Assessing an individual’s ability to mobilize

Motor function and the ability to move can impact on both quality and quantity of life. A full assessment of the person’s ability to mobilize should therefore be undertaken on admission/arrival and at all other times when changes to the individual’s abilities occur. Alongside this, movement and handling assessments should be undertaken to optimize the individual’s mobility, whilst at the same time caring for oneself. An example of an assessment form is given in Figure 2.1. Where a mobility deficit is identified assessment of pressure sore risk is also vital. Figure 2.2 gives an example of a pressure risk assessment tool.

Remember that assessment of mobility is only part of a holistic nursing assessment and should not be undertaken in isolation without reference to or consideration of the client’s other activities of living.

Specific points to consider when assessing an individual’s ability to mobilize include:

• Physical
Does the client have a fully functioning motor nervous system?
Is there any alteration in structure, function or processes?
Is the client able to undertake a full range of movements?
Are there any obvious fractures, swelling or other signs of injury?
Does the client have any pain inhibiting mobility?
Is this related to any specific movements?
Does the client have any reduced (or absence of) feeling or any strange or unusual sensations such as tingling in the fingers or toes?

Figure 2.1 Example of a client moving and handling assessment form

Figure 2.1 Example of a client moving and handling assessment form

Figure 2.2 Example of Pressure Risk Assessment Tool

Figure 2.2 Example of Pressure Risk Assessment Tool

Does the client use any aids, for example wheelchair, frame, walking stick,
specially adapted footwear?
Does the client have any illnesses or disorders that might affect their
ability to mobilize, for example lung disease, anaemia, vertigo?
If reduced, does their limited mobility inhibit other activities, for example
cleansing and dressing?
If impaired, is this likely to be temporary or permanent?

• Psychological
Is the client depressed?
Anxious?
Frightened?
What is their level of motivation?
What does the client consider influences their ability to mobilize?

• Sociocultural
Are they able to carry out fundamental domestic activities such as
cooking, cleaning, shopping?
Do they walk, drive, use public transport?
What type of social activities do they undertake, for example vigorous,
sedentary?
Are they involved in any sporting activities, for example swimming,
dancing?
What is their type of employment, if any, for example manual, sedentary?
What is their preferred style of dress?
Does this enhance or inhibit the potential to mobilize, for example high heels, worn carpet slippers, tight-fitting trousers?

• Environmental
What is their type and place of residence, for example high-rise flat,
urban, rural?
What type of terrain does the client need to negotiate?
Is the client able to negotiate stairs?
Is this a necessary function prior to discharge?
What available space do they have to mobilize at home/in the care
environment?
Is this conducive to mobilizing?
Are there any obstructions?
Is the environment safe in which to mobilize?
Does the client feel safe?
Type and design of furniture: is this conducive to mobilizing?
Will the current change of environment affect them in any way, for
example further to walk to the toilet, washroom?

• Politico-economic
Is the client financially independent?

Do they need assistance with the purchase of aids and adaptations?
Is there local provision for sport and social activity?
Is there adequate street lighting, safe pavements and crossings in their
locality?
Is local transport accessible?
Can public buildings be easily accessed?
Are there any facilities to exercise in the locality?

• Past history
Does the client have a history of falls or difficulty mobilizing?
Does the client normally exercise, if so to what degree?