Using the Elderly Mobility Scale (EMS) to Assess Mobility

March 29, 2024   191

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If you're observing a decline in the mobility of an elderly family member, noting longer times to rise from a seat or a slower gait, it's essential to address these changes. Such alterations in daily activities, including household tasks and personal care, could signal the need for additional support.

At Prolife Home, we recognize the importance of assessing and supporting our clients' mobility to enhance their safety and quality of life. The Elderly Mobility Scale (EMS) is a critical tool we utilize to evaluate seniors' mobility levels comprehensively. This guide will introduce the EMS, demonstrate how to administer the test, and discuss its role in tailoring home care services for your loved one.

Elderly Mobility Scale (EMS): What You Need to Know

The EMS is a widely recognized assessment tool employed by health professionals to gauge the mobility of older adults accurately. It is designed to determine the effectiveness of mobility-enhancing interventions such as physiotherapy or the need for mobility aids.

Key Benefits of the Elderly Mobility Scale

The reliability and simplicity of the EMS make it an indispensable tool in geriatric care. It allows for the quick assessment of a senior's mobility level, providing a solid foundation for any needed adjustments to their care plan.

Conducting the EMS Test: A Step-by-Step Approach

The EMS encompasses several tasks that measure an individual's mobility, from transitioning between positions to walking and balance. Each task is scored, culminating in a mobility score that helps guide care decisions.

Utilizing the EMS Score

A comprehensive understanding of the EMS score is crucial for making informed care decisions. High scores indicate good mobility, possibly requiring minimal intervention, while lower scores may necessitate more substantial support.

Prolife Home Care approach to improving mobility

Prolife Home Care company is committed to not only assessing mobility through the EMS but also implementing personalized strategies to improve it. Whether through encouraging regular physical activity, ensuring a balanced diet, or providing physiotherapy, we aim to enhance our clients' mobility and overall well-being.

Navigating Through Care Options

Depending on the EMS outcomes, various care options can be considered, from in-home care services tailored to meet daily needs to more intensive interventions for those with significant mobility challenges. Our team is dedicated to finding the best solutions to support our clients' independence and quality of life.

The Elderly Mobility Scale (EMS) is also invaluable for deciding whether an older family member might gain from the use of mobility aids, such as walkers, or from engaging caregiving services.

The Elderly Mobility Scale (EMS) is utilized to evaluate an elderly individual's mobility level through a series of specific tests. These tests assess various mobility metrics, providing a comprehensive overview of an individual's physical capabilities and potential needs for support, such as exercise programs or therapy.

Key Components of the EMS Test

The EMS test comprises several activities designed to measure the ease or difficulty with which an elderly person can perform certain movements. Each of these activities is scored based on the time taken and the level of assistance required, if any. The primary tests include:

• Transition from Lying to Sitting: Evaluates the individual's ability to move from a lying position to a sitting position on the bed.
• Transition from Sitting to Lying: Assesses the ease with which a person can go from sitting on the bed to lying down.
• Sitting to Standing: Measures the time and assistance needed for an individual to stand up from a sitting position.
• Standing Balance: Determines whether a person can stand independently or needs support, highlighting balance issues.
• Gait Evaluation: Observes walking patterns to identify any balance or coordination issues.
• Timed 6-Meter Walk: A functional test to gauge walking speed and endurance over a short distance.
• Functional Reach: Tests the ability to reach forward while standing, indicating balance and stability.

Scoring the EMS Test

Upon completion of these tests, a total score is calculated, which ranges from 0 to 20. A score closer to 20 indicates better mobility and a higher level of independence, while a lower score may signal the need for additional support or intervention. This scoring system helps caregivers and healthcare providers make informed decisions about the level of care or specific interventions that may be necessary to improve or maintain the individual's mobility.

Using the EMS Score

The EMS score is instrumental in determining the appropriate course of action for enhancing an elderly person's mobility and overall quality of life. It can inform decisions regarding the introduction of exercise programs, physical therapy, or the need for mobility aids like walkers. Additionally, it helps in evaluating the effectiveness of ongoing interventions by tracking progress over time.

Understanding and interpreting the EMS score is crucial for developing tailored care plans that address the unique mobility challenges faced by elderly individuals. Whether it's in a clinical setting, a care facility, or home care, the EMS provides valuable insights that contribute to the well-being and independence of older adults.

The Elderly Mobility Scale (EMS) is recognized for its significant benefits in assessing and managing the mobility of elderly individuals. Here are the key advantages of using the EMS:

1. Accuracy and Reliability: The EMS is a well-established tool that offers a reliable method for quantifying an elderly person's mobility. Its standardized approach allows for accurate assessments, making it a trusted choice among healthcare professionals.

2. Simple to Administer: One of the EMS's most practical benefits is its ease of use. The scale requires minimal training to administer effectively, making it accessible for a broad range of caregivers and healthcare workers. This simplicity ensures that it can be widely implemented in various settings.

