The 5 Best Ways to Keep Your Grandparents Mobile

Hello and welcome back to the ThreeSpires Physiotherapy blog where we take a look at all things physiotherapy and health related. In the previous blog we looked at the 5 best exercises to keep your elderly relative (e.g. mum/dad/grandparents) mobile. Following on from that I thought it would be good to highlight some of the ways in which you can make a massive difference to the health and well being of your relatives and help them stay on their feet. In general these ideas will come under the heading of "Prevention is Better than the Cure!". For anyone that is elderly or getting in in years my experience as a physiotherapist has been that the sooner we can address any issues with balance and strength the better the result is likely to be. 

Why is it Important to be Aware of Your Grandparent's Mobility?

Before continuing it is probably a good idea to understand why being aware of the level of your grandparents' mobility is important. When you are young, fit and strong it is often hard to relate to the problems that many people have as they grow older and how this can affect them slowly over time. The ability to get up and have a walk around is essential to keeping healthy and maintaining quality of life. The loss of this ability has a tendency to happen slowly and over a long period of time and often has serious repercussions for the person involved. As it mostly occurs slowly and over a lengthy time period, loss of mobility can be hard to detect and often goes unnoticed until too late. Reduced mobility can look like as if it is a natural part of aging - especially to those who are young and fit and as such relatves may have a tendency to look at their grandparents and think: "I know they are looking a bit wobbly but after all they are getting on a bit!". It is essential to realise that a loss of mobility is not just a simple part of getting older, getting wrinkles may be but having significant losses of mobility and being unable to walk long distances is not. A drop of mobility and becoming wobbly or unsteady on their feet is an obvious sign that your grandparent has difficulties with their strength, balance and fitness that need to be addressed quickly before things get worse.

Many older people have a general tendency to be a bit less active each year and will try to avoid the activities that they find difficult. My opinion here (based on a fair amount of experience of working with older patients) is that this is not a good idea and is often a way of storing problems for later on in life. As an example: if each year you do a small amount less and become ever so slightly less active each year, very likely, your strength, balance, fitness and and general ability to manage will decline. Now this won't happen quickly and as such your family will find it very difficult to spot but after a while you will find yourself that day to day tasks such as the cleaning or shopping become more onerous and fatiguing. Eventually, however, you may get ill and need to spend some time in hospital. At this point if you have stayed strong and fit you will most likely make a full recovery once you are well again. However, if already you are finding walking and every day tasks difficult this illness may well take you completely off your feet and mean that you have a very long road to making a recovery (if this is at all possible).

DISCLAIMER ALERT: Please remember that if you have serious concerns about someone that you should contact a medical professional and that none of the advice in this blog replaces this need. These are simply some useful tips from my experience as a physiotherapist. This blog describes a slow decline in mobility and does not apply to anyone who has had a rapid loss of mobility. If this is the case, you should seek urgent medical advice.

My 5 Best Ways to Keep Your Grandparents Mobile

Okay, disclaimer over, lets move on and have a look at what should you be doing in order to help keep your grandparents on their feet and mobile So, here are my top 5 tips from my experience as a physiotherapist working with many older patients in the community.

1. Watch Them Walk:

You can learn a whole lot about how someone is feeling, their balance and general fitness just by watching them walk. Now, you don’t need to do lots of complicated gait analysis and you don’t need to put them on the treadmill and discuss how much they are pronating. As a physiotherapist visiting a large number of elderly patients in their own homes this is a key component of our asessment and often I will walk behind the patient on the way into their home as a way of seeing them walk without formally assessing them.  You can simply just watch them walk over a period of time and have a look at the following key points:

• Do they look unsteady? No need to be too picky about this one, if you feel worried about them when they are walking this is generally a good indication that they look unsteady. My own way of thinking about it as a physio when seeing patients is that if I would happily turn my back on them when they are walking then they would be classified as independent and safe in my notes. 
• Do they clip their heels or the floor with their toes? Most times patients fall over it is from something very simple such as catching their feet on something. Often as patients become less steady on their feet they become less willing to lift their feet up off the ground and therfore begin to catch their feet on the floor. 
• Do they reach for furniture to keep themselves steady? This is a classic sign of someone who does not feel steady on their feet. Often patients will do this very naturally and in their own homes they can look very confident and to have good mobility but when they go out into an open area they look extremely unsteady. If you see your grandparents reaching for furniture when they are waking around their home this is a sure sign that things are declining. 
• Do they shuffle their feet? As mentioned beofre the less confident someone feels on their feet the less willing they will be to lift their feet up and the will often begin to shuffle their feet along the floor rather than take normal steps.

Just by having a look at these things every time you see them you will be able to keep an eye on them and notice early on if anything starts to change or deteriorate.

 

2. Ask how much walking or exercise they are doing:

As with watching patients walk, discussing how much exercise and walking they are doing is a key part of my own initial assessment as a physiotherapist. I generally make quite a point when assessing someone's mobility and fitness to inquire about how often they go out, how far they walk, do they walk regularly, do they spend a lot of time on their feet and how has this changed over the last say 5 years. This information generally gives me a really clear picture of their overall activity levels very quickly and often it is very illuminating to the patient themselves to have a think about how much they actually do!

