My mother walked in Glacier View Lodge a month ago. I was concerned to find her in a wheelchair when I came to visit today. I would like to know why every effort isn’t being made to keep her walking?
We often do get questions about how we decide to use a wheelchair or any other mobility aide. The following is a brief overview of our assessment protocols.
A gait assessment and falls history is completed on admission. If a resident has used furniture to scoot around a small apartment and/or has suffered numerous falls, we know that our open spaces, long hallways and “traffic” can be daunting. Often a resident requires time to adjust to these new circumstances and build endurance. This may involve short walks with assistance and a wheelchair for distance. Our activity department does run weekly exercise programs to help maintain fitness.
Safe mobility has many components: posture, balance, stance, ability to take steps, coordination, and judgment. These can vary- a person can be stable when standing but be unsteady when they start taking steps or vice versa.
Safest independent mobility requires the following: can sit up-right without assistance; can stand without assistance; is able to stand unsupported; can take a step without moving backwards to seat self, and recalls that they need to use a walker or a cane. These abilities can vary from day to day and from morning to night. Difficulty walking can arise when, for example, residents are tired, in pain, have swollen feet, or ill fitting shoes.
How can you help maintain your loved one’s mobility? Provide proper fitting shoes and slippers. Assist with walking (check with the nurse first to see how much help is needed). We invite you to help us keep your loved one active and safe.
My father has recently been started on Morphine. What is it exactly and what does it mean?
Morphine is a relatively old drug – it was first extracted from opium in 1803. Since then it has been modified and a host of painkilling variations can be found today, including codeine, meperidine (now known as Demerol), methadone, hydromophone (Dilaudid) and Fentanyl (the only opiod that is given in patch form and absorbed through the skin).
Opiods work by circulating though the body to latch onto specific receptors on the outside of cells in the brain and elsewhere. Think of a receptor as a lock on the door of a cell. Molecules, in the form of a naturally produced hormone or an opiod drug, act like a key that fits into that lock to open the door to the cell. Morphine, once it has unlocked the receptor, may cause the nerve to fire more slowly or more quickly. This change in cell action produces pain relief as well as other sensations.
It is important to remember that analgesics affect different people in different ways. A smaller dose may be adequate for one person while a larger dose is required by another.
The use of opiods for pain relief does not cause addiction. Addiction does not occur when these drugs are taken regularly, at intervals which provide continuous pain relief in an amount that has been individually adjusted to the particular person’s needs.
We hope this information is helpful to you and addresses your questions and concerns. Please feel free to speak with the RN, Charge Nurse, or your physician should you have any other concerns.