Adults/Older Adults module 2

functional mobility

moving from one position or place to another (during the performance of everyday activities), such as in-bed mobility, wheelchair mobility, and transfers (e.g., wheelchair, bed, car, shower, tub, toilet, chair, floor); includes functional ambulation and transportation of objects

driving & community mobility (IADLs)

planning and moving around in the community using public or private transportation, such as driving, walking, bicycling, or accessing and riding in buses, taxi cabs, ride shares, or other transportation systems

mobility-components

• range of motion

• strength

• coordination

• vision

• cognition

• contexts

mobility-training phases

1. accessible environment-clinic

2. client’s home

3. community

mobility-transfers

• movement of the body from one surface to an adjacent surface

• completed independently or with assistance

• with or without an assistive device and/or adaptive equipment

body mechanics

• activities should permit client to use several different safe postures

• Where muscular force must be exerted, use largest appropriate muscle groups

• perform activities with joints at mid-point of ROM

• arms close to body

• maintain posture

stand pivot transfers

• scoot forward

• on “3” push up to stand ½

• turn to sit

repositioning

• position close

• client leans forward

• hands under buttocks

• on “3” stand ½
  push on knees

aging theories

explains aging phenomenon as it occurs over the lifespan

• aging is viewed as a total process that begins at conception

senescence

change organism behavior with age, leading to a decreased power of survival and adjustment

stochastic

aging as events occur randomly & accumulate over time

error theory

error in transcription of DNA protein synthesis of DNA, causing reproduction of an enzyme or protein that is not an exact copy, compromising function

free radical

reaction to O2 from cell mitochondria causing cellular membrane damage, decrease O2 delivery, accumulation of aging pigments, trigger pathological changes

cross-linkage theory

chemical bonding of elements not normally join thus interfering with normal cell function

wear & tear theory

cells simply wear out over time because of continued use

nonstochastic

certain predetermined, timed phenomena

hayflick limit

AKA programmed theory; set number of cell replications

immunity theory

thymus size decreases, becoming less functional & bone marrow cell efficiency declines, resulting in less immune responses; less “killer cells” or T-lymphocytes

selective optimization/compensation

managing between gains & losses with age; develop strategies to manage losses of function that occur over time

stress theory

homeostatic imbalance resulting in structural & chemical changes

disengagement theory

reduction in roles; change in behavior patterns resulting in withdrawal

activity (developmental task) theory

Social activity is necessary for adjustment, continuing in roles = life satisfaction & positive self-image

continuity theory

how a person has been throughout life is how that person will continue through the remainder of life

primary aging

• innate maturational processes

• no control over biological aging

• inevitable

secondary aging

• effects of environment and disease

• lifestyle factors that accelerate pathology

orthostatic hypotension

decreased in systolic BP 20 mm Hg or a decrease in diastolic blood pressure of 10 mm Hg within three minutes of standing when compared with BP from the sitting or supine position

sarcopenia

loss of muscle mass associated with aging

• lead to impaired mobility

• loss of independence

• increased risk for falls

urinary incontinence types

stress- movements increase pressure

urge- need or urge from bladder contractions

functional- cognitive or mobility deficits

overflow- always full so leaks

mixed- combinations of types

transient- temporary; triggered by medications, etc.

bowel issues

• loss of normal control of the bowels

• nerve damage to anal muscle or rectal sensation

• reduction in the elasticity of rectum

• diarrhea is added stress