Mobility Decline Prevention
::
::
::
::
::
::
::
::
::
::
::
::
|
|
Modules - Mobility Decline Prevention
ASSESSMENT PROCEDURE
Here, organized around questions and answers, is the procedure for conducting resident assessments for a walking program based on the one we tested:
Q. Who should conduct the screening assessment?
A. A registered nurse
Q. When should assessments be conducted?
A. At admission, when staff conduct the resident's Minimum Data Set (MDS) assessment, and with each quarterly MDS reassessment. When starting a new program, you may want to screen all residents in the facility within a week or two to get appropriate candidates onboard as soon as possible. Thereafter, screening assessments at admission (for new residents) and quarterly (for all other residents) will be sufficient.
Q. What resident assessment criteria should be used to identify appropriate candidates?
A. Residents should meet these criteria:
- Residents should be able to walk without human assistance. Use MDS items G1c(A), "walk in room," and G1d(A), "walk in corridor," to identify these ambulatory residents. Residents should be rated "0" (independent) or "1" (requires supervision) on both of these items to qualify for the walking program.
- Residents should be able to sit-to-stand.
- Some residents who can walk may nevertheless be inappropriate candidates for the program due to behavioral problems. At the very least, residents need to be able to follow a one-step command. During the assessment, hold up a pencil and a glass in opposite hands, and ask residents to look at the pencil. Residents should be able to follow this command in one try. Any resident who fails to comply should be excluded from participation.
As a practical matter, ask any resident who meets all of the above criteria what time of day he or she prefers to exercise. The answer will help set walking schedules for qualified residents (see the next section).
Q. If the resident passes this assessment, what next?
A. Residents also need consent to participate from their physicians. Before contacting the physician, the nurse should collect the following relevant medical history information:
- Current medications, some of which might exclude the resident from exercise
- Any cardiac conditions that might exclude the resident from exercise such as frequent angina or severe congestive heart failure
- Any other unstable medical conditions, or...
- A terminal diagnosis with life expectancy of less than six months
The physician or director of nursing may decide to exclude residents based on findings in the medical history.
Q. Should residents with serious cognitive impairment be excluded?
A. Not necessarily. If a resident with even severe cognitive impairment passes the functional ability and behavioral screens and earns physician consent to participate, then he or she should be given the opportunity to surprise you.
(prev | next)
|
|
|