3. Low Resource Requirement: Unlike some diagnostic tools that necessitate specialized equipment, the EMS can be conducted with basic items readily available in most clinical or home settings. This accessibility promotes its use in diverse environments, from clinical practices to residential homes.

4. Facilitates Targeted Care Planning: The insights gained from an EMS assessment are invaluable for creating personalized care plans. By identifying specific mobility challenges, healthcare providers can tailor interventions, such as recommending appropriate exercises, therapies, or the use of mobility aids, to meet individual needs.

5. Enables Monitoring Over Time: The EMS is not only useful for initial assessments but also as a tool for ongoing monitoring. It can track changes in an individual's mobility, helping to evaluate the effectiveness of interventions and adjust care plans as necessary.

6. Promotes Effective Communication: The standardized scores provided by the EMS facilitate clear communication among healthcare teams, caregivers, and family members. This shared understanding of an elderly person's mobility level enhances collaborative care efforts.

7. Supports Research and Development: Beyond its direct clinical application, the EMS contributes valuable data to research on elderly mobility and related interventions. This research can lead to advancements in care strategies and improved outcomes for the elderly population.

The Elderly Mobility Scale (EMS) is a comprehensive tool used to evaluate the mobility of older adults through a series of seven functional movement tests. Here's a detailed look at how to conduct the EMS test and the method for scoring each component:

Test 1: Lying to Sitting

Objective: Assess the ability to move from lying on a bed to a sitting position.

• Scoring:
  • Independent (no help): 2 points
  • Requires help of 1 person: 1 point
  • Requires help of 2 or more people: 0 points

Test 2: Sitting to Lying

Objective: Evaluate the ease with which an individual can move from sitting on the bed to lying down.

• Scoring:
  • Independent (no help): 2 points
  • Requires help of 1 person: 1 point
  • Requires help of 2 or more people: 0 points

Test 3: Sitting to Standing

Objective: Determine the ability to stand up from a seated position on a chair.

• Scoring:
  • Stands independently in 3 seconds or less: 3 points
  • Stands independently in more than 3 seconds: 2 points
  • Requires help of 1 person: 1 point
  • Requires help of 2 or more people: 0 points

Test 4: Standing

Objective: Assess the ability to stand and extend arms without support.

• Scoring:
  • Stands with no support, can reach without help: 3 points
  • Stands with no support, needs help to reach: 2 points
  • Can stand but needs support: 1 point
  • Can only stand with assistance: 0 points

Test 5: Gait

Objective: Evaluate walking ability and balance.

• Scoring:
  • Walks independently without aid: 3 points
  • Walks independently with a frame: 2 points
  • Can walk with aid but is unstable: 1 point
  • Requires the assistance of another person to walk: 0 points

Test 6: Timed Walk

Objective: Measure the time taken to walk a distance of 6 meters.

• Scoring:
  • Completes walk in under 15 seconds: 3 points
  • Completes walk in 16-30 seconds: 2 points
  • Completes walk in more than 30 seconds: 1 point
  • Unable to complete 6 meters: 0 points

Test 7: Functional Reach

Objective: Determine the distance an individual can reach forward while standing.

• Scoring:
  • Reaches over 20 cm: 4 points
  • Reaches 10-20 cm: 2 points
  • Reaches under 10 cm: 0 points

Calculating the EMS Score

Once all tests are completed, scores from each test are added together to derive a total mobility score, which ranges from 0 to 20. A higher score indicates better mobility and independence, helping healthcare providers and caregivers make informed decisions about care needs, potential therapies, or interventions to improve mobility.

We have the EMS score. What is the next step?

After obtaining the EMS score for your elderly family member, the next steps involve interpreting the score to understand their mobility level and deciding on the best course of action to support their physical health and well-being. Here’s a guide to what the EMS score means and potential actions you can take:

Interpreting the EMS Score

Mobility Score: 14 – 20

A score within this range indicates that the elderly individual has good overall mobility and is likely able to perform most daily activities independently. However, they may still require occasional assistance, depending on specific circumstances or tasks.

Preventing Mobility Issues and Enhancing Fitness

Even with a high score, it's important to remain proactive about maintaining and improving mobility and fitness. Here are factors that may impact mobility and strategies to address them:

Factors Affecting Mobility

• Osteoporosis: This condition weakens bones, making them more brittle and increasing the risk of fractures. It can affect movement and posture, requiring caution during physical activities.
• Neuromuscular Issues: Conditions like multiple sclerosis and muscular dystrophy affect nerve and muscle function, potentially hindering mobility.
• Arthritis: Common in older adults, arthritis causes joint inflammation, pain, and stiffness, impacting movement.

