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It’s Not Your Father’s Wheelchair:  Mastering Mobility in 2016

With the aging of America, physicians now encounter an ever increasing number of patients with mobility issues.

The National Health Interview Survey (1994-95) revealed that about 10% of non-institutionalized U.S. residents—then estimated at 19 million people--reported  at least some mobility difficulty; 3.1% (approx.5.82 million) noted major problems.

Over the decades those numbers will grow rapidly. As of 2014 the U.S. Census Bureau noted 14.5% of residents older than 65 years, but that is a drop in the bucket as baby boomers join the geriatric set.

In the “good old days” the wheelchair that grandma used may have been high tech; though it required Rambo-sized arm muscles or a volunteer to push. These days, many disabled and senior patients with far-flung families lack a good support system near to them so helping patients remain independent is essential to maintaining their physical, emotional, and psychological health. As the National Health survey noted, “Without assistance or mobility aids, difficulty walking can lead to increasing isolation, anxiety, and depression.”

"There are so many other things that doctors have to pay attention to—heart problems and lung problems—that screening for mobility gets pushed to the background. However, it’s one of the most important, because it makes the difference between living
at home or living in a facility."
--Dr. Suzanne Salamon at Harvard Medical School
The Mind, Body & Mobility Connection

As a physician, you work to maintain a patient’s mobility through healthcare, therapy and other interventions. However, when the patient is beyond accomplishing normal tasks, then a mobility device is essential.
Geriatrician Dr. Suzanne Salamon at Harvard Medical School notes: “If you’re unable to get out then you can’t go shopping, you can’t go out with your friends to eat dinner or go to the movies, and you become dependent on other people… you become a recluse, you stay home, you get depressed.”
Without a safe mobility solution, falls all too often lead to hip fracture. “That’s the worst,” she adds,” because within a year 20% of people with hip fractures die from complications.”

Putting Mobility Options into Practice

It’s usually apparent that a patient has mobility issues, though in the beginning some may ignore the issue or even deny it. It’s import- ant to identify and address the difficulties before the situation becomes more serious.
A simple mobility assessment can be easily integrated into primary care encounters. Enlist the help of your staff to  note any mobility issues in the patient. They are already greeting patients, seeing them rise from chairs in the waiting room, and watching them walk down the hall—something you won’t usually see in the examination room.
Some physicians ask patients to complete functional status ques- tionnaires in waiting rooms prior to their visits and, according to the NHIS, patients’ acceptance of such questionnaires is generally high. For example, two simple questions may be: Do you have difficulty climbing up ten steps or walking one-quarter of a mile? Has a physical factor caused you to modify the amount or the way you climb steps or walk?
You can also ask the patient to stand up from a chair, walk ten feet, turn, walk back and sit down again. “You look at how long that takes and how steady the person is,” says Dr. Salamon, who notes that the person’s walk should be faster than a yard per second. A slower pace or a gait problem indicates a problem and increases the chance of falling.
If the patient’s mobility can’t be improved through health care or physical therapy, then suggest the patient compensate for its loss. Us- ing a mobility device can increase independence while minimizing falls--a major factor in senior hospi- talizations.
Modern Mobility Options

Being aware of contemporary options in mobility allows you and your staff to offer valuable information that can supplement your patients’ well-being. Among these are the host of new products espe- cially designed to address current mobility needs.
It’s no surprise that Americans are increasing in height or weight. Extremely tall or bariatric patients are simply not comfortable—or safe—in a traditional wheelchair or power chair.

Hoveround designs and engineers  a range of chairs, including those specifically for bariatric use. They can be prescribed based on the patient’s specific needs. For exam- ple, the Teknique Series includes the FWD model for taller users of up to 300 lbs. Heavy Duty designs for users up to 450 lbs or up to 600 lbs. incorporate wider seating, heavier support, more traction and more powerful motors.
The Teknique Series shares a proprietary design with Hoveround’s standard MPV5 power chair—the unique patented Round for a Reason® design. The tight turn radius is a vital benefit in enabling users to navigate narrow halls and corners more easily at home and away. Last but not least, Hoveround power chairs are customized to meet each patient’s medical needs. Positioning aids are designed for their condition and comfort, plus oxygen holders and other medical equipment add functionality.
"Although many mobility aids now exist, primary care physicians are typically unaware of these options, the process for prescribing them,
and approaches for evaluating patients’ needs.

--National Health Interview Survey (NHIS)"

Today’s power chairs are a far cry from yesterday’s wheelchairs. When patients need more mobility, contemporary options make it easier, safer, and more convenient for them to enjoy an independent lifestyle.

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