Function, mobility, falls and rehabilitation

Function is what turns disease into lived consequence. Mobility, ADLs, falls and rehabilitation potential determine whether recovery plans are meaningful.

Function is central to CGA because it links disease to everyday life. Assessment should cover personal ADLs, instrumental ADLs, transfers, mobility, gait, falls history, fear of falling, equipment and rehabilitation potential. Baseline and current function must be separated.

NICE NG249 (2025) provides the current falls framework. In hospital and residential care, comprehensive falls assessment does not require additional eligibility criteria. Assessment should lead to modifiable actions rather than a generic “falls risk” label.

Rehabilitation goals should be meaningful and measurable. Early mobilisation, strength and balance work, appropriate aids, pain control and environmental modification should be coordinated with the person’s goals and medical stability.

Before admission Mrs Morgan walked outdoors with a stick and wanted to keep tending her small garden. She now needs one-person assistance to transfer. The rehabilitation plan should aim toward meaningful baseline activities, not only an abstract mobility score.

Functional trajectory exercise: baseline ADLs/IADLs versus current function; learner sets two meaningful rehabilitation goals and selects appropriate MDT actions.

• Document baseline as well as current state.
• Use collateral information when history is incomplete.
• Convert every important finding into an action or explicit decision not to act.
• State uncertainty rather than disguising it as a score.
• Name ownership and review whenever the plan crosses teams or settings.

How could rehabilitation goals in your setting become more specific and meaningful to patients?