neuro, musculoskeletal, continence)

Question 7

Universal Falls Risk

SAFE

Answer 7

S- safe environment

• bottom bed rails down
• pathways clear of clutter and tripping hazards
• bed and chair brakes on
• lights are working and on as required

A- assist with mobility

• mobilize at least 2x/day
• safe and regular toileting q2-3h
• transfer/mobility status documented and visible
• glasses, hearing and mobility aids within reach

F- fall and injury risk reduction

• call bell and personal items within reach
• bed lowered to pt’s knee height
• proper footwear or non-skid socks
• assess need for hip protectors

E- engage patient and family/caregiver

• discuss avoidable/ongoing risk factors
• discuss how, why, when to use intervention
• mutual falls/injury risk reduction plan developed

Question 8

Pathologic conditions affecting mobility

x4

Answer 8

1. Gait disorders
2. Osteoporosis
3. Parkinson’s disease
4. Arthritic conditions

Question 9

Pathologic conditions affecting mobility

(gait disorders)

(x5)

Answer 9

1. Ataxia: disorganized gait, staggering, side-stepping
2. Parkinson’s disease: stooped posture, short, rushing, shuffling steps, uncontrollable propulsion, body ahead of feet
3. Frail senior gait: stooped posture, hip and knee flexion, diminished arm swing, stiffness in turning
4. Hemiplegia: poor arm and leg swing, affected limb does not bend at knee, ankle fixed, inverted, leg swings in wide circle, foot drag
5. Osteomalacia: softening of bones d/t vitamin D deficiency, skeletal pain on weight bearing, unstable waddling gait

Question 10

Pathologic conditions affecting mobility

Osteoporosis

Answer 10

aka porous bone: when the body loses too much bone or does not make enough bone or both

• “silent disease”
• affects about 55% of people 50+ yrs
• high risk of bone fracture
• osteoblasts: bone building cells decrease
• osteoclasts: bone breaking cells increase

Question 11

Risk Factors

(Osteoporosis)

(x)

slide 17

Answer 11

• female (decline in estrogen at menopause)
• caucasian
• age
• family history of it
• previous fragility