Older Adult Mobility Planning Brochure

Attachment E
Confirmatory Letter

Form Approved
OMB No. 0920-0572
Expiration Date: 03/31/2018
Public Reporting burden of this collection of information is estimated at 15 minutes per
response, including the time for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed, and completing and reviewing the collection of
information. An agency may not conduct or sponsor, and a person is not required to respond to
a collection of information unless it displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of this collection of information,
including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer, 1600
Clifton Road NW, MS D-74, Atlanta, GA 30333; Attn: PRA (0920-0572).

Dear [PARTICIPANT NAME],
Thank you for agreeing to participate in the MyMobility Focus Group. I am
writing to remind you of your scheduled appointment at Battelle on [DATE] at [TIME]
to participate in a focus group. Battelle is located at [customize for Battelle office
location – Atlanta, GA or St. Louis, MO]. The focus group discussion will take about 2
hours. At the end of the focus group, you will receive $75 for your participation.

Before the appointment, please take 15 minutes to read the enclosed MyMobility
brochure. You do not need to fill out the tool before the focus group. During the 2 hour
focus group we will ask questions about the information in the tool and how the Centers for
Disease Control and Prevention (CDC) should distribute tool so that it reaches the most
people.

Customize with address of Battelle location

While we will have extra copies available, we ask that you please bring the
enclosed copy of the MyMobility brochure with you to the focus group. If you have
questions, please contact me at [PHONE NUMBER] or by email at [EMAIL
ADDRESS].
Best wishes,
[NAME]
[TITLE]

Battelle | Date

2

MyMobility
A Plan for Staying Independent

What can you do to stay
independent as you age?
Many people make financial plans for retirement, but not
everyone plans for other changes that may come with age.
This includes changes in your mobility - your ability to
get around.
It’s not easy to talk about, but as we get older, physical changes
can make it harder to get around and do things we want or need
to do—like driving, shopping, or doing chores around the house.
You might not have mobility problems now, but maybe you know
others who do—perhaps a parent, relative, friend or neighbor.

1 in 4

adults now 65
will live to 90+
There may be a
time when you

While it may not be possible to prevent all of these changes, there

still need to get

are actions you and your loved ones can take today, and as you

around, but can

age, to help keep you safe and independent tomorrow.

no longer drive.

Use this planning tool to begin your journey protecting your
mobility and independence.

Make a plan today. Stay independent tomorrow.
MySelf
A plan to stay independent

MyHouse
A plan to stay safe inside my home

MyNeighborhood
A plan to stay mobile in my community

MySelf – A plan to stay independent
To start building MyMobility Plan, complete the checklist below.
oo Get a physical checkup each year.
Some health issues may increase risk of falling
(such as leg weakness, mobility problems, and
problems with balance).
Last Exam Date:
Next Exam Date:
oo Review all medications with healthcare
provider or pharmacist, including over-thecounter medicines.
Certain medications can have side effects – such as
dizziness or drowsiness – that may affect the ability
to drive, walk, or get around safely.

MyMobility Tip
Reduce your chances of falling by doing
strength and balance activities
as little as 3 times per week.

oo Get a medical eye exam each year.
Eye problems can increase risk of falling
or being in a car crash.
Last Exam Date:
Next Exam Date:
oo Follow a regular physical activity program to
improve strength, balance, and coordination.
Begin Date:
Strength activities:
Balance activities:

Drivers 65+ are some
of the safest drivers on
the road. However, in
a car crash, this group
is more at risk for
injury and death because our bodies
become more frail as we age.

To begin improving strength & balance, try these activities
Strength Activity

Toe Stand
Stand behind a sturdy chair for balance.
Stand with feet shoulder-width apart.
Slowly stand up on tiptoes - hold for 1 second.
Slowly lower heels to floor.
Repeat 10-15 times.

Balance Activity

Stand on One Foot
Stand behind a sturdy chair for balance.
Stand on one foot.
Hold for up to 10 seconds.
Then, switch feet.
Repeat 10-15 times.

Go to go4life.nia.nih.gov for more suggestions.

MyHouse – A plan to stay safe inside my home
To continue building MyMobility Plan, complete the checklist below.
Schedule a day to go through the following home safety checklist to help prevent falls.

ooCheck the FLOORS in each room and
reduce tripping hazards:
oo Keep objects off the floor.
oo Remove or tape down rugs.
oo Coil or tape cords and wires next to the
wall and out of the way.
ooCheck the KITCHEN:
oo Put often-used items within easy reach
(about waist level).
oo For items not within easy reach, always
use a step stool and never use a chair.
ooCheck the BEDROOMS:
oo Use bright light bulbs.
oo Put in night-lights to be able to see a
path in the dark.
oo Place lamps close to the bed where
they are within reach.

MyMobility Tip
Falls are more likely when going
barefoot or wearing slippers.
Wear shoes that have good support
when inside or outside the house.

oo Check the STAIRS and STEPS inside and out:
oo Check for loose or uneven steps.
Repair if needed.
oo Make sure carpet is firmly attached to
every step, or remove carpet and attach
non-slip rubber treads.
oo Check for loose or broken handrails.
Repair if needed.
oo Consider installing handrails on both sides
of the stairs.
oo Use bright overhead lighting at the top
and bottom of the stairs (inside and out).
oo Consider putting light switches at both the
top and bottom of the stairs.
oo Check the BATHROOMS:
oo Put non-slip rubber mats or self-stick strips
on the floor of the tub or shower.
oo Consider installing grab bars for support
getting in or out of the tub and up from
the toilet.

MyNeighborhood – A plan to stay mobile in my community
To finish building MyMobility Plan, fill out the table below.

Fill in all the places you go. Fill in how you get there. Then, fill in how you would get to these same
places if you couldn’t use your current way. See first row for an example: If you drive to the doctor’s
office now, how would you get there if you could no longer drive?
Find transportation options in your zip code:
Rides in Sight
1-855-60-RIDES
www.ridesinsight.org

Where do I need to go?
(Such as doctor, grocery store,
shopping, social/recreation trips,
work,physical activity class, etc.)

Doctor's off ice

How do I get there now?
(Such as drive, get a ride,
use public transportation, etc.)

Drive myself

Consider the following:
oo Driving Refresher Course
AARP (888) 687-7277 or www.aarp.org
AAA (800) 222-4357 or www.aaa.com
Refresher Course Date:
oo CarFit Review
See how well my car fits me for comfort
and safety at www.car-fit.org

To download a copy of MyMobility, visit:
https://www.cdc.gov/motorvehiclesafety/mymobility
CS283526-A

It is important to stay social
as you age. Consider car ride
services to stay connected.

How will I get there
in the future?
(Such as bus, rideshare, get a ride
with a friend, etc.)

Car ride service

MyMobility Tip
Good eyesight is about more than
20/20 vision. For example, seeing well
in the dark is needed to drive safely at
night. Get a medical eye exam each
year and address any issues.