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Elderly Mobility and Independence

A guide to a more active lifestyle

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Chapters

01: Knees and Hips
02: Feet and Ankles
03: Back and Posture
04: Living Well With Limited Mobility
05: How Elder Can Help

As we get older, it can become more and more difficult to get around. Even the simplest of tasks – popping to the shops, getting up and down stairs and so on – can become much more challenging with stiff and painful joints.

But your loved one shouldn’t have to say goodbye to their independence altogether. Medical and technological advances are already making major improvements to the lives of those with mobility troubles, and the right kind of care can play a key role in building preventative measures into their routine – as well as supporting those day-to-day activities that might otherwise be off-limits.

In this guide, we’ll take a look at the joints that are most vulnerable in later life, and the sorts of mobility issues you might expect to arise. We’ll also explore the importance of diet and exercise in sustaining mobility in the long term, and how you can make a difference to your loved one’s lifestyle right away.

01: Knees and Hips

As the two biggest joints in the human body, your loved one’s knees and hips have had to bear the brunt of a lifetime of physical activity. It’s no surprise, then, that they’re some of the most common complaints among the elderly.

Why do we get knee and hip pain?

The hips are a ball and socket joint, which means they can rotate in multiple different directions. The knees are a hinge joint, and can only move back and forth.

Both rely on muscle, ligaments or cartilage to move smoothly and painlessly. Joint pain is a symptom of the damage done to these components, through years of general wear or by injury, inactivity or excessive exercise. After all, knees take the pressure of 1.5 times the weight of your body with regular walking on even ground, which almost doubles ascending and descending stairs.

This can manifest itself in multiple different ways, including an inflammation of the sac of skin over the joint (known as bursitis), or eroded and swollen cartilage (arthritis). The good news is there are some measures they can take to ease their pain and speed up the healing process.

How to manage knee and hip pain

For those with severe pain, joint replacements and other medical options have dramatically improved mobility. But to prevent it from ever reaching this stage, there are a number of things you can do to care for your joints.

Regular exercise

Contrary to the belief that rest is the best medicine for sore joints, the right kind and amount of exercise can actually prove fundamental for easing them. There are plenty of exercises and tips to stay healthy out there and it’s worth looking into.

It doesn’t matter if your elderly relative hasn’t had a particularly active lifestyle up to now, or if they’re already experiencing joint pain. It’s never too late to start. The key is simply not to overdo it, and to look into low impact exercise so as not to cause more damage to the joints.

Water aerobics and swimming are perfect examples. The natural resistance of water can allow for more movement than on dry land without putting unnecessary pressure on the joints themselves. And, as a bonus, the warmth of the pool can help soothe any aches and pains.

But if dry land is more your loved one’s cup of tea, yoga and Tai Chi are proven to improve flexibility in joints, as well as one’s overall balance. This is particularly important as it’ll serve to limit the risk of future falls and accidents when your loved one is up and about.

Many local gyms and recreation centres offer classes specifically designed for older people, but if not, it might still be worth enquiring if they can cater for your loved one in their regular classes. Many elderly people are welcome to take part in such activities, and instructors are usually happy to accommodate varying levels of ability.

The most important thing is that they listen to their body. When they feel too much tightness in their muscles, it’s time to stop. Heat is beneficial before exercise because it allows for increased muscle flexibility, while ice is best applied after a workout, to prevent inflammation.

Even if your loved one doesn’t want to get involved in organised classes to stay fit and healthy, they may find simply waking to the shops or up and down stairs can make all the difference. Whatever it is they choose to do, they should aim to be active for at least half an hour a day, five days a week. This will help keep their weight down (which can put extra pressure on joints), as well as keep muscles and bones strong.

Consult a medical professional on how best to do build up slowly, rather than pushing the body into too much, too quickly. The objective of physical therapy is also to increase both the range of motion in the joint, and the muscle which gives it the joint the quality of support it requires. You might find your elderly relatives are a little resistant to suggestions of exercise, but over time, exercising will get easier.

