Provide Support for Mobility

Provide support for mobility (HSC 2002) Outcome 1 Understand the importance of mobility 1. define mobility Mobility is defined as, * being able to move or be moved freely and easily * the ability to move physically * The ability to move a part of the body 2. explain how different health conditions may affect and be affected by mobility No matter an individuals age, level of disability or infirmity it is important that everyone maintains some level of exercise. There are a vast range of disabilities and conditions which can result in mobility difficulties.

Some of the most common on-going or permanent conditions result from muscular and skeletal disabilities and from on-going medical conditions which affect mobility. Some examples of disabilities and conditions which can have an impact on mobility are: Back and neck problems, accidents or injury leading to long term disability, arthritis and any other condition affecting the joints, dementia, amputation, fibromyalgia, multiple sclerosis, partial or total paralysis, cerebral palsy and head injury.

Other conditions such as respiratory and cardiac diseases, epilepsy, diabetes, cancer and AIDS can all have an impact on co-ordination, dexterity, strength, speed and stamina. There are a vast range of health conditions which can be improved by mobility, here are a few. After an individual has suffered a stroke areas of their body will be weak and it is important that a physiotherapist devises a programme of exercise to strengthen the weak areas in order to regain the mobility.

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After joint surgery such as hip replacement exercise is key to making a full recovery and mobility of the joint. For individuals who are asthmatic or with chest problems, exercise can expand airways to make breathing easier. 3. outline the effects that reduced mobility may have on an individual’s well-being Both mobility and physical difficulties, and regular or constant pain can impact on an individual’s overall sense of wellbeing. Some people may be affected at times by low-self esteem and self confidence, and motivational difficulties.

Keeping mobile is extremely important for health and for giving an individual increased self esteem and a sense of well being. It is vital as we get older to maintain our mobility, to help us remain active as an elderly person and avoid having to sit in a chair all day. Being mobile enables individuals to remain independent. Being able to go when and where they want when they want without having to rely on others for assistance can make a major difference to individuals lives. 4. describe the benefits of maintaining and improving mobility.

It is important to maintain and improve mobility and this can be done through exercise. The benefits of exercise for any individual regardless of the level of their disability are both physical and an emotional improvement in their condition. Physically exercise increases heart and lung activity which improves and strengthens the cardiovascular system, which controls breathing and blood circulation. Physical exercise also increases the use of muscles which improves the muscles strength and tone. It also improves sleep and burns calories to keep our weight balanced.

Frequent and regular physical exercise boosts the immune system, and helps prevent the "diseases of affluence" such as heart disease, cardiovascular disease, Type 2 diabetes and obesity. It also improves mental health, helps prevent depression and helps to promote or maintain positive self esteem. By maintaining and improving an individual’s mobility it will increase their independence and freedom to choose actions and destinations. Outcome 2 Be able to prepare for mobility activities The learner can: 1. gree mobility activities with the individual and others Exercise can be both formal and informal. It could also take place as a group or as an individual. Exercise as a formal programme will be assessed by a physiotherapist and will help to increase mobility, improve strength stamina or suppleness. An exercise programme has usually been devised by a specialist in order to meet a specific outcome, so it is important to encourage the individual to follow the programme by explaining it’s importance and getting them to agree with it.

You need to carry out an exercise programme exactly as specified in the care plan and record and report the outcomes and any problems at each step. Others involved in an individual’s mobility activities could include an occupational therapist, physiotherapist, G. P. or community nurse. If the mobility activities are less formal and the outcome required is to maintain the individual’s mobility on a daily basis this can be done through active support and encouragement. You should encourage the individual to do things for themselves and participate in activity and exercise where possible.

An example would be to encourage their participation in household activities You should identify and agree with the individual the best way for them to maintain their mobility and any preferences to the form of exercise they prefer. It is important to ensure the individual agrees as it is important they are willing to participate in order for the programme to work. 2. remove or minimise hazards in the environment before beginning a mobility activity It is important to carry out a risk assessment of the environment prior to beginning a mobility activity.

This is to ensure the health and safety of the individual and yourself and prevent any accidents or injuries from occurring. You need to carry out a risk assessment in relation to both the activity and the individual. This will include * The floor surface is safe and free of trip hazards * The support the individual needs in the area of equipment and number of carers * Ensure any walking aids to be used are being used properly and have been measured correctly for size of the individual

If the individual is wheelchair bound or bed bound * Ensure the chair/bed is stable and the brakes are on 3. check the suitability of an individual’s clothing and footwear for safety and mobility The individual should be wearing comfortable, easy wear clothing items to allow for mobility and unrestricted movement. Shoes should be comfortable and firm and offer good support and with non slip soles. The correct type of clothing is also important to preserve an individual’s dignity if they are bending and stretching. . check the safety and cleanliness of mobility equipment and appliances. Any equipment used should be checked to ensure it is safe and clean before use. Any walking aids should be measured correctly and be the correct size for the individual. Usually any equipment to be used will be recommended by a professional such as a physiotherapist or occupational therapist, who will ensure the individual can used the aid correctly and safely. Walking sticks – for an individual needing some support, mainly to give confidence

