Actions for maintaining the musculoskeletal system and preventing complications will be discussed in Chapter 11. These actions can be summarized by the phrase, “Use it or lose it,” meaning the functioning of the musculoskeletal system declines quickly when it is not being used. Small, everyday activities help maintain flexibility in joints, muscle strength, and healthy bone density. The NA can help residents maintain their musculoskeletal health by encouraging them to do as many activities for themselves as possible.

While it may be faster to perform ADLs for a resident, allowing them to provide care for themselves not only maintains musculoskeletal function but also gives them a sense of control that can enhance their self-esteem and quality of life. Here are ways NAs can encourage residents to participate in their self-cares:

• Allow residents to dress themselves to maintain flexibility in their shoulders, wrists, hips, and knee joints. Using buttons and zippers helps to maintain flexibility in the fingers, as well as promoting hand-eye coordination.
• When toileting a resident, encourage them to walk into the bathroom rather than bringing them in their wheelchair to the toilet or commode.
• Encourage residents to walk to meals (with assistance as needed) rather than being transported by wheelchair.
• Play board games or card games to promote upper body mobility, as well as to stimulate their cognitive status.
• Encourage residents to feed themselves. If they require extensive assistance, offer finger foods they can hold and eat more easily.
• Ask residents to wash their face, brush their teeth, or shave. Prepare the soap and washcloth, toothbrush and toothpaste, or razor, and assist in completing the task as needed.
• If a resident can’t walk, take off the foot pedals from their wheelchair (if it is safe to do so). Encourage them to move their feet while sitting to propel themselves around the facility independently.
• Inform residents of scheduled daily activities and promote movement and social interaction.