Mobility Decline and Immobility Complications

Mobility decline is a change from the person’s usual ability to turn, transfer, stand, walk, or use an assistive device. Immobility may be temporary, such as bed rest after acute illness, or may develop gradually through pain, weakness, fear of falling, medication effects, or deconditioning. The loss of movement starts a self-reinforcing cycle. Inactive muscles weaken, and the calf-muscle pump becomes less effective, allowing venous blood to pool in the legs. Reduced weight-bearing accelerates muscle and bone loss. Lying in one position increases pressure over bony prominences, while reduced chest expansion and a weaker cough increase the risk of retained secretions and atelectasis. Slower activity can also contribute to constipation, urinary problems, poor appetite, and sleep disruption. Older adults often have less physiologic reserve. A short period in bed can therefore cause a noticeable loss of function, especially when illness, pain, delirium, poor nutrition, or sedating medications are present. Immobility can make a person weaker; weakness makes movement less safe; and an avoidable fall or pressure injury can extend the period of immobility. The practical nurse’s first task is to...