Mobility Issues and Limitations in Aged Care

Mobility is a key factor in the health and wellbeing of older people, playing an important role across all settings. Understanding mobility and its challenges helps support older people in maintaining independence, staying connected, and living with dignity (DoH 2024).

Why is Mobility Important?

The ability to move freely between positions, known as functional mobility, is essential for older people to take part in everyday routines and activities. Functional mobility covers a wide range of movements and activities, including walking, using a wheelchair, moving in bed, accessing the toilet, driving, using public transport, and transferring between positions such as getting in and out of a car (DoH 2024).

A decrease in functional mobility can lead to:

• Loss of independence
• Loss of muscle strength
• Incontinence
• Pressure ulcers and skin tears
• Reliance on others/care providers
• Increased risk of falls
• Increased risk of hospital readmission
• Increased risk of mortality and morbidity
• Reliance on inpatient/outpatient/residential aged care/community care.

(NSW Health 2024)

Mobility Under the Strengthened Aged Care Quality Standards

Under Standard 5: Clinical Care - Outcome 5.5: Safety of clinical care services (Action 5.5.4) of the Strengthened Aged Care Quality Standards, providers are encouraged to optimise older people’s mobility, provide timely post-falls care and continuously review previous incidents to prevent future occurrences (DHDA 2025).

Mobility Aids

Mobility aids enable people with mobility limitations to move around and perform tasks that would otherwise be challenging or impossible for them (AIHW 2024).

Examples can include:

• Walking frames
• Canes and walking sticks
• Electric and manual wheelchairs
• Scooters
• Specially modified car, car aids
• Guide dogs, other assistive animals
• Crutches
• Orthotics, built-upbuilt up shoes
• Braces, belts
• Electric lounge chairs
• Lifting machines, hoists

(AIHW 2024)

Tips for Looking After an Older Person with a Mobility Impairment

These include:

• Ensure mobility aids are clean and in good working condition
• Ensure appropriate footwear is worn (closed, non-slip, flat and well-fitting shoes)
• Ensure the older person has all equipment required and properly fitted (e.g. any required braces, belts, orthoses, hearing aids, glasses)
• Understand the older person’s capabilities (e.g. level of assistance required, amount of duration possible for the person)
• Plan the route and ensure the environment is clear of tripping hazards, pedestrian traffic and obstructing equipment
• Ensure equipment and environment are safe (e.g. chair in correct position, bed brakes on, correct bed height)
• Ensure the older person is feeling well throughout (e.g. no signs of dizziness, shortness of breath, shaking)
• If relevant, stand to the weaker or affected side of the older person
• Be in close enough proximity to provide hands on assistance for balance, be sure not to obstruct the path or view
• Educate the older person on the safe use of the equipment.

(CEC 2017; QLD Health 2026)

Exercise

Exercise programs can be delivered in individual or group settings and may include strength, balance, functional retraining, and aerobic exercises. Group classes facilitate social interaction and may help counteract loneliness and isolation (DoH 2024).

The exercise undertaken by older people with mobility limitations does not need to be strenuous.

A major 2020 review found that regular exercise can reduce falls by up to 24%. When programs included at least three hours of balance and functional exercise per week, that reduction increased to as much as 42% (Sherrington et al. 2020).

Older adults can also build activity into their day through incidental activity - physical activity that occurs as part of a daily routine.

Examples include:

• Getting out of bed
• Walking to the toilet
• Getting dressed
• Eating meals outside of bed
• Showering and grooming.

(DoH 2024)

Incidental activity is also beneficial in encouraging self-care. These activities can be performed with supervision or assistance if required (DoH 2024).

Falls Prevention

In 2023–2024, falls were the leading major cause of injury-related hospitalisations, and in the prior year of 2022–2023, they were also the leading major cause of injury-related deaths (AIHW 2025).

During the 2023-2024 period alone, the health system is estimated to have spent $5 billion on falls related injuries alone (AIHW 2025).

Research has shown that home-safety interventions alone can reduce the risk of falls by 26% (Injury Matters 2026).

To learn more about fall prevention strategies, see Ausmed’s Article on Preventing Falls in Aged Care.

The Effects of Long-term Bed Rest Due to Mobility Restriction

In a situation in which drastically reduced mobility results in bed rest, there is a heightened risk of additional health complications:

Cardiovascular

• Increased risk of deep vein thrombosis (DVT)
• Postural/orthostatic hypotension
• Decline in aerobic capacity.

Respiratory

• Increased risk of pneumonia
• Decline in arterial oxygen level
• Increased risk of atelectasis.

Musculoskeletal

• Decline in muscle mass
• Decline in muscle strength
• Decline in bone density
• Structural joint changes and contractures
• Weight loss
• Frailty
• Increased risk of falls/injury
• Pain and discomfort.

Gastrointestinal

• Constipation
• Malnutrition.

Skin

• Increased risk of skin tears
• Increased risk of pressure injuries

Psychological

• Loss of confidence and motivation
• Loss of independence
• Disturbed sleeping patterns
• Reduced cognitive stimulation
• Increased risk of delirium
• Social isolation
• Low mood and depression.

(NSW Health 2024; DoH 2024; Berger et al. 2025)

Conclusion

Mobility is central to the independence, dignity, and overall wellbeing of older people. Its decline can have serious and wide-ranging consequences, many of which are preventable.

Through person-centred care, appropriate aids, regular exercise, and proactive falls prevention, older people can be better supported to move safely and live well.