Immobility – It’s a Big Deal for Lots of Reasons
The human body works best when its 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. 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 having a sprained ankle, or long-term as in the case of my husband, who has multiple sclerosis.
Our organs function best when they are active. They get more oxygen, nutrition, glucose, and everything else it needs as blood circulates. During inactivity, blood delivery slows down. As a result, organs receive smaller amounts of glucose, oxygen, and nutrition.
During extended periods of inactivity, all the body’s organs are affected. The organs work don’t work as well producing less of what they are supposed to make. Since they make less, they get less for their own use and they get less from other organs in return. The effect is an increase in fatigue, weakness, and complications.
Since long-term movement disorders tend to get worse over time due to this ongoing trend, those who have chronic conditions purchase many different types of mobility assistive devices. The discarded devices become a reminder of life changes as they sit in crowded storage rooms awaiting donation to someone else.
Why is Immobility (Not Being Able to Move) a Problem?
Each major system in our bodies works better when we are mobile. As each system becomes impaired by the effects of immobility, the decrease in how well it functions impacts the ability of the other organs to do their job too. Therefore, immobility has both a singular and cumulative effect making the effect particularly troublesome.
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! That’s what Becoming a Family Caregiver is all about!
Common Complications of Immobility
- Pressure ulcers (skin and tissue loss over bony areas)
- Bone loss (bones become brittle from lack of pressure against them)
- Constipation (lack of activity causes stomach muscles to become very still leading to very slow digestion)
- Weight loss or gain (appetite decreases leading to weight loss or boredom eating leads to weight gain)
- Muscle atrophy (muscle tissue breaks down over time from disuse – protein content increases in the blood)
- Atelectasis/hypostatic pneumonia (harder to take a deep breath in bed so loss lung expansion ability leading to loss of lung volume)
- 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.
- Urinary system calculi (sediment from urine sitting in bladder; often dehydration also factors in promoting stone formation)
- Depression due to isolation and inability to take care of self
- Changes in the sleep cycle
- Sleep deprivation due to 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
Caring for someone with immobility issues is both emotional and physically challenging. While most of the content on this page deals with the physical aspects of immobility, I don’t want to fail to mention the emotional side as well. 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.
Most people take a full day to complete those requirements for just themselves, and you must do them for two people. Also, you include all the prep work and clean up that is required associated with 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 after a while, 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.
Unfortunately, that degree of closeness also brings with it other emotions that are not as nice and which we don’t like to admit are there. 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.
Personal Side of Caregiving
I talk more about these “other emotions” under the “Personal Side of Caregiving.” Just know that dealing with someone who is significantly immobile for a long time is likely to bring out some negative emotions. Be prepared to admit they are there and to reach out to talk to someone.