Mobility Provide Support to meet Personal Care Needs – CHCICS301A
Ambulation <ul><li>The act of walking – perhaps with varying degrees of assistance! </li></ul><ul><li>Encouraged to :  </l...
Issues <ul><li>May just need some steadying – ie hand rails or carer support for added stability </li></ul><ul><li>May nee...
Principles of Safe Ambulation <ul><li>Ensure client wears well-fitting footwear with non-slip soles, laces tied securely <...
Supporting Ambulation <ul><li>After obtaining verbal consent : </li></ul><ul><li>Walk with client, taking their arm, and p...
<ul><li>Establish client’s pace – allow time and ensure client isn’t being lead or “dragged” </li></ul><ul><li>If one-side...
Walking Aids <ul><li>Act to broaden base of support, therefore increase stability </li></ul><ul><li>Type used depends on c...
Walking Sticks <ul><li>Used with one-sided weakness or injury, occasional loss of balance, or to reduce weight-bearing on ...
<ul><li>Either single point, tripod or 4 point stick – sticks with more points provide broader base and greater stability ...
Walking Frames <ul><li>Often provide greater sense of support and security than a stick </li></ul><ul><li>Height should al...
Any Walking Aid <ul><li>Client needs assistance and supervision until ambulating confidently </li></ul><ul><li>Still need ...
Common  Musculoskeletal Disorders that can Affect Mobility <ul><li>Most disorders of the musculoskeletal system cause : </...
<ul><li>Some musculoskeletal disorders are  acute,  others form slowly and with  degeneration </li></ul><ul><li>Some may b...
Arthritis <ul><li>Inflammation of a joint, which affects its movement, flexibility and stability </li></ul><ul><li>Causes ...
Osteoarthritis <ul><li>Most common form, usually associated with ageing, but can affect younger age groups </li></ul><ul><...
<ul><li>Often r/t repetitive overuse, strain r/t obesity, and ageing changes </li></ul><ul><li>Very common in weight beari...
Rheumatoid Arthritis <ul><li>Less common disease of joints, which is known as “systemic” – also affects other body systems...
<ul><li>Unknown cause - ? family, ? Viral </li></ul><ul><li>Eventually causes gross joint damage and deformity, with pain,...
Problems with arthritis <ul><li>Pain  – pain and aching around affected joint </li></ul><ul><li>Stiffness  – often worse i...
General Treatment Principles <ul><li>With  acute inflammation , aim to decrease pain and inflammation, utilising  rest , a...
Supportive care <ul><li>Pain relief </li></ul><ul><li>Ensure adequate rest of joint, gentle mobilisation </li></ul><ul><li...
Use of Warmth <ul><li>Need to check suitability of client first, and agency policy </li></ul><ul><li>Contraindicated in an...
Supportive Care <ul><li>Impaired mobility </li></ul><ul><li>Encourage range of motion exercises, to keep joints and muscle...
Osteoporosis <ul><li>Condition in which bones lose calcium and phosphate – leading to “thinning” of the skeleton, which be...
Contributing causes <ul><li>Prolonged negative calcium balance (insufficient dietary intake of calcium) </li></ul><ul><li>...
Osteoporosis  <ul><li>Common for osteoporotic change to occur in spine, but also in long bones, ie femur </li></ul><ul><li...
Supportive care <ul><li>Emphasis on  prevention  of osteoporosis – by modifying known risks early in life </li></ul><ul><l...
<ul><li>Encourage continuation of weight bearing exercise and ambulation as able </li></ul><ul><li>Medical treatment inclu...
Fractures  (#) <ul><li>Fracture = break in the continuity of a bone, but may involve other structures – muscles, nerves, b...
Amputation  <ul><li>Commonly, below knee or above knee </li></ul><ul><li>Extensive surgery, and post-operative bleeding co...
