VMS, prevention physical functional decline

Interventions to prevent physical functional decline (e.g. Katz score > 2) are:

Interventions aimed at improving mobility, such as: • patients walking or standing, at least three times a day
An active rehabilitation attitude of the nurses • explanation about the use of aids • attention to stable and sturdy footwear for the patient. • Treatment by a physiotherapist and/or occupational therapist aimed at maintaining and restoring function
Avoiding medically unnecessary bed rest. If bed rest is unavoidable, the patient may receive the following (preventive) advice:
- Prevent bedsores by: • regularly lifting the buttocks off the sheet • not rubbing the bottom sheet with your heels • occasionally taking turns raising the leg or turning it to the side • reporting pain complaints in a timely and clearly manner, such as pain in the coccyx, buttocks or heels
- Prevent stiffening caused by contraction of muscles in a certain position, such as when the knee is raised, by: • regularly moving the limbs, do not forget the hands • do not use a pillow in the hollow of the knee
- Prevent pneumonia by: • breathing deeply in and out a few times every hour • sitting on the chair three times a day as soon as possible • Assessing medication, such as sleeping pills and tranquilizers.
- Adequate pain treatment with regular pain scores.
- Indication of dizziness when changing position (especially after bed rest), possibly in combination with blood pressure lowering agents.
- Daily evaluation of IVs, catheters, restraints and restraints.

Reference : Praktijkgids kwetsbare ouderen (2017) Praktijkgids Kwetsbare ouderen – VMS zorg

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