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Mobility

In addition to using a PDSA cycle to create change, the AE Campaign has identified best practices to help you get started.

Resident Mobility Assessment Tools
All Resident Levels
Website MDS 3.0 Mobility Assessment
See in particular:
Section G: Functional Status
Section H: Balance During Transitions and Walking
Section J: Falls
For Intervention Ideas See Section I
Adobe PDF Continuing Care Activity Measure (CCAM)
Performance-based measure of gross motor function and mobility developed for long-term care. Higher scores reflect higher level of function. Takes approximately 20 minutes to administer.
Ambulatory Residents
Adobe PDF Timed Get Up and Go Test (TUG)
Widely used performance-based measure of functional mobility in community-dwelling older adults. Quick and easy method to describe and monitor functional mobility. Consists of timing an individual as he or she stands, walks 3 meters, turns 180 degrees, returns to the chair, and sits down. The score on the test is the time it takes (in seconds) to complete the task.
Website The Short Physical Performance Battery (SPPB)
Assessment tool developed by the National Institute of Aging for evaluating lower extremity functioning. Includes gait speed, repeated chair stands, and standing balance.
Video Demonstration of Safe Walker Use: YouTube Video
Introductory video for therapy staff to use in training aides in basic safety issues with walking residents, including demonstrations of adjustment of assistive devices and safe footwear.
Residents in Wheelchairs
Adobe PDF Wheelchair Seating Assessment Form
One page wheelchair seating assessment for therapists to evlaute older adults in wheelchairs that includes recommended interventions.
Website Wheelchair Skills Program (WSP)
Set of assessment and training protocols related to wheelchair skills that includes the Wheelchair Skills Test (WST), the Wheelchair Skills Training Program (WSTP) and related materials.
Mobility Intervention Tools
All Resident Levels
Website Where Does Balance Come From?
Introductory explanation of roles of vision, vestibular and proprioceptive functions and recommendations to improve balance by encouraging walking, even with device.
Adobe PDF The Falls Management Program
Comprehensive, interdisciplinary falls management program for long term care with several toolkits and videos. Useful for setting up a fall prevention program.
Website National Center for Patient Safety 2004 Falls Toolkit
Comprehensive falls management program developed by the VA for both long term and acute care facilities. Includes multiple fall reduction tools addressing clinical interventions, equipment, and environment. Recommendations for hip protector use should be re-evaluated based on latest evidence. 
Website American Geriatrics Society Guideline for the Prevention of Falls in Older Adults
Clinical guidelines for the reduction of fall risk in nursing home residents. Useful as background information which summarizes the evidence for and against fall prevention interventions in nursing homes.
Website Centers for Disease Control and Prevention: Falls in Nursing Homes
Website with a variety of background information for nursing home staff, residents, and families.
Website Improving Patient Safety in Long-Term Care Facilities Training Modules: Falls Prevention
One of three self directed training modules with an instructor's guide and detailed content for educating staff on reducing falls risk. INSTRUCTOR'S GUIDE.
Website Improving Patient Safety in Long-Term Care Facilities Training Modules: Falls
Student Workbook of above resource.
Website Limiting Physical Restraint Use
Primaris' comprehensive list of resources on all topics related to physical restraint reduction in nursing homes. 
Website Safety Without Restraints
Minnesota Department of Health website for residents and family givers. Case example of releasing a restraint to enhance continued mobility as well as general education about restraints and safety.
Website Strategies for Improving Resident Mobility
From Illinois Council on Long-Term Care. This website includes information of potentia impacts of immobility such as increased stress on heart, loss of bone, muscle atrophy, and others.
Ambulatory Residents
Website Vanderbilt Center for Quality Aging: A Walking Program
Training module that provides instructions for implementing a walking program to help residents maintain function in Activities of Daily Living (ADL). Can be tailored to level of resident; good for those who are minimally mobile if there is supervision and support.
Video Safe Movement: YouTube Video
Includes ideas for therapy staff concerning exercises for strength and balance and fall prevention examples. One on one trained staff supervision is required.
Video Balance Exercises: YouTube Video
Simple exercises, integrated into daily life and care within resident's room for balance training and good movement. One on one supervision needed.
Website Prompt and Praise Procedure for Increasing Walking Distance and Independence
Journal article discussing a program to increase distance and independence of ambulation around meal times.
Video Seniors Exercise Group. The Dance: YouTube Video
Simple music supported standing exercises that include chair exercises for higher functioning residents with one on one staff supervision.
Video Stronger Seniors Chair Exercise -Balance Exercises for Those Able to Stand: YouTube Video
Exercises that demonstrate simple standing exercises and video exercises that allow for work alone or group training. Unusual resource on balance development.
Non-Ambulatory Residents
Adobe PDF Illustrated Chair Exercises for Seniors
Variety of seated exercises divided into four modules. Developed through National Institute on Aging, Tufts University and CDC Growing Stronger: Strength Training for Older Adults and University Of Georgia.
Environment and Equipment Mobility Concerns
All Resident Levels
Website Dementia Design Info
Website that provides practical design suggestions for supportive environments for people with dementia.
Staff Communication
Website To access the Pioneer Network's free Starter Toolkit for Engaging Staff in Individualizing Care, go to http://www.pioneernetwork.net/Providers/StarterToolkit/.