To ensure a walking stick is the correct height for the individual you need to ask them to hold the stick in the hand opposite their “bad” side if there is one otherwise in their dominant hand eg right or left handed. Their hand should be level with the top of their thigh when resting on the stick, elbow slightly bent, shoulders level. Ensure the ferrule (suction foot) is not worn to avoid the stick slipping when leant on. Quadrupeds and tripods – for individuals who have difficulty walking on one particular leg Quadrupeds are for individuals with very poor mobility in one leg such as hip r knee degeneration or stroke. To ensure this is the correct size use the same method as described for the walking stick and again check the ferrules are not worn. Walking frames – for individuals needing considerable support Again use the same method to measure if they are the correct size as with the walking stick and again check the ferrules are not worn. Wheelchair All wheelchairs should be fitted with the appropriate cushions to minimise the risk of developing pressure area problems Outcome 3 Be able to support individuals to keep mobile 1. romote the active participation of the individual during a mobility activity Active participation is a way of working that recognises an individual’s right to participate in the activities of everyday life as independently as possible; the individual is regarded as an active partner in their own care or support, rather than a passive recipient. It is important to encourage active participation of the individual during a mobility exercise through encouragement and support. You should encourage them to stretch just a little more or try one more repetition, providing it is following the set plan of care.

Instead of clearing away their crockery after a meal, encourage them to assist you where possible. Don’t use a wheelchair to move an individual around just because it is quicker. It is important to give an individual the time to do things at their pace rather than at yours. Sometimes a specific piece of equipment may be able to be used to assist the individual to participate in the move. For example - an individual may be able to transfer themselves from a wheelchair to a chair either by the use of a transfer board or simply by sing their upper body strength to slide across, once you have removed the wheelchair arm for them. This encourages the individual to exercise their upper body muscles and actively participate in the move, rather than you using a hoist to transfer them. 2. give feedback and encouragement to the individual during mobility activities. It is important to encourage and support an individual during mobility activities. This will increase their confidence and affect how well the individual carries out the activity.

It is also important to ensure that the exercise is not too difficult or painful for the individual as this will make them reluctant to participate. Always report this if the individual is suffering pain or discomfort during the activity. Discuss any reluctance they may have to participate with them especially if the plan of care advises they are capable of the activity. It may be a lack of confidence or fear of falling which is stopping them from participating. Gentle encouragement, support and discussion will encourage the individual to be more willing to attempt the activity.

Never be tempted to change the exercise activity which a physiotherapist has recommended, because an individual finds it easier as this could cause further mobility problems or pain. You can give an individual feedback on their improved mobility. Remind them of how much they have improved since starting the mobility activities, for example, “When you started these moves Mrs B you could only do five repetitions now you can do fifteen and twice as quickly”. Outcome 4 Be able to observe, record and report on activities to support Mobility

The learner can: 1. observe an individual to monitor changes and responses during a mobility activity As a carer you are in a good position to be able to monitor changes and responses to an individual’s mobility activity. These observations are vital when planning the care an individual needs. If you observe the individual having difficulties or improvements in their mobility, if the individual complains of pain or suffers the loss of confidence in a particular technique, it is important to report and record this.

Who you report these changes to, will depend on the plan of care but it could be your senior or manager, the GP, community nurse, occupational therapist or physiotherapist. For example As a carer it may be your role to encourage and monitor how many times an individual is able to squeeze a rubber ball, to strengthen their hand and arm muscles after a stroke. By counting and reporting on the number of repetitions carried out you will enable the physiotherapist to see any improvements in the individual’s mobility. 2. record observations of mobility activity

Recording an individual’s progress on a mobility activity is important. You need to carry out an exercise programme exactly as specified in the care plan and record and report the outcomes and any problems at each step. This is necessary as the physiotherapist will need to review what progress the individual is making, so that the exercise programme can be adjusted as and when needed. You will need to note how often the individual carried out the exercises and if you noticed any improvement to their flexibility or strength, alertness, general level of fitness and mobility.

This should be recorded in the care plan notes. 3. report on progress and/or problems relating to the mobility activity including: * choice of activities If an individual enjoys a particular form or type of mobility activity, this should be recorded so that other are aware. It should also be reported to the person in charge of their mobility activity plan eg Physiotherapist. They will then be able to write an exercise plan to suit the individual based on the type of activities they enjoy.

There are numerous mobility activities which individuals could take part in, some as a group activity and some as individuals, formal and informal. It is important that an individual agrees with the activity and also cooperates in it otherwise the activity will not take place or benefit them. * Equipment * Appliances These are items which assist an individual to become or continue to be mobile, by providing support. This includes walking sticks, crutches, quadrupeds and walking frames, transfer boards, wheelchairs, mobility scooters etc.

It is important to monitor and regularly check how an individual is progressing when using any type of mobility appliance or equipment. As their mobility changes so might the aid they need for support change. If an individual has been using mobility equipment or appliance for support, whilst recovering from an injury or illness, it is important to encourage them to manage without it, before they become too dependent on it. If you feel an individual is not managing to use an appliance or piece of equipment correctly or safely, you should report this immediately the support provided. It is important to immediately report on any problems regarding the mobility support provided to an individual. This could be that you feel the support is inadequate or even excessive. For example the plan of care advises two carers assist the individual to move with the aid of a hoist, where you feel one carer would be sufficient as the individual is able and willing to use a transfer board, because their mobility had improved. You should always report accurately any observations you make regarding an individual’s support needs.

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