Reframing Mobility in the Aging Population

By Thea Franke

When I began my PhD looking at the experiences of older adults’ mobility in the community, I noticed that the majority of work looked at mobility as a physical experience. A lot of the research examines how much physical movement an older adult achieved, or how much physical space they covered, rather than seeking to understand mobility as an emotional experience. Most mobility research captures ‘mobility’ at a single point in time, rather than seeing it as a process that occurs over time.

Through my work, I understood that mobility is not merely a physical experience, but rather is composed of emotions, motivations, perspectives, and attitudes that are all influenced over time– a lifetime.

Our capacity for physical movement changes due to our personal emotional story. This finding led me to develop and adapt a mobility framework that reflects the importance of recognizing the individual as key to the mobility experience. The adapted framework is a tool that could be used across a multitude of sectors serving older adults to better understand and communicate older adult’s mobility needs.

Adapted Mobility Framework

James’ mobility captured on the new framework.

The framework has three main categories which make up the individual mobility experience:

What differentiates this framework

There are three key features that set this adapted framework apart. First, and foremost, the framework places individuals’ ‘subjectivity’ as the main category. Previously, frameworks have not valued subjectivities as vital to influencing mobility choices.

Two other novelties of this framework are that each of the influencing factors is on a sliding scale, and that the mobility experience is acknowledged as a fluid construct, from youth to old age, rather than as a static snapshot. Meaning, we recognize that mobility will change and fluctuate day to day and over the life course. The framework simply places an individual on each sliding scale at each point in its life in order to tell a story of that individual’s mobility experience. Early life positioning is indicated by the black triangle, adult life by the grey triangle and late life by the white triangle.

So how do we use this framework practically?

The following is a story of one of the participants who took part in my study. I present his story on the framework image in this article. It shows how the framework can communicate an individuals’ mobility experience:

Physiological — (physical, chronic conditions, cognition)

James is a 67-year-old man. He has visual impairment, back pain and arthritis. James manages to meet physical activity guidelines for older adults, by accomplishing greater than 150 minutes of moderate-to-vigorous physical activity per week (Tremblay et al., 2011), which is equivalent to approximately 7,000 steps per day (Tudor-Locke et al., 2011) . He describes himself as an ‘avid yogi,’ increasing his attendance from one day a week to two, over a period of 4 years.

Subjective — (psychological, attitudes, perceptions)

James previously worked as a building manager in his neighbourhood and also worked in landscaping. James now spends the majority of his time reading, and findings peace through his meditation practice, something he has been practicing on and off since he was 14. James seeks out relationships with the individuals in his local yoga class as they are ‘like-minded’ and he enjoys this. Although his physical ailments have increased over the years, he describes himself and his fellow like-minded yoga friends as all happier than they were when they were younger.

Context — (financial, built, social, natural environment and culture)

James is a low income older adult and lives in a tiny one-bedroom apartment. He cannot afford to travel but spends wisely in order to purchase organic foods, as he has always believed nutrition contributes to maintaining his health. James does not have access to a car and therefore walks and/or takes public transportation. James has access to two large local malls that are a 10-minute walk from his door. In the summer months, he walks as much as he can, but, in the winter months, he opts to take the bus more often. James speaks about the importance of having access (by walking or bus) to affordable shopping to get out of the home, and he appreciates access to environments that allow him to accomplish multiple activities in one place. James describes himself as a hermit, disengaged socially by choice as he enjoys his time alone. Admittedly though, over the years he began to speak about the joy he receives in talking to members of his community at the bus stop or grocery store. James used to go for walks through the parks close to his house, but over four years he stopped going to the parks and spent most of his focus on walking to conduct his own activities, such as attending a yoga class or grocery shopping.

James’ story demonstrates that the mobility experience is made of many factors that work together to influence mobility choices. These choices may change over days, months or years. For example, weather conditions can impact daily choices of distances travelled or modes used to travel. James’ account shows how previous habits, such as being ‘health conscious’ can influence choices, later on, even increasing healthy choice making later on in life. There are also multiple references in James’ story of how subjective aspects (a dominant category in the framework) play a role in influencing mobility choices. For example, he does not seek extensive, robust social networks but rather enjoys spending the majority of his time alone. The casual encounters that he experiences with others at the bus stop or grocery store draw him out of his home each day. Though James is a low-income older adult with physical conditions that could potentially limit his mobility, the story (and use of a sliding scale in the framework) illuminates how a healthy attitude and self-efficacy, affordable and accessible built environment and satisfying social environment helps him adapt to maintain his mobility over time.

Because this framework attempts to capture the mobility story of an individual over time, we see broad practical applications for its’ use. Adopting this framework reframes how mobility can be conceptualized and approached across a potential range of users and user groups. Not only does this framework provide a snapshot into the individual case, but can be used to explore patterns amongst various populations of older adults. Politicians and government agencies can use this information to enhance their resource planning and development strategies by determining what health-care and other services will be needed using frameworks assessment of various populations’ needs. The framework might also be used in clinical or community settings for the assessment of individuals.

Mobility is not merely a physical experience, but also an emotional one. This framework may support future research that will help to reshape how we understand mobility and better account for the individuals’ motivations towards mobility and how this may change over time.

Thea Franke is a PhD candidate at the University of British Columbia. She is a member of the Active Aging Research Team.

Author’s Note: If this blog piques your interest, please read our hot-off-the-press paper in Qualitative Research in Sport, Exercise and Health:

Franke T, Sim-Gould J, Winters M, Chaudhury H, McKay H. Re-framing Mobility in Older Adults: An Adapted Comprehensive Conceptual Framework. Qualitative Research in Sport, Exercise and Health.

REFERENCES

Tremblay, M. S., Warburton, D. E. R., Janssen, I., Paterson, D. H., Latimer, A.E., Rhodes, R. E., … Duggan, M. (2011). New Canadian physical activity
guidelines. Applied Physiology, Nutrition, and Metabolism, 36(1), 36-46; 47-
58. https://doi.org/10.1139/H11-009

Tudor-Locke, C., Craig, C. L., Aoyagi, Y., Bell, R. C., Croteau, K. A., De Bourdeaudhuij, I., … Blair, S. N. (2011). How many steps/day are enough? For older adults and special populations. International Journal of Behavioural Nutrition and Physical Activity, 8, 80. https://doi.org/10.1186/1479-5868-8-80.

Empowering people to live independent, active and connected lives as they age. Community-based research and evaluation team at University of British Columbia.