Caring for an older adult with limited mobility
When an older adult becomes less able to stand, walk, balance, turn around, bend over, and perform other movements that use their large muscle groups, they are considered to have limited mobility. This article discusses some causes of limited mobility, and then lists the main steps to take when caring for an older adult with limited mobility.
Causes of limited mobility
When an older adult becomes less able to stand, walk, turn around, bend over, and perform other movements that use their large muscle groups, they are considered to have limited mobility.
An older adult may become less mobile for various reasons.
- If they have been physically inactive, their major muscles can become too weak to support free movement and good balance.
- Obesity can impair mobility, as can chronic diseases such as diabetes, arthritis, and heart disease.
- Brain tumors and degenerative diseases such as Parkinson’s can reduce the person’s control over their muscles and cause imbalance.
- Illnesses such as colds and other viruses can worsen mobility problems, even if the cases are mild.
- Commonly prescribed medications such as cholesterol drugs (statins), antidepressants, and blood-pressure medications can cause muscle weakness, dizziness, and drowsiness. For this reason, the older adult should be observed closely for mobility issues after starting a new medication.1
Some basic actions to take when caring for an older adult with limited mobility are to assess the issue, get a fall-alert system, make the home safe, encourage physical activity, and get mobility aids.
Assess the issue
Since mobility problems often develop gradually, it is a good idea to check the older adult’s capabilities at regular intervals. Even if their mobility is good at the start, the assessments are still useful in establishing baseline abilities to compare to future assessments.
Get a gait and balance evaluation
A doctor, physiotherapist, or occupational therapist can diagnose mobility issues and their progress by giving the older adult gait and balance evaluations. This will usually involve asking the person to perform actions such as standing up from a chair, walking a certain distance, turning, and standing on one leg.2
Caregivers or others involved with the older adult can carry out informal assessments through a similar method. They can ask the older adult to stand up from a chair, walk about 10 feet from it, turn, come back to the chair, and sit down. The caregiver should note how quickly they walk (if they take more than 12 seconds to walk 10 feet, they are at increased risk of falling3), how many steps it takes them to turn around, and whether they waver, stumble, or shuffle as they walk.
Once a baseline for mobility is set, the caregiver should make notes of any changes (negative or positive) in future assessments.
Keep an eye out for changes in mobility
Mobility problems often get worse with time, and a person who could make their way to the bathroom on their own one week may need a walker the next. Signs of worsening mobility issues include unsteadiness and more difficulty getting in and out of a chair.
Falls are another clear sign of worsening mobility, but it is extremely important to take action before, not after, the person has a fall. Falls are the number-one cause of both fatal and nonfatal injuries for older adults.4 Even a fall that does not cause injury will often make the person more fearful of moving about, which can start a vicious cycle of inactivity that leads to a weaker body and an even greater likelihood of falling.
Get a fall-alert system
Since people with lower mobility are at greater risk for falling, they should always have a fall-alert system or a medic-alert system with fall detection. These have become increasingly affordable, available, and customizable. Simple fall-alert pendants that connect to a call center can cost only $20-$30 a month.5 The most popular systems are wearable (such as a pendant or wrist strap), but some are voice activated.
Important considerations for fall alerts include:
- Comfort and stylishness
- Battery life
- Ease of use
- Connectivity range: how far the person can be away from the base unit and still have it operate, and how far away from a cell-phone tower or wireless connection the device will work
Make the home safe
Home safety is especially important when mobility limitations make falls and serious bumps more likely. Some key ways to improve home safety are:
- Eliminate trip and slip hazards by keeping traffic corridors clear, removing rugs, and decluttering rooms
- Reduce the need for stretching, stooping, and other balance-testing movements by putting lamps, phones, and other devices where the older adult can easily reach them, moving dishes to lower shelves in the kitchen, and, if possible, relocating appliances that are in the basement to the main floor. A hand-reacher device (also called a grabber tool) can reduce the need for risky movements
- Create “rest stations” by putting seating in every room and hallway
- Install grab bars and railings, especially in the bathroom and on frequently used routes
- Add lighting, including nightlights in hallways and bathrooms
- Modify home elements, if possible, by installing a walk-in tub, stair lift, and so on
Encourage physical activity
The best thing an older adult can do to slow, halt, or even reverse mobility problems is to be physically active. The stronger their muscles are, especially in their lower body, the more able they will be to stay balanced and mobile.
The person should focus on four areas in order to maintain or increase mobility: strength, balance, flexibility, and endurance. Walks, stretches, and exercises such as standing up from a chair and sitting down again are some ways to improve these areas.
Since many people with reduced mobility become dejected and isolated as they lose their physical independence, having the older adult enroll in exercise classes or attend an adult day care with some physical activities can be a wise step.
Get mobility aids
Obtaining mobility aids can greatly enhance an older adult’s life by increasing their independence and confidence. Common aids include:
Both the older adult and all caregivers should learn how to use mobility aids properly. This includes elements such as how to adjust them for height, how to transition to them from a sitting or lying position, how to turn and use stairs with them, and which hand a cane should be in. They can receive training by making a visit to a doctor or physical therapist and add to their knowledge with online videos. Incorrect use can cause injury.6
The older adult and caregiver should schedule time to practice with the aid, and do so in a hazard-free setting, until the correct procedures are learned and habitual.
Aging well: Making your home fall-proof
Caregiving: Making a home safe
Checklist for preventing falls at home
How to get up safely after a fall
Making the home environment safe for older adults
Physical activity as you get older
Preventing falls in older adults
Preventing falls in older adults who take high-risk medicines
Preventing falls: Exercises for strength and balance
Preventing falls: Use a home safety checklist
External supporting content
1 The past 2 decades have seen dramatic rise in elderly taking drugs that can lead to falls. Washington Post.
2 Assessing gait and balance impairment in elderly residents of nursing homes. Journal of Physical Therapy Science.
3 How to Assess When an Older Adult Requires Caregiving Assistance. AARP.
4 Get the Facts on Falls Prevention. National Council on Aging.
5 Most Affordable Medical Alert Systems. SafeWise.
6 What types of mobility aids are available? Medical News Today.