Indication of Mobility Aids and Training of Older Patients in a Geriatric Emergency Department: Abiding by International Guidelines
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Falls are the main cause of injuries, hospitalization, and loss of functionality among adults over 65 years of age. Thus, proper indication of assistive gait devices should be part of multidimensional fall prevention. However, many patients receive little or no professional assistance when selecting a mobility aid, and inadequate selection and use can result in a poor gait pattern.
All patients admitted to our emergency department (ED) undergo a medical evaluation, in which, based on their clinical condition, the protocol for indication and training in the use of walking aids can be triggered. Patients need to be clinically stable and have enough physical and cognitive function to benefit from it. Once the patient is deemed able, the next step is an assessment of needs and potential benefits.
Then, the patient and his proxy are asked if they agree to undergo specific evaluation and training for the use of mobility devices. If they refuse it, the physician recommends the hospital’s Rehabilitation Center for directed outpatient rehabilitation. However, if they accept it, the physician or the ED nurse call the physical therapy team for prompt assistance at the ED or for early outpatient appointment at the rehab center. The physical therapist then carries out a broader assessment that includes the Timed Up and Go (TUG) test.
Following the functional evaluation, the physical therapist identifies the mobility needs of the patient and indicate the most appropriate walking device. The TUG test is performed again with the use of the mobility aid device and the results are compared to confirm the improvement in the patient's performance regarding balance and mobility. Finally, the physical therapist refers the patient to the rehab center of our hospital for further rehabilitation, if applicable, and provides a written document with the type of the suggested device and possible purchase locations.
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de Andrade Junior, Mario C.; Morinaga, Christian V.; Brito, Christina M M; Moraes, Igor G.; Yamaguti, Wellington P.; and Curiati, Pedro K.
"Indication of Mobility Aids and Training of Older Patients in a Geriatric Emergency Department: Abiding by International Guidelines,"
Journal of Geriatric Emergency Medicine: Vol. 3:
4, Article 6.
Available at: https://institutionalrepository.aah.org/jgem/vol3/iss4/6
January 18th, 2023
February 9th, 2023
March 2nd, 2023