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Activities of daily living (ADLs) are fundamental skills that are necessary for independent self-care, such as eating, walking, using the toilet, dressing, bathing/showering, and mobility. ADLs are used to indicate an individual’s functional status and to determine qualifications for medical care, therapy, nursing care, and insurance eligibility. When loved ones need assistance with ADLs, this may require family caregivers to learn how to appropriately support and provide care in a manner that allows their loved one to maintain some independence living at home. This document will address challenges with mobility, define the actions of transferring and ambulating as they relate to mobility, and provide tools to support your caregiving responsibilities. 

Mobility includes the concepts of ambulating and transferring. Ambulating is the ability to move from one place to another independently (Edemekong 2022). Transferring is defined as moving from one position to another such as moving from sitting to standing

Challenges with Mobility

Mobility is an ADL that has strong ties with other ADLs. A loss in mobility can impact the ability to bathe/shower and toilet. Because of this, this ADL may have a stronger connection with one’s sense of independence. Having difficulty with mobility whether due to an injury, fall, or other cause, can be challenging due to the following:

  • Safety concerns: Limited mobility may indicate an increased risk for falls. The care recipient who is experiencing mobility challenges may want to do things on their own or rush to get from place to place. Caregivers must also be aware of their own limitations to avoid straining their back and joints when helping the care recipient to move (Family Caregivers Online, 2022).
  • Loss of independence: The care recipient may not want to be a burden to their adult children, spouses, and/or loved ones, and they may wish to get up and complete their daily activities by themselves without being reliant on support.

Ambulating

Ambulating is the ability to move from one place to another. Oftentimes the care recipient may need assistance with ambulating if they have difficulty with balance, or have muscle weakness. This may be potentially caused by arthritis, Parkinson’s disease, or injury.

Tools to Assist with Ambulating

Finding the right tools can help contribute to both the safety and ease of ambulating while also helping the care recipient to remain independent longer. There are different assistive devices that can help with various levels of mobility.

For those with limited mobility who can operate a vehicle:

  • Scooters, often referred to as medical or handicap scooters, are typically electric and are made for those who cannot walk shorter distances or cannot operate a manual wheelchair.
    • 3-wheeled scooters typically have a tighter turning radius than 4-wheeled scooters.
    • 4-wheeled typically have similar features to the 3-wheeled but offer more stability.
    • Portable and foldable scooters are easier to transport.
    • Electric or “power” wheelchairs are for those who lack the strength to wheel themselves and can maneuver the chair with their hands and offer more comfort, stability, and support for longer periods of time.
person fastening gait belt on older adult

Transferring

Transferring is the ability to move from one position to another including the ability to get in and out of bed or getting in and out of a chair. Transferring takes place in different locations including the bed, chairs, toilet, car, or even a shower bench. As the first action taken before ambulating, it is essential to understand how transferring contributes to mobility, and to recognize that limitations with transferring can lead to mobility concerns.

Products for Transferring

Consider products and positioning aids to help the care recipient transfer both independently and with assistance.

  • Grab rails, bed safety rails or bed transfer handles, transfer poles, and grab bars may be used to allow for self-transferring or assisted transferring.
  • Positioners such as bed bolsters may be used to allow for postural support and the care recipient to be in a comfortable position while transferring.
  • Transfer boards also referred to as slide or sliding boards are rigid, flat boards typically made of wood or plastic that may be used to allow those with limited balance to move from one surface to another.
  • Gait belts may be used to aid in safe movement, transferring from a bed, chair table, etc. allowing the care recipient to move from one position to another with assistance.

For Education on the use of Assistive Devices

Consulting with your physician about durable medical equipment (DME) such as canes, wheelchairs, etc. which may be covered by insurance, rented, or purchased through medical equipment providers can be helpful to decrease the physical demands of you as a caregiver. 

Additionally, consulting with a physical or occupational therapist may help you understand proper body mechanics, lifting techniques, for transferring, strengthening exercises, and for making the home more “mobility-friendly”.

For Additional Assistance

If additional assistance with mobility is needed due to needs greater than your physical capability, in-home care may be an option.

man helping older adult holding cane

Conclusion

With knowledge of the right tools based on the care recipient’s level of independence for safety and accessibility that works best for both you and your care recipient, mobility can be a safer and easier process to navigate with more confidence in meeting them where they are at.

Sources

AARP. (2024). Caregiver tips: Improve balance with hiking poles. Retrieved from https://www.aarp.org/caregiving/tips-hacks/mobility/improve-balance-with-hiking-poles/

Edemekong, P.F., Bomgaars, D.L., Sukumaran, S., et al. Activities of Daily Living. [Updated May 2, 2022]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK470404/

Family Caregivers Online, (2022). Caregiver tips – transferring. Retrieved from https://familycaregiversonline.net/caregiver-tips-transferring/

Texas Health and Human Services. (2023). Retrieved from https://www.hhs.texas.gov/sites/default/files/documents/maintaining-ind-assisting-adl.pdf

VA. (2023). TSGLI Activities of Daily Living Background. Retrieved from https://www.benefits.va.gov/INSURANCE/docs/TSGLI_ADL_Training_Slides_revised_with_PM_input.pdf