Getting older is associated with the slowing down of activity level. Physical activity of elderly people is limited. Limited mobility contributes to the development of various diseases. For instance, lack of exercise leads to diminished musculoskeletal performance (Miller, 2008). In order to assess musculoskeletal performance, one should look at changes in gait and change of speed of performance of some ADLs (activities of daily living) (Miller, 2008). Also, it is important to identify whether these changes are the result of ageing or of pathologic conditions. The starting point of musculoskeletal function assessment is evaluation of person’s mobility and activities (Miller, 2008). The nurses should pay attention to the way the elderly patient gets up from chair without arms (Miller, 2008). Also it is necessary to ask elderly patient whether he or she uses any assisting devices to walk (Miller, 2008).
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Also, aging increases the risk of such disease as osteoporosis. Osteoporosis refers to “a metabolic bone disease characterized by relatively low bone mineral density and increased susceptibility to fracture” (Nguyen et al, 1996). Lack of physical activity is one of the factors influencing osteoporosis. Risk factors can be different for men and women. As far as women are concerned, early menopause, late menopause, and low level of endogenous estrogen increase the risk of development of the osteoporosis (Miller, 2008). In men, the risk for osteoporosis increases with low estradiol levels (Miller, 2008). Osteoporosis often causes fractures in spine, wrist, ankles, and hips. To identify osteoporosis it is necessary to assess risk factors and then conduct a diagnostic evaluation which includes radiographic absorptiomery, quantitative ultrasonography, quantitative computed tomography, and some other technologies (Miller, 2008).
Furthermore, ageing is associated with increased risks for fractures. The main contributing factors are: history of falls, history of fractures, environmental hazards, impaired cognition, impaired vision, lack of physical activity, and smoking (Miller, 2008). Various researches suggest that, for instance, hip fractures occur, men tend to be older than women (Miller, 2008). It can be explained by the fact that men have greater bone mass (Miller, 2008).
Another health and safety factor associated with ageing is increased risk for falls. Various surveys suggest that about 25 % to 35% of people over the age of 65 years fall at least once a year (Shumway-Cook et al, 1997). There are various groups of risk factors for falls: functional impairments and common pathologic conditions, age-related changes, environmental factors, and medication effects (Miller, 2008). It is suggested that falls can be the result of combination of aforementioned factors (Miller, 2008). The age-related changes that contribute to falls are decreased muscle strength, hearing and vision changes, osteoporosis, gait changes, nocturia, changes in central nervous system, and orthostatic hypotension (Miller, 2008).
Falls, fractures and osteoporosis may cause depression, confusion, and diminished cognitive activity. There is no doubt that there is a need for intervention for high risk patients. The intervention may include assistance with ADLs, use of movement detection devices, making the call light available 27/7, and frequent check of people who cannot call for help (Miller, 2008).
I conducted an assessment of the mobility and risk for falls of my neighbor who is elderly woman of the age of 72. First, I made functional assessment. I asked my grandmother to sit in a straight-backed chair with armrests and then to stand up and walk. I noticed that the woman stood up with the help of her arms: she leaned upon the armrests. It was the first sign of limited mobility. Furthermore, I looked at the way she walked. I noticed that she has a bit staggering gait. From this preliminary assessment I concluded that the woman is at the risk group. Obviously her gait and balance are impaired and thus there are risks for falls.
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