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Mobility aifl march 11

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Mobility aifl march 11

  1. 1. Mobility Provide Support to meet Personal Care Needs – CHCICS301A
  2. 2. Ambulation <ul><li>The act of walking – perhaps with varying degrees of assistance! </li></ul><ul><li>Encouraged to : </li></ul><ul><li>prevent immobility complications </li></ul><ul><li>promote sense of equilibrium </li></ul><ul><li>enhance self-confidence and independence </li></ul>
  3. 3. Issues <ul><li>May just need some steadying – ie hand rails or carer support for added stability </li></ul><ul><li>May need to completely re-learn to walk, perhaps with a different technique </li></ul><ul><li>May need assistive aids </li></ul><ul><li>May undergo progressive ambulation – slowly increasing difficulty or distance </li></ul>
  4. 4. Principles of Safe Ambulation <ul><li>Ensure client wears well-fitting footwear with non-slip soles, laces tied securely </li></ul><ul><li>Monitor client for ill-effects – faintness, fatigue, pain – rest if distressed </li></ul><ul><li>If the resident begins to fall, try to ease down the wall onto floor, or into chair – try to avoid “catching” client </li></ul><ul><li>Ensure environment is uncluttered throughout – floor surface clean and dry, no equipment in thoroughfares </li></ul>
  5. 5. Supporting Ambulation <ul><li>After obtaining verbal consent : </li></ul><ul><li>Walk with client, taking their arm, and providing support underneath elbow and hand </li></ul><ul><li>Support is enhanced, by keeping your body in close to theirs </li></ul><ul><li>Place hand at base of lower back to provide support & sense of security for the resident </li></ul>
  6. 6. <ul><li>Establish client’s pace – allow time and ensure client isn’t being lead or “dragged” </li></ul><ul><li>If one-sided weakness exists, support on the affected side </li></ul><ul><li>Use environment – client close to railed wall, rest chairs positioned strategically </li></ul><ul><li>Ensure any attachments or tubing cannot leak or dislodge </li></ul>
  7. 7. Walking Aids <ul><li>Act to broaden base of support, therefore increase stability </li></ul><ul><li>Type used depends on client’s condition, type of disability, and amount of support required </li></ul><ul><li>Important, whatever aid is utilised, that it is appropriately selected , is safe, and proper instruction in the use of the aid has occurred (ideally by a physiotherapist) </li></ul>
  8. 8. Walking Sticks <ul><li>Used with one-sided weakness or injury, occasional loss of balance, or to reduce weight-bearing on a hip or knee </li></ul><ul><li>Stick provides balance or support, and reduces fatigue and strain on joints </li></ul><ul><li>Should extend from client’s hip bone, to floor, and needs rubber tip to prevent slipping </li></ul>
  9. 9. <ul><li>Either single point, tripod or 4 point stick – sticks with more points provide broader base and greater stability </li></ul><ul><li>Stick is held close to body on unaffected side, taking weight off affected side – ie stick and affected leg are moved first, followed by unaffected leg </li></ul>
  10. 10. Walking Frames <ul><li>Often provide greater sense of support and security than a stick </li></ul><ul><li>Height should allow 15-30 degree flexion of elbows, when hand grips are held </li></ul><ul><li>Can get attachments (baskets, trays, seats) to promote greater independence </li></ul><ul><li>Need to pick up frame and advance it – not push or carry it!! </li></ul><ul><li>Client needs to use steps to walk right into frame - if too far in front, causes stability problems </li></ul>
  11. 11. Any Walking Aid <ul><li>Client needs assistance and supervision until ambulating confidently </li></ul><ul><li>Still need safe shoes with non-slip soles </li></ul><ul><li>Need to ensure floor surfaces are even, and unnecessary articles (ie loose mats) are removed from path </li></ul>
  12. 12. Common Musculoskeletal Disorders that can Affect Mobility <ul><li>Most disorders of the musculoskeletal system cause : </li></ul><ul><li>- difficulty with movement (mobility), loss of function and range of motion </li></ul><ul><li>- pain, stiffness and inflammation </li></ul>
  13. 13. <ul><li>Some musculoskeletal disorders are acute, others form slowly and with degeneration </li></ul><ul><li>Some may be cured, some may be modified with treatment, others may require surgical intervention, and some have little effective treatment available </li></ul>
  14. 14. Arthritis <ul><li>Inflammation of a joint, which affects its movement, flexibility and stability </li></ul><ul><li>Causes pain </li></ul><ul><li>Can affect any joint in the body </li></ul><ul><li>Very common in the elderly </li></ul><ul><li>2 main types : osteoarthritis, and rheumatoid arthritis </li></ul>
  15. 15. Osteoarthritis <ul><li>Most common form, usually associated with ageing, but can affect younger age groups </li></ul><ul><li>“ Wear and tear” arthritis – caused by deterioration of joint cartilage, and damage to bone ends, progressively leading to joint deformity </li></ul><ul><li>Can be caused initially by a traumatic injury </li></ul>