Exercise is just one part of a healthy lifestyle. Diet and hydration are just as essential – not only for the best results within the body, but to make training more efficient.

No matter how much your loved one looks after their own body to reduce the risk of falls and broken bones, accidents may still occur. To cover all ground, look into home safety for the eldery for some great tips on how to reduce accidents at home. Make bathrooms safe for the elderly, especially, will be a high priority as this is where a lot of slips can occur.

If your loved one lives in a house with more than one floor, look into how to make stairs safe for older people too. If implementing specialist modifications in your relatives home to help them stay independent for longer are not your forte, invest in the help of a Home Improvement Agency for any alterations or adaptations.

Diet

It goes without saying that a balanced and wholesome diet is essential for overall health, not just for joints.

But the more you weigh, the more your bones and joints are put to work. And that’s just the start: there are lots of nutrients your bones and joints need for their repair and development, and without them, your loved one will struggle even more.

Supplements and vitamins for these nutrients are readily available in pill form, but your elderly relative may already be taking a number of medications and not want to add more pills to their rota. Fortunately, it’s easier than ever to find healthy, nutritious sources of everything your loved one needs.

  • Calcium is the mineral in bone which causes its rigidity and hardness. Sources include dairy products, soya milk, tofu, sardines, salmon, figs, beans, broccoli, tinned tomatoes, dried apricots, oranges, almonds and brazil nuts. If your loved one is dairy free, make sure they get their calcium intake from elsewhere
  • Vitamin D assists the body with calcium absorption. It can be found in fatty fish – tuna, salmon and mackerel – eggs, portobello mushrooms, beef liver, cod liver oil and cheese
  • Vitamin K facilitates the production of a protein necessary for the making of bone. Good sources include Brussels sprouts, kale, spinach, cabbage, spring onions and prunes
  • Protein is good for muscles, and can be found in meats, fish, nuts, beans, chickpeas, peas, soybeans and lentils.

If your loved one is on Warfarin (a widely prescribed anticoagulant), be aware that the consumption of too much vitamin K can make the drug less effective in preventing blood clots. If in doubt, always consult a doctor.

Anti-inflammatory foods can help with conditions where the tissue around the joints becomes inflamed, such as arthritis and bursitis. Some good examples include:

  • Potatoes and sweet potatoes
  • Coconut milk
  • Salmon
  • Kale and spinach
  • Nuts

Above all, a healthy diet is all about eating on a frequent basis. If the body isn’t getting enough food, it will store fat to keep from starving and will cause weight loss. It’s not good for your loved one to dramatically cut down on food intake. This is more common than you’d think when someone lives alone or has difficulty preparing meals or shopping for themselves. Proper nutrition is a medicine in and of itself.

The RICE strategy

According to a report by AgeUK, an elderly person who has a fall has a 50 percent chance of suffering from some degree of mobility problem.

If your loved one has a fall, there’s a simple procedure you can follow before seeking medical attention. It’s called the RICE strategy, and it goes as follows:

  • Rest: Try to keep from aggravating the injury further by giving it some time to heal. Keep the injured area still and comfortable while you continue with the procedure.
  • Ice: This helps reduce swelling and ease the pain (though it is ineffective on deep hip injuries). Wrap ice cubes in a kitchen towel, and apply them to the injured area for 20 minutes at a time, with equal breaks in between to avoid frostbite.
  • Compression: This works alongside icing to reduce swelling. Wrap up the injury with a bandage tight enough to provide support, but not so tight you reduce blood flow to the area.
  • Elevation: This will prevent blood from gathering and causing further pain. Elevate the injured area by propping the knee or ankle up on pillows, if possible, above the level of the heart.

Once the swelling has gone done, the next step is to apply heat. This will ease stiffness and bring some flexibility back to the muscle. Simply by immersing the area in warm bathwater, or apply a hot towel to the affected area, for half an hour intervals throughout the day.

Mobility aids

Your loved one’s doctor might recommend mobility aids to improve daily living, such as a cane or a walking frame to take some of the weight off their knees and hips.

