Elderly and Mobility

Taylor Clark
Christopher Lopez
Ryann Husain
Vivian Nguyen
Cassidy Thompson
Learning Objectives
1. Students will be able to recognize the importance of cultural competencies.
Learning Objectives (Cont’d)
2. Students will be able to identify 5 preventive factors to fall risk elderly.
Learning Objectives (Cont’d)
3. Students will be able to recognize effective interventions for the elderly at risk.
Cultural Competence Issues For Population
● Every culture deals with their elders differently. For example, Asian cultures
typically take in their elders and take care of them in, while American culture
typically puts their elders in nursing homes.
Cultural Competence Issues For Population
America is a very diverse country. Due to
America’s diversity, there are many cultural
differences in elderly care

● Due to cultural differences, language barriers,

and different beliefs, educating elders in
immobility issues is often times difficult.
● Elders may not agree with their treatment
methods due to their cultural beliefs and
therefore many health practices have to be
adjusted for them.
Cultural Competence Issues For Population
The definition of filial piety is “the
important virtue and primary duty of
respect, obedience, and care for one’s
parents and elderly family members”.

Uncommon in American culture, filial piety

is an idea of Confucius that describes caring
for you elders as they grow old. As our
parents grow old, their sons and/or
daughters shall step up and take care of
them.
Cultural Competence Issues For Population
Issues that come along with cultural
competence for immobile elderly affect their
treatment.

Language barriers are one of the highest

reasons the older population may not seek
proper care. Even if they understand the
English language, they may still have a low
health literacy which effects how well they
understand their health care providers.
Epidemiological Data
● 30%-60% of people age 65+ fall each
year
● Risk increases after the first fall
● 70% of elderly people are
overweight, which is a risk factor
● 30%-50% of elderly people falling is
caused by unsafe environmental
conditions
● 44% of elders have an income less
than minimum wage
Epidemiological Data
● 68.5% of elders live with relatives
○ Most (about 40%) being spouses
● Many elders don’t have high levels of
education
○ One study showed that 80% of their
participants only have 3 years of education
● 87% of elderly women
○ Have greater longevity
○ But also report more falls
○ Have a higher risk due to large abdominal
circumference (90%)
Specific Concerns For This Population
What can lead to immobility:

- Obesity
- Impaired strength and balance
- Fractured and broken bones
- Chronic diseases
- Parkinson's Disease
- Symptoms of depression
- Feelings of helplessness
- Problems with memory or thinking skills
- Recent hospitalization
Specific Concerns For This Population
What immobility can lead to:

- Gastrointestinal
- Constipation
- Can lead to infections
- Musculoskeletal
- Muscle deterioration
- Less motivation to move at all
- Bone loss
- Respiratory
- Shallow breathing
- Shrinking of the heart
Individual Intervention
● Program: Acute Care for Elders (ACE)
● Target: Older adults in hospitals
● ACE is a 26-bed geriatric unit that promotes patients getting
up and walking rather than spending their majority of the
time in bed.
● Over 83% of older adults spend their time in bed which can
lead to delirium and muscle loss.
○ ⅓ of older adults have a decrease in their function
and may not recover at all.
● At hospital discharge, older adult patients leave more active
and functional than when they first arrived.
Relationship Intervention
● Program: Health and Retirement
● Target and Focus: The elderly and the association between social
relationships and recovery from severe mobility limitation such as:
difficulty walking.
● This intervention aims at encouraging older adults with mobility
limitation to be engaged in their neighborhoods and/or provide
instrumental support to peers may improve functional health
outcomes.
● Health risks measured were: health behaviors, healthcare access,
healthcare utilization and chronic conditions such as: arthritis, cancer,
diabetes, heart problems, high blood pressure, lung disease, stroke,
and psychiatric problems.
○ Two most important: smoking status and body mass index
(BMI)
○ Only <3% of respondents recovered from experiencing multiple
recovery episodes.
Relationship Intervention Cont.
● Partnered men were more likely to experience recovery than partnered women. It was
noted that marriage/partnership may be more advantageous for men’s health than
women’s health.
● Respondents who reported visiting friends and neighbors were more likely to experience
partial recovery.
● Sociodemographic characteristics, health risk factors, and morbidity status, respondents
who gave instrumental support had about a 45% increase in the odds of complete recovery
in the next 2-year period.
● Respondents living in the same neighborhood as relatives had about a 20% decrease in the
odds of complete recovery, controlling for all other risk factors.
● Engaged respondents, relative to disengaged respondents, had approximately a 20%
increase in the odds of partial recovery, whereas respondents who had given instrumental
support had approximately a 34% increase in the odds of partial recovery.
Community Intervention
● Program: Lifestyle Interventions & Independence for
Elders (LIFE)
● Target: Physical activity program for elders ages
70-89.
● Promotes, maintains and restores independent
mobility when an older person is disabled.
● Activity consists of: mainly walking, strength,
flexibility & balance training exercises.
● Reduces the risk of experiencing a first major episode
of mobility disability.
● This program has reduced major disability by 25%.
References
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Andrade da Silva, R.; Sá Brandão, G.; Soares Silva, A.; Urbano, J.J.,; des de Oliveira, E.F.; Oliveira, L.V.F; Camelier, A.A; Sá Brandão, G. Silva,
“Physical Activity Level, Functional Mobility And Fall Risk In The Elderly.” Manual Therapy, Posturology & Rehabilitation Journal, 15, 1–6.
doi:10.17784/mtprehabjournal.2017.15.479.

Godman, H. (2013, September 19). Two questions can reveal mobility problems in seniors. Retrieved from

https://www.health.harvard.edu/blog/two-questions-can-reveal-mobility-problems-in-seniors-201309186682.

Latham, K., Clarke, P.J., & Pavela, G. (2015). Social Relationships, gender, and recovery from mobility limitation among older

Americans. The Journal of Gerontology Series B: Psychological Sciences and Social Sciences, 70(5), 769-781. Doi:

10.1093/geronb/gbu181.

Mack, L. (2019, August 15). Filial Piety: An Important Chinese Cultural Value. Retrieved from

https://www.thoughtco.com/filial-piety-in-chinese-688386.
References (cont.)
Rooth, R. (2019, April 25). Immobility in the Elderly: Complications & Prevention: Rooth Law Firm. Retrieved from

https://www.roothlawfirm.com/immobility-can-kill-elderly/.

Satariano, W.A., Guralnik, J.M., Jackson, R.J., Marottoli, R.A., Phelan, E.A., & Prohaska, T.R. (2012). Mobility and aging: New

directions for public health action. American Public Health Association, 102(8), 1508-1515. doi:

10.2105/AJPH.2011.300631.

Yale University. (2016, September 28). Moderate activity helps older adults maintain mobility, independence. ScienceDaily.

Yeh, Kuang-Hui, & Bedford. (2019, January 14). The History and the Future of the Psychology of Filial Piety: Chinese Norms to

Contextualized Personality Construct. Retrieved from https://www.frontiersin.org/articles/10.3389/fpsyg.2019.00100/full.