Mobility Decline Prevention
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Modules - Mobility Decline Prevention
REDUCE THE NUMBER OF "FIT" PARTICIPANTS
If, after shifting some of their duties, CNAs still lack sufficient time to implement FIT, then cut back on the number of residents who participant in the program. If need be, pare down the participant list one by one until each CNA on the daytime shift is responsible for only one FIT participant.
This may sound like an insignificant number but it adds up. Consider this scenario: In a 40-bed facility, an estimated 20 residents will be incontinent and thus eligible for FIT. If the facility is staffed at 10 residents to one CNA during the day, then four CNAs are available to provide FIT to four residents, or one-fifth of all eligible residents. Yes, this approach excludes residents who could benefit from FIT. But despite this serious drawback, it is ethically and clinically preferable to foregoing the intervention altogether, a strategy that in most facilities means none of these frail residents will get exercise to prevent further decline.
How do you decide who makes the cut? There are no hard and fast rules to follow here, so we let reason guide us to this recommendation: Target for services first those residents who stand to lose the most functionality if denied regular exercise. In our clinical judgment, these are residents who are on the verge of losing their ability to walk. "They're wobbly," one of our researchers observed. "They can still bear weight, but they can't walk safely without assistance." They're not the most impaired residents, nor the least impaired; they're between these two extremes.
For these residents, their FIT-ness goal should be to maintain their walking ability.
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