They can help to prevent falls and injuries, as well as increase mobility and stability on existing injuries. They are a temporary aid to improve and sustain mobility rather than a permanent fixture.

02: Feet and Ankles

After a lifetime of wear and tear – not to mention squeezing into ill-fitting shoes – your loved one’s feet may not be in the best condition.

Foot pain can make getting out and about far more difficult, and it can increase the likelihood of an accident. So let’s take a look at the most common foot problems, and how best to manage them.

Common foot problems

There are many different kinds of problems which can affect the foot, but there are a few key ones to look out for.

Achilles tendinitis/tendinosis

The Achilles tendon is located on the back of the heel and can be painful if it becomes damaged or inflamed. This occurs when it is overworked by high-impact exercise, under exertion from too much bodyweight and insufficiently supported from uncomfortable shoes.

When the tendon becomes inflamed, it is known as Achilles tendinitis. When it starts to degenerate, it is known as Achilles tendinosis. Both can be treated with the RICE strategy, painkillers and gentle stretching.

Bunions

Bunions occur when the alignment of the bone in the big toe is altered, turning inwards and squashing the toes together. They look like a lump at the base of the big toe, and are usually located at the side of the foot.

Given that bunions are often caused by pointy-toed shoes, they are found to more commonly affect women than men. We recommend wearing amply spaced, comfortable shoes, or cushioning inserts. Applying ice and heat to the area can help, too.

Hammertoes

So called due to its resemblance to a hammer, a hammertoe bends and curls due to the contraction of tendons and ligaments. This disfigurement can cause rubbing in shoes and against other toes, leading to corns, calluses, bursitis and more.

Initially, the toe will be able to be flattened back down with pressure, but over time it will harden and potentially become even more painful. To combat the effects of hammertoe, it’s best to apply cold and hot compresses to the affected area, and to soak your loved one’s feet in warm water every night. Again, your loved one’s choice of footwear is important.

Foot osteoarthritis

Osteoarthritis causes joints to become painful and stiff. It’s the most common type of arthritis in the UK, and can be caused by weight gain. It’s most likely to occur in areas that have been injured previously.

Luckily, there are ways of easing arthritis pain in the elderly. The pain and rigidity is best treated with cold and heat and comfortable shoes and inserts. There are also a number of simple exercises your loved one can do to improve the condition, including picking up a towel with scrunched toes or rolling the arch of your foot on a tennis ball.

Your relative’s GP may also suggest prescription painkillers to manage the discomfort or – in persistent cases – surgery to replace the impaired joint.

In looking after the overall health of the feet, it’s important to:

  • Maintain a healthy diet, to limit the strain on joints and the risk of contracting medical conditions
  • Wear shoes that fit properly, to prevent cramping or rubbing
  • Keep your feet clean and dry to avoid bacterial growth, and nails cut and maintained to prevent inward growth
  • Stretch and massage feet, to keep an active blood-flow

Calluses and corns

Usually found on the underside of the foot, calluses are areas of thick, hard skin caused by friction with the ground or the soles of shoes. Corns are similar, but smaller and usually on the toes. They aren’t necessarily unusual, but in more extreme cases they can limit mobility and cause pain.

They’ll often get better by themselves with comfortable shoes, though you can help them along by soaking them in warm water, removing dead skin with a pumice stone and applying moisturiser to the area. Make sure you’re careful if your loved one has diabetes or other circulatory issues, as overzealous treatment can cause infection. In these cases, it may be better to consult a doctor or specialist.

Plantar Fasciitis

The plantar fascia is the band of tissue connecting the ball of the foot to the heel, and is vulnerable to irritation and inflammation. This is known as plantar fasciitis, and can cause severe heel pain.

To manage plantar fasciitis, your loved one may need to massage the underside of the foot with a massage ball (a golf or tennis ball will do), and do some very gentle toe-point stretches. They may also want to apply a cold compress to the area and, if the pain persists, take anti-inflammatories.

Gout

A form of arthritis, gout is caused by uric acid crystals forming in/around the joint, typically at the base of the big toe. It can be identified by a shiny red swollen joint.