  16. 16. <ul><li>Often r/t repetitive overuse, strain r/t obesity, and ageing changes </li></ul><ul><li>Very common in weight bearing joints – hips, knees, cervical and lumbar spine </li></ul><ul><li>Also in small joints – fingers, hands </li></ul>
  17. 17. Rheumatoid Arthritis <ul><li>Less common disease of joints, which is known as “systemic” – also affects other body systems </li></ul><ul><li>Classified an auto-immune disorder (antibodies made that break down normal joint tissue), and commonly affects younger people (especially women) </li></ul><ul><li>Not related to injury, or “wear and tear” </li></ul>
  18. 18. <ul><li>Unknown cause - ? family, ? Viral </li></ul><ul><li>Eventually causes gross joint damage and deformity, with pain, inflammation and swelling – often affects small joints initially, wrists, hands and feet </li></ul><ul><li>Characterised by remissions and flare-ups </li></ul>
  19. 19. Problems with arthritis <ul><li>Pain – pain and aching around affected joint </li></ul><ul><li>Stiffness – often worse in the morning with RA, more common after use/exercise with OA </li></ul><ul><li>Joint swelling, redness, heat </li></ul><ul><li>Impaired mobility – muscle weakness/fatigue </li></ul><ul><li>Altered body image – r/t joint deformity and loss of function </li></ul><ul><li>With RA, other body symptoms , ie fever, general fatigue </li></ul>
  20. 20. General Treatment Principles <ul><li>With acute inflammation , aim to decrease pain and inflammation, utilising rest , analgesic and anti-inflammatory medications, splinting etc </li></ul><ul><li>With chronic inflammation , need to achieve a balance between activity and rest (modification of ADL’s), medications, and supportive care, ie warmth </li></ul><ul><li>Long term/destructive problems may need surgery </li></ul>
  21. 21. Supportive care <ul><li>Pain relief </li></ul><ul><li>Ensure adequate rest of joint, gentle mobilisation </li></ul><ul><li>Comfortable position, perhaps elevated, or supported by pillows, or special splints </li></ul><ul><li>Often more comfy with joint in slightly flexed position – less pressure than extension </li></ul><ul><li>Application of warmth – to improve circulation and relieve muscle spasm </li></ul>
  22. 22. Use of Warmth <ul><li>Need to check suitability of client first, and agency policy </li></ul><ul><li>Contraindicated in an area of acute inflammation </li></ul><ul><li>If OK, apply for short periods only </li></ul><ul><li>Ensure safety with temperature </li></ul><ul><li>Perhaps therapeutic use of warm water </li></ul>
  23. 23. Supportive Care <ul><li>Impaired mobility </li></ul><ul><li>Encourage range of motion exercises, to keep joints and muscles as flexible as possible </li></ul><ul><li>Important to keep things moving, but rest if joint is acutely inflamed </li></ul><ul><li>Encourage use of mobility aids for stability </li></ul><ul><li>Balanced diet – to avoid obesity, prevent increased stress on weight-bearing joints </li></ul>
  24. 24. Osteoporosis <ul><li>Condition in which bones lose calcium and phosphate – leading to “thinning” of the skeleton, which becomes porous, brittle and vulnerable to fracture </li></ul>
  25. 25. Contributing causes <ul><li>Prolonged negative calcium balance (insufficient dietary intake of calcium) </li></ul><ul><li>Inactive lifestyle – immobility, or lack of weight bearing exercise </li></ul><ul><li>Oestrogen deficiency – most common in post-menopausal and older women </li></ul><ul><li>Long term corticosteroid therapy </li></ul><ul><li>Excessive nicotine and caffeine intake </li></ul>
  26. 26. Osteoporosis <ul><li>Common for osteoporotic change to occur in spine, but also in long bones, ie femur </li></ul><ul><li>Causes chronic pain, especially lower back, hips, neck </li></ul><ul><li>Causes pathologic fractures – a break in bone with no traumatic episode or apparent cause - and poor bone healing ability, if a break does occur </li></ul><ul><li>Causes loss of stature – height loss, stoop forward </li></ul>
  27. 27. Supportive care <ul><li>Emphasis on prevention of osteoporosis – by modifying known risks early in life </li></ul><ul><li>Screening tests – Dexascan for people at risk </li></ul><ul><li>Safety – gentle handling of client, promotion of safe environment to minimise risk of falls </li></ul><ul><li>Comfort and management of pain – positioning, warmth to affected areas </li></ul>
  28. 28. <ul><li>Encourage continuation of weight bearing exercise and ambulation as able </li></ul><ul><li>Medical treatment includes calcium supplements </li></ul><ul><li>Other medications which inhibit/slow down bone reabsorption </li></ul>
  29. 29. Fractures (#) <ul><li>Fracture = break in the continuity of a bone, but may involve other structures – muscles, nerves, blood vessels </li></ul><ul><li>Usually associated with traumatic injury (ie fall/ forceful blow), or repeated minor stress </li></ul><ul><li>In older people, often occur r/t osteoporosis - heal very slowly, and risk immobility problems </li></ul>
  30. 30. Amputation <ul><li>Commonly, below knee or above knee </li></ul><ul><li>Extensive surgery, and post-operative bleeding common </li></ul><ul><li>Stump wound infection/breakdown common </li></ul><ul><li>May have problems with phantom limb pain and sensation </li></ul>

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