Ambulation PDF - Assisting Clients

## Ambulation Ambulation relates to walking without assistance. ### Assisting a Client to Ambulate: #### Older Adults: - Inquire how the client has ambulated previously and check any available chart notes regarding the client's abilities and modify assistance accordingly. - Take into account a de...

## Ambulation Ambulation relates to walking without assistance. ### Assisting a Client to Ambulate: #### Older Adults: - Inquire how the client has ambulated previously and check any available chart notes regarding the client's abilities and modify assistance accordingly. - Take into account a decrease in speed, strength, resistance to fatigue, reaction time and coordination due to decrease in nerve conduction. - Be aware of any fall risks the older adult may have such as the following: - Effects of medications - Neurologic disorders - Orthopedic problems - Presence of equipment that must accompany the client when ambulating - Environmental hazards - Orthostatic hypotension - Be alert to signs of activity intolerance especially in older adults with cardiac & lung problems. #### Using Mechanical Aids for Walking 1. **Canes** - may either be single-tipped, a tripod or quad cane. It is usually used on the stronger side; the client's weight will be balanced between the cane and the involve side. Cane tips rubber caps to improve traction & prevent slipping. The length should permit the elbow to be slightly flexed. - The client walking with a cane will: - Place the cane about 12 inches in front of his stronger side. - Bring the weaker leg forward so that it is even with the cane. - Bring the stronger leg forward, just ahead of the cane. 2. **Crutches** - assist a client who cannot put complete weight on one or both legs. - Crutch walking: - **Swing to** - put, both crutches ahead with weight on stronger leg - **Standard three point gait** - advance both crutches and the weak foot, balance weight on both crutches, then advance stronger leg. - **Two point gait** - advance right foot and left crutch, then advance left foot and right crutch simultaneously. - **Four point gait** - put right crutch forward and advanced left foot. Then put left crutch forward and advance right foot. - Using Crutches: - Maintain an erect posture as much as possible to prevent strain on muscles and joint and to maintain balance. - Each step taken with crutches should be a comfortable distance for you. - The weight of your body should be borne by the arms rather than the axillae. Continual pressure on the axillae can injure the radial nerve & eventually cause crutch palsy. - Keep the crutch tips dry and clean to maintain surface friction. 3. **Walker** - helps a person who requires support because of greater imbalance or weakness. - The walker is safe to push down only when all four legs are on the ground in a level position. - If the walker is being moved, the client's leg should be stationary. - If the walker is stationary, the client can move his feet.