Immobility – It’s a Big Deal for Lots of Reasons

The human body works best when it’s in motion. In fact, some part of us is in motion almost all the time when our muscles, nerves, and skeleton function properly. All that movement is called mobility. It’s mobility that gives us the ability to eat, drink, dress, walk, work, play, sleep, heal, and function. Unfortunately, when we get ill or injured, the nerves, muscles, or bones weaken, affecting their ability to function, resulting in complete or partial immobility. The damage to the functioning of the bones, nerves, or muscles may be slight to significant. Therefore, the impact on the body may be anywhere from minor to massive.

What is Immobility?

Immobility refers to a complete or partial inability to change positions or move from one place to another. The underlying issue may be short-term such as a sprained ankle, or long-term, as with a chronic illness, such as multiple sclerosis.

Organs Function Best when Active

Our organs function best when they are active. They get more oxygen, nutrition, glucose, and everything it needs as blood circulates. During inactivity, blood delivery slows down. As a result, the organs receive smaller amounts of what they need. As a result, the organs don’t work as well, producing less of what they are supposed to make.

Since all the organs are making less for their own use and have less to share with other organs, the entire body feels sluggish. Whatever an organ makes, it has less to share with everyone else. When the other organs receive less of what they need to function correctly, they don’t work efficiently, resulting and less productivity.

The decrease in how well one organ functions impacts the other organs ability to do their job. When all the organs are affected, as is the case with immobility, the impact has both a singular and cumulative effect making the effect particularly troublesome. In addition, the effect increases fatigue, weakness, and complications from illnesses or injuries.

Long-Term Conditions Require Multiple Assistive Devices

Long-term movement disorders tend to worsen over time due to this ongoing trend. As the body weakens, the need for more assistance with activities of daily livening increases requiring a progression of the need for mobility assistive devices over time. For example, rollators replace canes which lose their place to walkers. Ultimately a wheelchair, probably a powerchair, replaces them all, and the individual has a room of discarded mobility devices available to loan or sell to those in need.

What can be Done to Help Decrease the effects of immobility?

As a caregiver, you have many tools available to help you fight the effects of immobility. The key is knowing the risks and prevention strategies. With those tools in your toolkit, you have what you need to put a plan in place to prevent problems from occurring. With proper planning, your workload decreases, and your family member stays healthier!

Common Complications of Immobility

• Pressure ulcers (skin and tissue loss over bony areas) – Obtain information on preventing pressure ulcers under the skincare topics.
• Bone loss (bones become brittle from lack of pressure against them) – The best way to prevent bone loss is to include calcium and vitamin D in your diet and activities that require weight-bearing. Calcium loss occurs because the bones require pressure against them to help hold the calcium intact.
• Constipation (lack of activity causes stomach muscles to become very still, leading to delayed digestion) – Drink plenty of fluids; it doesn’t have to just be water. Eat vegetables, fruits, nuts, and other things you like that have roughage (fiber). You can also add things like Miralax and Metamucil to your diet to help keep stools soft.
• Weight loss or gain (appetite decreases leading to weight loss or boredom eating leads to weight gain). If you tend to snack between meals, plan for when the craving starts by having healthy, low-calorie snacks.
• Muscle breakdown (muscle tissue breaks down over time from disuse – protein content increases in the blood) To combat muscle breakdown, add protein to your meals like meats, nuts, fish, etc.
• Pneumonia (harder to take a deep breath in bed with less lung expansion ability leading to loss of lung volume) – avoid eating and going right to bed. If congestion begins to accumulate, refer to the respiratory section about breaking up phlegm.
• Blood clot in your leg (Venous thromboembolism) (e.g., deep venous thrombosis and pulmonary embolus – blood pools due to gravity.  It causes an increase in the likelihood of clot formation. Clots break loose and travel, becoming emboli. Keep legs moving through range-of-motion exercises, use compression stockings, and watch for signs of redness, swelling, or warm, tender areas around the calf that would indicate a blood clot might be forming.
• Kidney stones -Urinary system calculi (sediment from urine sitting in the bladder; dehydration also promotes stone formation). Drink lots of water and cranberry juice to help keep kidney stones from forming.

Psychosocial Complications

• Depression due to isolation and inability to take care of self
• Changes in the sleep cycle
• Loss of sleep-Sleep deprivation due to the discomfort of immobility

*Reference: Ignatavicius, Donna D., Workman, M. Linda, and Rebar, Cherie R. (2018) Medical-Surgical Nursing. Concepts for Interprofessional Collaborative Care. (9th Ed.). St. Louis: Elsevier

Immobility Has Both Physical and Emotional Challenges

The Emotional Side 

Caring for someone with immobility issues is both emotional and physically challenging. While most of the content on this page deals with immobility’s physical aspects, I don’t want to fail to mention the emotional side. Unfortunately, the physical side takes a serious toll on the caregiver.

Do Everything Twice

Caring for someone who cannot do anything for themselves leaves you exhausted by the end of the day. Each 365-day cycle, 24 hours a day, you perform life’s essential living requirements at least twice—once for you and once for the person under your care. Often you complete them more than twice a day.

Physical Exhaustion

Most people take a full day to complete those requirements for themselves, and you must do them for two people. Also, you include all the prep work and clean-up required for those tasks. It’s exhausting. You fall into bed at night, aching, hardly able to take a deep breath at times.

Extension of Other 

However, the emotional side of dealing with someone who cannot move on their own is also very demanding. By default, you become an extension of the other person, and they begin to expect you to know what they need and want instinctively. After a while, you are so attuned to them that you honestly do know them that well.

Negative Emotions

Unfortunately, that degree of closeness also brings other emotions that are not as nice, and we don’t like to admit. We all have them, whether we realize it or not. Thankfully most of us don’t act on them, but it’s human nature to feel them, mainly because we’re tired. When we feel them, it’s a signal that we need rest or need to talk to someone or get away for a while. Be kind to yourself. You’re experiencing Caregiver Fatigue. There’s a section on the website about Caregiver Fatigue and Burnout. I recommend you look at it, so you’ll recognize the signs and be able to see it developing before it takes over your life. It’s painful and can cause you to lash out at others. None of us want to be that person. I hope some of what you find here will help.