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Immobility is a common pathway by which a host of diseases and problems in the elderly produce further disability. Persons who are chronically ill, aged, or disabled are particularly susceptible to the adverse effects of prolonged bed rest, immobilization, and inactivity. The effects of immobility are rarely confined to only one body system. It may later cause a wide range of complications. Immobility in the elderly often cannot be prevented, but many of its adverse effects can be. Improvements in mobility are possible for the immobile older adults. Relatively small improvements in mobility can decrease the incidence and severity of complications, improve the well-being of the elderly as well as relieve the burden of caregivers.
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| What are the common causes and risk factors of immobility in older adults? |
| Musculature, joint, and skeleton problems
• Arthritis
• Osteoporosis
• Fractures (especially hip & femur)
• Podiatric problems |
Neurological problems
• Stroke
• Parkinson's disease
• Cerebellar dysfunction
• Neuropathies |
| Heart, lung, and circulation problems
• Chronic coronary heart disease
• Chronic obstructive lung disease
• Severe heart failure
• Peripheral vascular disease
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Cognitive, psychological and sensory problems
• Dementia
• Depression
• Fear and anxiety (e.g. fear from instability
and falling)
• Pain
• Impaired vision |
| Environmental causes
• Forced immobilization (restraint use)
• Inadequate aids for mobility
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Others
• General weakness after prolonged bed
rest
• Malnutrition
• Drug side effects
• Severe illness of any type |
| What are the complications of immobility? |
Physical
Muscle wasting, Contractures, Muscle pain, Osteoporosis, Pressure sores, Hypothermia, Aspiration pneumonia, Constipation, Incontinence, Deep vein thrombosis and Anorexia
Psychological and Social
Isolation, loss of independence, Sensory deprivation, depression, delirium and dementia
| What you can do to alleviate or prevent the complications of immobility? |
• Continue with daily activities that you are able to perform as tolerated but avoiding overexertion. Do not let others do for you what you can do for yourself.
• Perform exercises to keep your limbs flexible and promote circulation. Do not stay in bed with little movement. Do stretching and range of motion exercises to each of the joints on a daily basis.
• Maintain a sufficient fluid intake. Ensure 1.5-2 liters fluid intake per day as possible.
• Focus on abilities and not disabilities. Find possible ways to enhance mobility through the use of assistive devices (e.g. walking aids, wheelchairs) and making the home accessible. You may ask therapists for further advice.
• Maintain regular contact with people. Engage in pleasurable activities with family, friends or caregivers.
• For bed-bound cases, maintain proper body alignment and change positions every few hours. Pressure padding and heel protectors may be used to provide comfort and prevent pressure sores.
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