Indication of Mobility Aids and Training of Older Patients in a Geriatric Emergency Department: Abiding by International Guidelines

Abstract

Falls are the main cause of morbidity among older adults. In this context, assistive gait devices are used to improve function and safety. However, inadequate selection and use can result in poor gait and risk of injury. All patients admitted to our emergency department (ED) undergo a medical evaluation in which, based on their clinical condition, the protocol for indication and training in the use of walking aids can be triggered. Patients need to be clinically stable and have enough physical and cognitive function to benefit from it. Once the patient is deemed able, the next step is an assessment of needs and potential benefits. After the patient and his proxy agree to undergo specific evaluation and training, the physician or the ED nurse calls the physical therapy team to carry out a broader assessment that includes the Timed Up and Go (TUG) test. Following the functional evaluation, the physical therapist identifies the mobility needs of the patient and indicates the most appropriate walking device. The TUG test is performed again with the use of the mobility aid device and the results are compared to confirm the improvement in the patient's performance regarding balance and mobility. Finally, the physical therapist refers the patient to the rehab center of our hospital for further rehabilitation, if applicable, and provides a written document with the type of the suggested device and possible purchase locations.