Walkers and canes can be valuable aids for the elderly, but they also can pose a hazard

(Editor's Note: This is the first in a series of articles on how to make walker and cane use more safe.)

BY JUDITH STROM —
According to a recent Center for Disease Control and Prevention study, canes and walkers are associated with more than 47,000 serious injuries each year among older adults with fractures and bruises being the most common. The study found that 87 percent of fall injuries involved walkers and 12 percent involved canes. Sixty percent of fall injuries occurred at home, while 16 percent occurred at nursing homes.

“It’s important to make sure people use these devices safely,” said Judy A. Stevens, an epidemiologist at the CDC and the study’s lead author. “It gives them greater independence, but at the same time it can be a hazard if not used properly.”

Dr. Stevens said the findings are a call for better training in use of canes and walkers and also better design of the mobility aids. For example, patients may need more time or multiple sessions with a physical therapist or occupational therapist along with proper fitting for a cane or walker, she said.

Just bringing home a cane or walker for an elderly relative to solve a mobility problem should only be the first step. There needs to be training on how to use either device safely and also a check of the residence to remove obstacles, such as extension cords and throw rugs. Walkers and canes need to be adjusted to the right height for an individual; if they aren’t, it can cause seniors to stoop and provide inadequate support that can result in falls and cause.

Since there are many models of walkers and types of canes, it’s also important to match walker and cane to the ability, needs and physical condition of the user.

See a wide selection of walkers and accessories available in the GrayTimes Amazon.com store.

Some hazards stem from the design of this equipment. A walker with no wheels has to be picked up to be moved and the legs can get caught in thick surfaces such as carpeting. Using tennis balls or sliders on the leg ends can make the walker slide easier.

A walker with wheels but no brakes can cause it to slip away from an elderly user. One solution is an attachment that goes on the rear wheels of the walker — a spring loaded mechanism which functions as a brake. When you push down on the walker handles, the rubber tips touch the ground creating enough friction to stop the walker. However, walkers with push down brakes are not ideal for everyone, as people who lean on the walker while walking can inadvertently cause the brakes to come on and bring it to an unexpected halt.

Some wheels are so small they get stuck on such things as the edge of a rug. Or the wheels turn when the person backs up and then won’t go forward.

Rolling walkers (with four wheels) have brakes and can move quickly. But someone who is forgetful might not remember to engage the braking or parking mechanism before using it as a seat or for support. Arthritic hands and wrists may also make squeezing the hand brake difficult. The brakes on rolling walkers should be in easy reach. Brake “extenders” can make the reach easier, but the “squeeze” still might present a problem for some people with hand injuries, arthritis or lack of strength.

One rolling walker model (U-Step Walking Stabilizer) will not move unless you squeeze the hand brake. Lightly squeeze it and the unit moves. Once you release the break, the unit stops. This feature is particularly helpful when standing up from a chair because the unit will not roll away from you. However, this model is much more expensive than traditional walkers at about $575.

Getting and fitting the right cane

The right cane is also important. If help with balance is the main concern, the best choice might be a quad cane (one with four supports) which provides much greater stability because of its multiple points on the ground and has the advantage of being free standing. One disadvantage is that it is heavier.

Whatever walker or cane you buy, be sure that there is training on how to use it.

“How To” slide show

The Mayo Clinic website has a slide show that shows how to choose and use a walker or a cane. My only objection is that they show a walker with wheels but no brakes and I think those types are too likely to slide out from you. The back legs are suppose to prevent the walker from rolling away as you step forward, but if you place too much weight on the front legs with the wheels, the back legs won’t stop the front from moving. Substituting tennis balls or sliders allows the walker to slide but not roll.

(Posted August 14, 2009)