A buildup of uric acid in the bloodstream can be caused by eating certain foods in excess, such as red meat, seafood and offal. Those who are overweight, living with diabetes or have high blood pressure are at a greater risk of contracting gout. Uric levels in women increase after menopause, putting them at a higher risk of gout than men.

To treat gout, your loved one should take non-steroidal anti-inflammatory drugs as soon as possible. Until you get an appointment with a health professional, try applying a cold compress and elevating the joint to relieve the pain.

Damage caused by diabetes

Diabetes can cause nerve damage that impedes the body’s ability to sense pain, and impair blood vessels and lead to poor circulation.

This has two outcomes: nerve damage puts the individual at risk of unnoticed harm to the foot, and poor circulation means the body won’t be equipped to fight infection. In the most extreme circumstances, the infection may reach the bone and the limb may need to be amputated. This is why foot care is so important for diabetes patients.

This means your loved one needs to stick to some simple rules. They should wear clean socks every day and comfortable shoes with plenty of support, and avoid going barefoot altogether to avoid picking up any scratches or sores. If they do happen to cut themselves, they need to take it seriously, and get it seen to by a specialist immediately.

03: Back and Posture

The spine is formed by vertebrae, muscles, ligaments, discs and nerves, all of which work together to allow us to move, twist and bend. Over time, any and all of these components can start to wear down, and this is how back pain sets in.

Once it does, the pain can quickly escalate and become debilitating. This isn’t just bad news for mobility, it also has a significant impact on your loved one’s independence. And when those movements we do so instinctively and on such a regular basis become painful, quality of life can decline.

Posture

Many people think good posture is simply a matter of keeping your back straight, but this can be a misleading way of thinking.

After all, the spine isn’t actually straight: it’s divided into three sections, each of which is curved to support the weight of the body evenly. Instead, it’s better to think of it as keeping the body open, with shoulders back, chin up and chest forward. This naturally has the effect of stretching out the spine and the lines of fascia that keep the body moving in a cohesive and efficient way.

There are some simple ways to improve posture in day-to-day life:

  • Sit upright: Keep your feet flat on the floor (or on a stool or pillow if they don’t reach), with knees raised slightly higher than the hips and bent at a 90-degree angle
  • Have breaks from your armchair: get up, walk around and stretch your legs while watching television
  • Take a load off your feet: keep one foot elevated one a small stool while doing tasks like ironing that require standing for ongoing periods
  • Get a good night’s rest: Sleep on a mattress and pillows that adequately support the head and spine

In fact, sleeping badly is one of the key causes of back pain. Pillows which are too thin or too thick might not correctly support the neck, and a soft mattress might cause the spine to distort. Together, these are likely to increase the pressure on certain parts of the back. Even with a better quality of mattress, your loved one may still need to adapt the way they sleep – on their side with knees bent up towards the chest – to keep themselves comfortable.

Your loved one can also add some easy exercises into their daily routine, to condition their muscles. Squats, in particular, can provide added stability in the feet, legs, hips and lower back.

  1. Point your knees, feet and head straight ahead of you.
  2. Distribute your weight evenly across both feet and the hips, without leaning on either side too heavily.
  3. Keep your shoulders back, your chest out and your chin parallel with the floor.
  4. Squat on bended knees as far as is comfortable, keeping your abdominal muscles in
  5. Push upwards – through the glutes rather than the knees – to return to the standing position.

If you’re not available to check their alignment, your loved one might find it useful to use a mirror to see how their posture’s coming along.

Back

Back pain is usually caused by a muscle, tendon or ligament strain rather than anything serious. But it’s worth watching out for a few specific conditions.

Slipped or ruptured discs can occur when the spongy centre of the disc starts to bulge, tearing the outer casing and pressing into the nerves. Once it is ruptured, it can cause inflammation, pain and, in some cases, sciatica – a shooting pain down the length of the leg and foot.