Strategies for Maintaining Mobility

• Weight Management: Keeping a healthy weight reduces pressure on joints and facilitates easier movement. It also lowers the risk of chronic diseases.
• Regular Exercise: Encourage activities such as walking or participation in exercise classes designed for seniors. Exercise strengthens muscles, improves balance, and enhances overall mobility.
• Healthy Diet and Supplements: A balanced diet rich in proteins, healthy fats, and vegetables, complemented by supplements like collagen peptides, vitamin K, calcium, and vitamin D, supports bone health and reduces the risk of osteoporosis.
• Yoga: This practice offers numerous benefits, including improved mobility, increased core strength and balance, reduced stress, and better cardiovascular health.
• Engaging Hobbies: Activities like gardening, painting, or playing an instrument keep seniors active and contribute to their mobility and quality of life.

Regardless of the EMS score, it's crucial to consult with a healthcare professional before making any significant changes to your loved one's health regimen. They can provide personalized advice and ensure that any new activities or supplements are safe and beneficial for your family member’s specific health situation.

Mobility score: 10 – 13

For individuals whose EMS score falls between 10 and 13, they're considered to be in a borderline independent state. This means they possess sufficient mobility for some daily activities but might need assistance for others, indicating a need for careful monitoring and support to maintain and potentially enhance their mobility and safety.

Addressing Borderline Mobility: Strategies and Supports

Physiotherapy

At this critical juncture, physiotherapy emerges as a vital intervention. It's not merely about addressing current mobility limitations; it's about empowerment. A tailored exercise program, devised by a skilled physiotherapist, can significantly improve mobility. This improvement isn't just about moving back into a higher EMS score bracket; it's about reclaiming independence and enhancing quality of life. The ongoing assessment, including the use of the EMS, allows for fine-tuning the approach to ensure the most beneficial outcomes.

Companion Care

Companion care extends beyond the physical aspects of assistance; it touches the heart of emotional wellbeing. Providing emotional support and companionship, companion care addresses the holistic needs of the elderly. Whether it's aiding with daily tasks, encouraging adherence to an exercise regimen, or promoting a nutritious diet, companion care plays a crucial role. It's about creating an environment that not only supports physical health but also fosters a sense of belonging and happiness.

The Role of Engagement and Nutrition

Encouraging engagement in hobbies and activities isn't just about passing time. These activities are pivotal in maintaining mental agility, fostering social connections, and enhancing physical mobility. Similarly, a focus on nutrition—ensuring a diet rich in essential nutrients—supports overall health and complements physical therapy efforts.

Navigating the Path Forward

For those in the 10-13 EMS score range, the journey towards improved mobility is multifaceted. It involves professional interventions like physiotherapy, the compassionate support of companion care, and a lifestyle embracing active engagement and balanced nutrition. This integrated approach not only aims at enhancing physical mobility but also at elevating the overall wellbeing and quality of life for the elderly.

Mobility score: under 10

When an elderly family member scores under 10 on the Elderly Mobility Scale (EMS), it indicates a significant need for assistance with essential daily activities, including dressing, personal hygiene, and general household tasks. This level of mobility suggests that interventions are necessary to support their quality of life.

Short-Term Assistance and Long-Term Planning

While it's crucial to seek ways to enhance their quality of life through physiotherapy, a balanced diet, and social engagement, immediate needs must be addressed. Here are options to consider for providing the necessary support:

Assisted Living Facilities

For those requiring constant care, an assisted living facility might offer the most comprehensive solution. These facilities provide round-the-clock care and are designed to cater to the needs of those with significant mobility challenges. Discussing this option openly with your loved one is essential to make a decision that respects their preferences and needs.

Home Care Services

Many seniors prefer the familiarity and comfort of their own homes. Home care services offer a flexible solution by providing assistance with daily living activities directly in the senior's residence. This option allows for personalized care that adapts to the individual's specific needs, from basic household tasks to more complex health monitoring and medication administration.

The Role of CDPAP in Home Care

In New York, the Consumer Directed Personal Assistance Program (CDPAP) represents a unique opportunity for personalized home care. This program allows Medicaid recipients who require help with daily activities or health care tasks to choose their caregivers, who can be family members or friends, excluding spouses.

Benefits of CDPAP

• Financial Support: Caregivers receive compensation, which can help alleviate financial pressures, especially if they've had to reduce their work hours or stop working to provide care.
• No Special Training Required: The program does not require caregivers to have special medical training, making it accessible for many families.
• Performing Medical Tasks: Unlike traditional home care services, CDPAP caregivers can perform certain medical tasks, offering a higher level of care tailored to the recipient's needs.

Eligibility for CDPAP

• The care recipient must be a Medicaid beneficiary.
• They must have a stable medical condition requiring assistance with daily activities.
• The recipient must be capable of directing their care or have a legal guardian or designated representative who can direct care on their behalf.

For families considering this route, understanding the application process and requirements is crucial for leveraging CDPAP effectively. This program not only offers practical solutions for care but also fosters a sense of independence and comfort for the elderly by allowing them to remain in a familiar environment with care from trusted individuals.