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Why Too Much Inactivity Can Lead To Difficulties

Inactivity and improper activity can lead to unnecessary and avoidable health problems. And sometimes, problems may necessitate the use of assistive devices, which may not be necessary or even the best choice.  

It begs the question…

  • Why are assistive devices being used?
  • Are these devices used due to a lack of staff and time to provide care in a facility?
  • Is it faster with a wheelchair to get the individual from their bedroom room to the dining room rather than the staff taking the time to have them stand and walk?
  • Does the staff know and understand the individual plan of care for the resident? 

Knowing and understanding the individual’s physical and emotional needs is essential. To feel helpless, immobile, left to sit or use something inappropriate, unsafe, or that does not fit correctly can be considered neglect.   

A resident in a facility has the right to have freedom from neglect. Neglect includes, but is not limited to, a failure to provide the necessary care and services, including a proper walker or wheelchair.   

During one visit to a facility to assess a resident, I noticed a resident list at the nurse’s station. This list consisted of residents who were to be walked to the dining room for each meal. This also meant the resident would be sitting in a regular dining chair rather than a wheelchair. 

In another case, the assessed resident was sitting slouched in the wheelchair in front of the television with other residents waiting for the next meal. Later he was wheeled to the dining room, never assisted or allowed to walk, nor was he ever transferred to a regular dining chair for proper positioning to enjoy his meal.   

He had been left sitting for an extended period in the wheelchair without mobility, transfers, dignity, and respect. This lack of mobility was not only neglect, but the staff was not following the plan of care developed to meet this resident’s needs.   


Movement is essential

Most healthcare providers have counseled their older adults to lead moderately active lives and not to be “couch potatoes” and sedentary. 

Everyone, especially the older adult, needs movement and activity.  

“Motion is lotion” for reducing pain from arthritis. It encourages daily elimination, helps with contractures of the limbs, and avoids blood clots and pressure sores. And it reduces depression and anxiety, to name a few unnecessary and avoidable health problems. 

Even when people require an assistive device to help them with walking, they should be kept active, mobile and be helped.


All Assistive Devices Are Not Created Equal

A properly adjusted walker can be a safe assistive device for mobility and independence. 

This walking aid not only helps to maintain and improve the quality of life, but it also improves bone structure, helps with elimination, reduces pain, and, most of all, the dignity of life of the person.  

None of us want to depend on others; most people want to do for themselves. One individual stated, “This walker has made all the difference in my world. I don’t believe I could be as independent and enjoy my freedom as I am without it.” 

It is essential that the walker be adjusted to meet the needs of the individual because one size does not fit all. 

The wheelbase must distribute the weight for increased safety, balance, and mobility. The walker should slide across the floor and not just have “tennis balls” on the end of the legs, which can cause increased friction and shoulder pain.  

There are various specialty walkers for different diseases and mobility challenges. If possible, brakes to lock the walker should be installed; they are as important, as a padded seat to allow the individual to rest when fatigued. 

Another simple device is a properly fitted wheelchair for the less mobile or non-weight bearing individual.  

Again, a one-size wheelchair does not size all. The wheelchair sling seat area should have a nonmemory cushion for not only comfort but to distribute the weight to avoid any pressure points where pressure sores, also called decubitus ulcers, could develop from lack of movement. 

 An egg crate-looking type of cushion is not only uncomfortable after a while but does not support and distribute the weight to avoid pressure points. Allowing someone to sit directly on the wheelchair sling seat causes the hips to rotate and can be uncomfortable.

The use of assistive mobility devices should be assessed by a trained physical therapist and technician who understands and knows the individual’s care plan needs.  

Sadly though, too many times I have seen the wrong size wheelchair without a cushion or improper cushion, or lack of leg support. Or a walker that is not adjusted to the proper height for posture. This may cause the individual to lean forward and walk with improper posture causing strain on the back and shoulders.  

As with any “tool,” a good one for the job is critical. Additionally, the needs of the individual must be met.    

These are a few of the assistive needs all staff and facilities should be aware of and provide for the residents who have been “entrusted in their care.”


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