An intervertebral disc rests between each vertebra in the spine. They act as a ligament to hold the vertebrae together, as well as to allow for movement and absorb shock. When the spine is subjected to excessive weight, bad posture and sharp movements – or just as a result of a lifetime of use – these discs can start to deteriorate, and their alignment start to shift. This is known as a disc abnormality.

This kind of problem can take up to six months to heal. The best solutions in the meantime are medication for the pain, gentle exercises recommended by a qualified physiotherapist, and a range of therapies, such as acupuncture. In chronic cases, your loved one should consult a doctor who can refer your loved one for more intense solutions such as nerve blocks to help with the pain.

Spinal stenosis is a narrowing of the spinal canal, which can restrict the spinal cord, put pressure on the nerves and cause numbness. It is most common in those over the age of fifty.

If your loved one finds relief in sitting down or leaning over, or needs regular breaks from walking, they could be suffering from spinal stenosis. Sciatica and back pain are common symptoms, as are cramping, fatigue and numbness in the affected area.

Spinal stenosis is often treated with muscle relaxants, corticosteroid injections to ease inflammation and, if other treatments prove ineffective, surgery. Your loved one should consult their doctor for the most appropriate solution.

Gentle exercise or physical therapy might not directly heal the complaint, but it will aid strength and flexibility, especially while treating the issue.

Compression fractures occur when the vertebrae collapse under the pressure bearing down on the bone. They are particularly likely to occur as a result of osteoporosis, a condition that weakens the bone. For some, they cause sharp pain and spasms. But for others, they may only affect posture.

Compression fractures can heal naturally, and usually taking up to six months. In the short term, the discomfort can be intense, and your loved one may need a back brace, bed rest or painkillers to provide some relief. The pain should, however, start to lift within a few days or weeks. If this isn’t the case, your loved one may want to consider further treatment, such as surgery.

Hyperkyphosis can cause the back to hunch in an exaggerated way. This can compress the chest cavity, cause breathing problems and increase the risk of a fracture.

Treatment of hyperkyphosis can include specialised back braces, therapeutic tape to assist with posture, pain management in the form of ice or heat and training or advice from a physical therapist.

There’s no single cause of hyperkyphosis, and there’s no single way to prevent it. Improving posture and flexibility can help, making yoga and Tai Chi an increasingly popular pastime for people of a certain age. Arthritis Research UK also provides a number of exercises your loved one can do at home to strengthen your loved one’s back muscles and abdomen.

04: Living Well With Limited Mobility

Your loved one may struggle to get around like they used to, but that doesn’t mean they need to put their life on hold.

In fact, there are heaps of opportunities for those in later life to live as enjoyable and fulfilling a life as they always have done. From countryside walks to world-class museums, there are all sorts of ways to exercise the body and enrich the mind. It’s just a matter of finding the right places to go – and making plans in advance to prepare for anything that may come your way.

Planning ahead

Make sure you always check that your destination of choice is accessible, and that it has the facilities your loved one needs.

You might want to know if there are any stairs to climb, and if there are any lifts available. You might need to ask if paths are well-suited to your loved one’s level of mobility. And if there are longer distances involved, you might want to consider arranging a wheelchair even if your loved one doesn’t tend to use one.

Before you head out, work out where the rest stops are along the way. Your loved one may not want or need to take a breather, but at least you’ll know somewhere good to grab a cup of tea and bite to eat. You’d also be best starting with shorter, more local activities to see how your loved one manages, and try more ambitious outings next time.

So what sort of things might you want to do? Here are a few ideas to inspire you.

Walks

Walks are a great way to while away the hours with your nearest and dearest – and there are accessible, wheelchair-friendly walks all over the UK.

There are also plenty of online resources showing you where you can find those close to you. Check out Accessible Countryside for Everyone, Euan’s Guide, Walks with Wheelchairs and The Outdoor Guide. The accessibility guide on the government’s national parks website is a great resource, too.

Gardens

There are over 200 National Trust gardens and parks in the UK, and they’re the perfect place to stretch your legs and get some fresh air. Many of them even put on special events in the sunnier months.

It might also be worth checking out The National Open Garden Scheme, an annual event in which over 3700 people open their gardens up to visitors. Take a look at their online directory to find the gardens nearest you.

