Sudden mobility loss or "off legs" in older people

Sudden Mobility Loss or “Off Legs” In Older People

Mobility loss is common as we age, but is typically a gradual decline, or can be attributed to a health condition. However, sudden mobility loss in an older person is concerning. Being able to identify the signs and know when to seek medical help is important. Here, we are exploring the reasons for sudden mobility loss in older people, how this differs from gradual decline, common causes, how to recognise symptoms in a loved one, immediate actions to take, when to seek medical help, how home care services can help, and more.

At Home Instead, our aim is to help people age positively and in place by bringing expert care to their home. For nearly 20 years, we have been providing the highest standard of care, and creating industry-leading training programmes for our Care Professionals that are accredited by nursing and medical professionals. Today, we are the world’s largest global domiciliary care network, supporting over 100,000 older adults with personalised, tailored care at home. So whatever questions you have about mobility loss, we can help.

What are the most common causes of sudden mobility loss in older people?

There are a number of reasons sudden mobility loss could occur, all of which require medical intervention with varying degrees of urgency. Some of the most common causes include: 

Stroke 

Stroke is a life threatening health condition caused by the blood supply to the brain being cut off. This can cause outward symptoms that you can recognise using the F.A.S.T acronym:

F = Facial drooping

A = Arm weakness 

S = Speech difficulties 

T = Time to call 999

A stroke can affect the area of the brain that controls movement and coordination, leading to sudden mobility issues. If you suspect your loved one is having a stroke, this is a medical emergency and you should call 999 immediately (if in the UK). Every second counts with a stroke to ensure the person has the best chance of recovering. 

A Transient Ischemic Attack (TIA) is considered to be a temporary disruption of blood flow to the brain, and can be a precursor to a major stroke. Those who suffer a TIA may experience temporary mobility issues.

Heart Issues

There are a number of reasons why heart issues can impact mobility. Conditions like heart failure, heart attack, heart disease orarrhythmiascan lead to symptoms like fainting, reduced stamina or severe fatigue. These can result in sudden mobility loss due to reduced blood flow to muscles and the brain. In addition, blood clots caused by heart issues could lead to an ischemic stroke, which in itself can cause mobility loss (see above). 

A 2022 study suggested around 60% of those with heart failure also suffer from mobility problems. Any heart issues should be checked by a doctor as early as possible, and a suspected heart attack is a medical emergency that requires you to call 999. 

Infections

Infections can have long-lasting and unexpected effects on the body, particularly for older adults. Severe infections like sepsis, urinary tract infections (UTIs), E. coliand pneumonia can affect the nervous system and cause symptoms such as weakness, dizziness, delirium and balance and coordination problems. All of these can lead to sudden mobility issues. 

Swift identification and treatment of infections is crucial in older adults to prevent further complications, prolonged recovery and increased risk of long-term mobility loss.

Dehydration

Dehydration may not seem like a serious issue, but it can be for older adults. Dehydration or electrolyte imbalance occurs when the body’s fluids are depleted to a level which causes a drop in blood pressure, and can lead to symptoms like muscle weakness, dizziness, delirium, fainting, constipation/bowel issues, and sudden mobility loss. You can learn more in our guide to the symptoms of dehydration in the elderly.

Medication Side Effects 

For some, certain medications cause side effects, and if an older adult has recently begun taking one of these medications they may experience a sudden loss of mobility. 

Medications like sedatives, antipsychotics, antidepressants, muscle relaxants and blood pressure medications can all cause symptoms like dizziness, drowsiness or balance issues, leading to falls. While a medication may not cause mobility loss directly, its side effects could cause this symptom. 

Neurological Issues 

Neurological issues like peripheral neuropathy, Parkinson’s disease, dementia and multiple sclerosis (MS) can cause symptoms that impact mobility. Parkinson’s disease in particular is known to cause sudden episodes where the body freezes, causing temporary and involuntary mobility issues. If an older adult starts to notice loss of function in their legs or other areas, neurological issues could be at play. 

Falls

It is believed the number one mobility issue faced by older people is falls, and these are particularly dangerous. A fall can lead to serious issues like fractured hips, spinal stenosis or severe arthritis flare-ups, all of which can impact mobility. Also, if an older person suffers from a condition like osteoporosis, even minor falls can cause serious breaks. 

Falls can cause injuries like sprains, fractures, dislocated joints and more, so it is important to help older loved ones avoid falls in and out of their home. In addition, falls can have serious psychological and emotional impacts for an older person, even if they experience no injuries. Many older adults may develop a fear of additional falls, leading them to move less, avoid activities they may have previously enjoyed, and develop an increased dependency on others. Sometimes this post-fall anxiety results in sudden loss of mobility, even if there is no physical reason preventing movement. They may be suffering from feelings of embarrassment, shame, or low self-esteem, so gentle encouragement and emotional support from carers and family members may be needed, as well as help from physiotherapists or occupational therapists who can help to rebuild their confidence and prevent further decline. 

Try making home adaptations to minimise risk, arranging assistive devices and bringing in home care to assist with day-to-day tasks that could increase fall risk. You can learn more in our guide on what to do if an elderly person falls.

Other Injuries 

Some other non-life threatening injuries can contribute to sudden loss of mobility, such as a slipped disk or pinched nerve. A slipped disk can cause pain, muscle weakness, and a tingling or burning sensation which leads to a sudden inability to stand or walk. A pinched nerve, or sciatica, can lead to leg weakness, weakness or pain in one side of the body, and sometimes pain in the lower back, hips and/or legs. 

In older adults, these injuries can result from something as simple as sleeping in the wrong position. Although not typically life-threatening, they can be incredibly painful, uncomfortable, and can lead to sudden, sometimes long-lasting mobility issues.