As their relative I would strongly recommend that you have a regular but reasonably casual chat with them about their walking and exercise. This really does not need to be a formal investigation and can just be a series of chats over time but if you do it regularly you should feel confident that you know how much they are doing and if they are not doing enough. By knowing how much they are doing (or at least how much they say they are doing) you can have a good idea when things start to decline.

 

3. Go out for a walk with them:

This is an amazing way to check if what they say they are doing actually matches what they look like when they are wallking outdoors, it also helps you look at how they walk outdoors as compared to indoors in their own home. By doing this you can quite quickly compare what they are like in a familiar environent to what they are like in an open space with nothing to hold onto. As a physio visiting people at home and working on mobility, I will often try to have a quick venture outside if I think it is safe to do so and the weather plays ball, it really gives me a clear idea about how they cope with uneven and unfamiliar ground.

As a relative I would simply recoemmend that you regularly go out for a walk with them, now this doesn't need to be every week and it doesn’t have to be all day but just by heading out every so often with them for an hour or so you will be able to build up a very clear image of how they are actually doing. If they burn you off and complain you walk too slow then you know they are doing well!! It is also a less intrusive way of checking things than simply quizzing them each time you meet up. As before you really don't need to do a full gait analysis on your grandparents, instead I would simply recommend having a look at their breathing during the walk, how steady they look, do they need a stick, do they need to stop etc... If you see nothing that worries you then, great that is all the information you need. 

 

4. Check they have a regular exercise routine:

I think this could almost be put in one of the categories above such as finding out how much exercise or walking they are doing but I have put it separately because sometimes it is possible to underestimate the capacity of your grandparents to do formal exercise and also the importance of them exercising. You might be forgiven for thinking that at their age they shouldn't actually be doing any exercise and should just be saving their energy and not getting themselves too tired. This really couldn't be further from the truth and actually for your grandparents and anyone elderly it is even more important that they have a regular exercise programme, so that they stay as strong and fit as possible. This is something that I often have a very long chat with my older patients about and sometimes I do find that they are resistant to the idea of a formal exercise routine and see this as something that young people do but after chatting to them about the benfits and the consequences of not doing anything most patients will then try and find something that works for them as individuals. Commonly, when seeing these patients several months later they are much happier that they now have a routine which gets them out of the house, is getting them stronger and which also genuinely makes them feel better. 

Now when talking about a regular exercise routine, it is important to remember that everyone is an individual and each person will be different and some people will enjoy one thing such as the gym and others will not. Therefore it will be important to have quite a few ideas of possible types of exercise that yoru grandparents could do rather than just badgering them about doing something! Personally as a physio I try to give my patients at least 7 or 8 examples of activities that they could try to incorporate into a weekly routine such as the gym, swimming, Tai Chi, Yoga, Pilates, walking, aerobics, dancing (the list is endless) so that they feel that there are actually lots of options out there for them. Now the important point to note here is that it could be any type of exercises but everybody and I do mean everybody needs to be exercising each week in order to keep fit and strong. Your grandparents will be no exception to this.

 

5. Act Early!

Of all my experience and advice I have offered in this blog, I think this is the most important and is likely to make the biggest difference to the continuing mobility and quality of life of your grandparents. If you notice that things are starting to worsen intervene early. Now this doesn’t mean call the ambulance!! It simply means have a chat with them and discuss what is happening and make them aware that you are concerned. This is usually a wake up call to most of the patients that I see and often they and their family will then start a series of things such as getting out for a walk, going to an exercise class, increasing the distance that they walk, going to the gym or possibly going swimming, all of which then start to help address the issues. In my experience as a physiotherapist seeing a large number of elderly patients the worst thing to do is to ignore things and just wait and see what will happen, it is much better to catch things early and stop things getting to a point where the patient can not return to their previous levels of mobility. The earlier you can catch a decline in mobility the better the results usually are. 

 

6. Have an assessment with a physiotherapist:

Okay I know I said 5 ways and this is number 6! However if you have concerns about one of your grandparents or your mum etc then I really would recommend getting them an assessment with a physiotherapist to have a look at their mobility, strength, fitness and balance. The physiotherapist will be able to complete a full assessment, identify any strength, fitness or balance issues and give them a series of exercises aimed at improving these. The physio will also be able to have a long formal discussion with them about their fitness levels and all of the issues we have covered above. It has been my experience, as a physio, that often grandparents will listen and take onboard advice from a physiotherapist that they just won't accept from their own family. 

Even if the physio says everything is okay and they are doing well, this won’t be a waste of money. An early assessment with a physio will give both the physiotherapist and yourselves a base line to work from and compare how things are. They will also be able to identify early on any balance issues or problems that can be quickly addressed via some exercises.

 

Okay, hopefully you have found this article helpful. If you or anyone you know needs help with mobility or needs an assessment for their mobility then please get in touch. We are a home visit physiotherapy service based in Lichfield and providing physiotherapy in Sutton Coldfield, Tamworth, Cannock, Rugeley and Walsall.