Reserves and sanctuaries

The RSPB has made sure its reserves are fully accessible, and they provide detailed information for each on their website.

There are dedicated Blue Badge parking bays at all their sites, and visitor centres come equipped with accessible toilets and cafes. All paths are wide and level, providing regular resting places and seated bird hides, and you can choose the most suitable distance for your needs. Mobility scooters and wheelchairs are also available for hire.

You might also want to look into animal sanctuaries, petting zoos, farm visits and bird centres, like the Bird of Prey Centre in Bedfordshire. Remember to check accessibility, though, as some may not be suitable for those of limited mobility.

Heritage sites

If you’re looking for some of the country’s most beautiful buildings and grounds, look no further than the National Trust and English Heritage.

They’ve tried their best to make their locations suitable for those of poor mobility, with visitor centres offering the necessary disabled facilities. But since heritage sites weren’t exactly built with the elderly in mind, it’s important to find out ahead of time if your chosen destination is accessible. Simply check out to the location’s website, or give them a ring directly if you have particular needs.

Going to sports events

Most major venues these days are expected to cater for all sorts of mobility needs.

You’ll find a number of suggestions on accessible venues – from cricket grounds to football pitches – by visiting the AgeUK website. To take one example, the Queen Elizabeth Olympic Park in London boasts the Copper Box Arena, the London Aquatics Centre and many others – and all of these are fully equipped for those who have trouble getting around.

Theatre and cinema

With dedicated seating for the disabled available in both cinemas and theatres, there’s no reason to miss out on a regular fix of culture.

When going to the theatre, the only limitation may be that you have to stay on ground level. But get in touch with the venue ahead of time, and staff may even be able to offer something in the circles. There are also special senior rates for certain performances, making this a particularly affordable option.

Museums and displays

The UK is chock full of great collections, from the indoor (British Museum, V&A, Imperial War Museum) to the open-air (the Beaulieu National Motor Museum, RAF Cosford, Duxford Air Museum). They’ll be well used to accommodating the elderly, but as ever, you may need to ask your own questions ahead of time.

Other activities

Still short of ideas? OpenBritain and The Carers Trust charity offer plenty more to think about, as well as providing a list of accessible destinations and places to stay.

05: How Elder Can Help

We offer the one-on-one, round-the-clock care your loved one needs to live an independent life in the comfort of their own home.

To speak to one of our expert care advisors and get started, get in touch on 0330 134 6372 or at hello@elder.org.

What our customers say

“Judith is absolutely lovely and you could see the fantastic relationship she has with my mum. My mum’s smile nearly lit up the whole house when Judith arrived.”

Alison, Edinburgh

How Elder works

Our mission is to make live-in care the new standard for elderly care.

This means we go the extra mile in everything we do. We don’t just find highly qualified caregivers who provide those who mean the most to you with a higher quality of care: we handpick those who are a perfect match.

Introduce us to your loved one, let us know what they like and don’t like – and what they’re looking for in a carer. We’ll introduce you both to someone who’ll give them the confidence to live life as they always have done, and fit right into the family while they’re at it.

Our carers are some of the best in the UK, chosen by our in-house team of experts. Only 10% of our applicants make the grade, so you can sleep easy that your loved one is in good hands. Whether you need a long-term solution to ongoing conditions or just a short-term fix, get in touch and we can get your care plan set up in as little as 24 hours.

Mobility and independence

Our carers know just how important it is for your loved one to be able to get up and about and maintain their independence, and they’ll make sure they’re able to do just that.

There’s no end to the support they can offer: everything from help with exercises, medication and getting to and from appointments, to identifying accessible events and activities that will make your loved one smile.

We have an expert team on hand to help you make sense of how our carers can support your needs. You’ll get your own dedicated advisor who can explain everything we’ve covered in this guide in even more detail, and recommend a funding plan to suit your own unique circumstances.

Get in touch on 0330 134 6372, or drop us an email at hello@elder.org and we’ll be more than happy to help.

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