IRB Protocol Attachment - MPT

MyMobility
Attachment C3a Mobility Planning Tool

A P L A N F O R S T AY I N G I N D E P E N D E N T

CONSIDER THAT:

1 in 4 adults who are
now 65 years old will
live into their 90’s.

Because people are
living longer, there may
be a time when you still
need to get around, but
can no longer drive.

Making a plan to stay mobile as you
get older is important to help you
stay independent.
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. This planning tool can help you begin doing things to
protect your mobility and stay independent longer.
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 even doing
simple chores around the house. These physical changes can
also make us more likely to get injured.

Work through the MyMobility plan on the next few pages to help
you keep your freedom and independence as you get older.
The plan will take you through these sections:
1 in 3 older adults fall
each year. Fall-related
injuries can make it
hard to get around
and live independently.

Myself – A PLAN TO KEEP YOUR HEALTHY
My House – A PLAN TO KEEP YOU SAFE INSIDE YOUR HOME
My Community – A PLAN TO STAY MOBILE IN YOUR COMMUNITY

Myself – A PLAN TO KEEP YOURSELF HEALTHY
To start building your own MyMobility Plan, complete the checklist below.

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Get a physical checkup each year.
Some health issues may increase my risk of falling.
Last Exam Date:
Next Exam Date:

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Ask my healthcare provider or pharmacist

Falls are a growing problem for older

to review all my medicines – including
over-the-counter medicines.

adults and more than 95% of hip
fractures are due to falls.

Check for the right dose and possible side effects
(such as dizziness, drowsiness, etc.) that may affect
my ability to drive, walk, or get around safely.

Hip fractures are serious injuries that can
take a long time to heal, and affect mobility.
1 in 3 adults who lived independently

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Follow a regular exercise program to improve
my strength, balance and coordination.

before their hip fracture stayed in a
nursing home for at least a year after
their injury.

Begin Date:

I PLAN TO DO:

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Strength exercises

(such as chair rise exercise):
www.cdc.gov/homeandrecreationalsafety/pdf/steadi/
chair_rise_exercise.pdf

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

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Balance exercises

(such as Tai Chi or Balance classes):
Check with your local community center, gym or
YMCA for class offerings.

For more information, please visit:
What You Can Do to Prevent Falls
www.cdc.gov/STEADI

Healthy Aging
http://go.usa.gov/3cuMx

My House – A PLAN TO KEEP YOU SAFE INSIDE YOUR HOME
To continue building your MyMobility Plan, complete the checklist below.
Schedule a day to go through the following home safety checklist to help prevent falls.

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Check the FLOORS in each room
and reduce tripping hazards:

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Check the STAIRS and STEPS:
qq Check for loose or uneven steps.
Repair if needed.

qq Keep objects off the floor.

qq Make sure carpet is firmly attached to every
step, or remove carpet and attach non-slip
rubber treads.

qq Remove or tape down rug.
qq Coil or tape cords and wires next to the wall
and out of the way.

qq Check for loose or broken handrails.
Repair if needed.

qq Consider installing handrails on both sides
of the stairs.

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Check the KITCHEN and EATING AREA:
qq Put often-used items within easy reach

qq Use bright overhead lighting at the top and
bottom of the stairs.

(about waist level).

qq Never use a chair as a step stool.

qq Consider putting light switches at both the
top and bottom of the stairs.

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Check the BEDROOMS:
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Check the BATHROOMS:

qq Use bright light bulbs.
qq Put in night-lights so I can see my path in
the dark.

qq Put non-slip rubber mats or self-stick strips
on the floor of the tub or shower.

qq Place lamps close to the bed where they’re
easy to reach.

qq Consider installing grab bars for support
getting in or out of the tub or up from the toilet.

MyMobility tip

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Other actions (write in):

Avoid going barefoot or wearing slippers.
Wear shoes that make walking easier
inside and outside the house.

For more information, please visit:
CDC’s Check for Safety
www.cdc.gov/STEADI

AARP HomeFit Guide
http://bit.ly/1MYXzWT

Home Repair and Modification
http://go.usa.gov/3cutd

My Community – A PLAN TO STAY MOBILE IN YOUR COMMUNITY
To finish building your MyMobility Plan, complete the following.
Fill in how you currently get to all the places you need to go now. Then fill in how you would get to these
same places if you couldn’t use your current way. For example, if you use a car to get to the doctor’s office
now, how would you get there if you could no longer drive?

WHERE DO I NEED TO GO?

HOW DO I GET THERE NOW?
(Such as drive, get a ride,
use public transportation, etc.)

HOW WILL I GET THERE
IN THE FUTURE?

DOCTOR/MEDICAL TRIPS
GROCERY STORE/SHOPPING
SOCIAL/RECREATION TRIPS
EXERCISE CLASS
PAID OR VOLUNTEER WORK
OTHER (WRITE IN)

MyMobility tip

While older adult drivers (65+) are some
of the safest drivers on the road, they are
also most at risk for injuries and death

If your home has dangers for falls that can’t

when in car crashes. This is because our

be fixed, or, if you don’t have many options

bodies become more frail as we age.

to get where you need to go in the future,
consider whether moving might help.

CONSIDER THE FOLLOWING TO HELP
MAKE MYSELF SAFER NOW:

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Driving Refresher Course
AARP (888) 687-7277 or www.aarp.org
AAA (800) 222-4357 or www.aaa.com

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Medication Information

Look up medications to see how they
may affect safe driving. www.roadwiserx.com

Refresher Course Date:

For more information, please visit:
CarFit Review
See how well your car fits you at www.car-fit.org

www.cdc.gov/URL HERE • 1-800-CDC-INFO (1-800-232-4636)

Transportation options
Put in your zip code and see what’s available in your area
www.eldercare.gov/eldercare.net/public/resources/topic/Transportation.aspx
Rides in Sight
1-855-60-RIDES • www.ridesinsight.org/
CS253690-B