Care and mobility considerations
People in remission, people with mild disease and those whose exacerbations respond quickly to medication are unlikely to have any long term functional restrictions affecting their ability to walk or provide self care.
Some people with disease of moderate severity may be restricted in their ability to stand, bend/kneel and walk around due to abdominal pain and the effects of complications such as fistulas. These individuals are likely to be taking more potent drugs, have frequent exacerbations of abdominal pain and diarrhoea and be attending hospital regularly. Some may need help with dressings and treatments from nurses. They may be restricted in their ability to self-care, including preparation of meals if symptoms last for some months or fail to respond to standard drug regimes. It is unlikely however that walking would be severely restricted since lower limb function is normal. Anxiety and concern about diarrhoea and needing to locate a toilet when out are not considered to be an indication that guidance or supervision are necessary.
People with the most severe disease are constitutionally unwell, have low body weight, evidence of malnutrition, decreased muscle bulk and persistent pain. These individuals have progressive disease with complications that have failed to respond to both medical treatments and surgery. They are likely to need help with self care and some will have considerable restriction in walking.
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Amended April 2008