What immediate actions should be taken in the event of sudden mobility loss?

If an older loved one is experiencing sudden mobility loss over several days or hours, it is crucial to seek medical help quickly. You should begin by ensuring their safety. For example, if you suspect they have fallen, make sure they are in a safe place to prevent further injury, and do not encourage them to move. 

Monitor them for things likestroke symptoms(drooping face, slurred speech), cardiac issues like chest pain, or neurological issues like confusion. Many of the symptoms mentioned above can indicate a medical emergency, so if you notice them you should call 999 (UK) and keep your loved one calm and conscious while you wait for help to arrive. 

It is estimated 1 in 4 people over 65 years old experience a fall each year. If your loved one has fallen, you may need to take further steps to ensure their immediate safety and comfort, like checking for a head injury. You can read more in our guide on what to do if an elderly person falls.

Remember, sudden loss of mobility in an older person can be scary for them, so reassure them that they are in safe, capable hands at all times, and when help is on the way. 

If you believe the situation is not an emergency (for example, due to a previously identified pinched nerve) then you may be able to have their GP evaluate them at home. You should arrange this as soon as possible. Although the situation may not be an emergency, the longer an older person is off their feet, the longer it could take them to rebuild the muscle strength to get back to normal activities. Always trust your instincts when faced with mobility loss; if you believe this is unusual for your loved one and could be an emergency, call 999. 

When is it appropriate to call 999 for mobility loss?

Sudden changes in mobility in older adults should always be taken seriously, but as a caregiver or family member, it can be challenging to decide when it’s the right time to call 999 or contact an older loved one’s GP if they are experiencing sudden mobility loss for any number of reasons. 

Call 999 immediately if the person:

• Shows signs of a stroke (i.e. facial drooping, arm weakness, slurred speech – remember F.A.S.T.)
• Experiences chest pain, shortness of breath, or heart palpitations
• Becomes suddenly confused, very drowsy, or unresponsive
• Is unable to move and in significant pain or distress
• Has fallen and cannot get up, or may have injured their back, hip or head
• Has cold, pale, numb or discoloured limbs (especially if only on one side)
• Shows symptoms of sepsis (i.e. a fever, shivering, fast breathing, mottled skin, or extreme weakness)
• Is normally mobile but is now unable to stand, walk, or bear weight at all

If you are ever in doubt, call 999 and allow paramedics to assess the situation and rule out serious causes.

Contact a GP (Urgently, on the same day) if the person:

• Has had a gradual or fluctuating loss of mobility over hours or days
• Seems more tired, unsteady or weak than usual
• Is experiencing a flare-up of a known condition (i.e. arthritis, Parkinson’s, or MS)
• Has a low-grade infection (i.e. urinary symptoms, or a chesty cough) and has experienced mobility loss 
• Recently started a new medication and seems drowsy, dizzy or off balance
• Complains of new leg pain, stiffness or joint issues but is otherwise well
• Is at home after a recent fall or hospital stay and is declining in movement

If needed, the GP may arrange a home visit, urgent review, or refer them to community teams such as district nurses, falls prevention or frailty teams, physiotherapists, or occupational therapists (OTs). 

How can home care services help?

Home care services play a significant role in the support of older adults experiencing mobility loss. This may be sudden or a gradual decline over time, but both will require assistance with everything from transferring in and out of bed to using the bathroom. 

Carers might help older people with:

• Bathing
• Getting dressed
• Cooking and preparing meals 
• Doing gentlehousework and home maintenance 
• Moving regularly to avoid bed sores
• Moving and arranging furniture in the home to prevent falls
• Helping to arrange mobility aids and home adaptations
• Assisting with prescribed activities from doctors, like assisted walks or balance exercises 
• Monitoring their health conditions
• Providing emotional support and companionship to promote wellbeing and manage the difficulties of lacking independence 
• Coordinating visits from specialists like physical therapists
• Providinglive-in supportif their care needs are more demanding and frequent 

Having the support of a dedicated carer like our experienced Care Professionals at Home Instead can make mobility issues manageable for older adults, and can enhance their mental health and wellbeing as a result. Loss of independence is difficult for anyone, so having professional home carers to help with everything from home adaptations to daily personal care needs to arranging outings can enable older adults to recover from mobility loss faster, or help to maintain their current abilities. 

What can families and home carers do to help older people with sudden mobility loss?

A support system is key for older adults experiencing sudden mobility loss, from initial investigations to the recovery process and management of underlying conditions. Making sure your older loved one feels safe and supported will help them to not only remain as independent as possible, but will also help to manage their mental health. 

There may be ways to adapt their home environment to help them overcome physical challenges and encourage independence. For example, moving problematic furniture and clutter, installing grab bars or mobility aids and adjusting the kitchen with assistive devices to make cooking easier are just some of the ways you can help an older loved one feel like they have independence in daily life. 

Monitor their health and any identified conditions contributing to their loss of mobility, and ensure these are improving, not deteriorating. Maintaining communication with their healthcare team can keep you informed on what is needed for their comfort and recovery. Depending on the nature of their condition, it may be beneficial to keep a record of their symptoms and any incidents of sudden mobility loss to help their doctor identify the cause.

If looking after a loved one with mobility loss is becoming difficult around other responsibilities, our highly trained Care Professionals are experienced in helping older adults who struggle with mobility. We provide everything from general companionship and mobility care to more specialised, complex care needs and respite care for families. Whatever support you need, reach out to your local Home Instead office to discuss your options.

We’re an award-winning home care provider and part of a worldwide organisation devoted to providing the highest-quality relationship-led care for older people in their own homes. Arranging care for yourself or your loved one shouldn’t be stressful, so whatever questions you would like answered, feel free to reach out to the Home Instead team to discuss your needs.