Assistive devices for mobility: Recognizing when to employ walkers and canes
Choosing the right mobility aid like a cane or a walker can empower older adults and those with disabilities to maintain their independence and ensure safety during daily activities.
As many of us grow older, chronic conditions can make it harder to move around. The Centers for Disease Control and Prevention (CDC) reports that falls become a significant concern in older age, often leading to serious injuries to muscles and bones.
Assistive devices can be crucial in helping individuals navigate their daily routines and reduce the risk of falls. Canes and walkers are suitable for people with some degree of mobility but are in need of extra support.
A broad comparison of canes and walkers can help you choose the best option:
| Mobility Device | Advantages | Disadvantages | Conditions | Cost ||----------------|------------|---------------|-----------|------|| 1-legged cane | -Aids with balance
-Adjustable | -Provides minimal weight-bearing support
-Some may find the curved handle difficult or painful for joint or muscle conditions | -Mild balance issues
-Mild to moderate arthritis of the lower limbs | $10-$40 || 3-4 legged cane | -More stability than a standard cane
-Carries more weight
-Adjustable | -Heavier
-More cumbersome
-May be difficult to use on stairs | -One-sided muscle weakness (hemiparesis) or more significant balance issues | $15-$40 || Standard walker | -Stable
-Folding | -No wheels
-Needs lifting with each step | -Issues affecting the function of muscles or nerves
-Fractures | $20-$60 || 2/4 wheeled walker | -Easier to move
-May have a seat and basket | -Less stable than standard
-Not foldable | -Issues affecting the spinal cord, conditions that slow down mobility like heart or lung diseases | $35-$100 |
When and how should I choose my mobility aid?
-helps with balance-adjustable
A cane can help those experiencing minor balance or stability issues, weakness in their legs or trunk, or living with an injury or pain from conditions like arthritis. A typical user holds the cane with one hand, depending on the type, it can have one to four legs, with more legs and a wider base offering more stability.
-for minimal weight bearing only-some have a curved handle that some may find difficult to grasp and cause pain, especially for people with joint or muscle conditions
However, walkers are a better fit for those who have more significant balance and mobility issues, especially after total knee or hip replacement surgery. Walkers require the use of both hands, making it possible for users to shift some or all of their body weight while moving. For comfort, a person can add wrist or arm support and various accessories like wheels or brakes.
-mild balance issues-mild to moderate arthritis of the lower limbs
What types of canes and walkers are available?
$10-$40
Standard canes are more suitable for those needing minimal assistance, with wood or aluminum construction, a rubber tip, and either a hook-shaped or flat handle.
Multi-legged canes, known as "sit-to-stand" canes, can be an excellent option for those needing greater support, as they allow for extra help getting up or sitting down through a secondary grip.
-offers greater help with balance than a standard cane-can bear more weight-adjustable
In the case of walkers, there are three primary types:
-heavier-more cumbersome-may be harder to use on stairs
- Standard walkers have four rubber-tipped legs, providing more stability but requiring users to lift the device with each step.
- Two-wheeled walkers offer easier maneuverability, featuring front wheels and backsliders, but are less stable and require more cognitive effort to handle.
- Four-wheeled walkers, or rollators, offer more natural gait and come with features like brakes, a seat, and a basket, but they demand more coordination and can be heavier to maneuver.
-one-sided muscle weakness (hemiparesis) or more significant issues with balance
Each walker type has its advantages and drawbacks, depending on the user's specific needs and abilities.
$15-$40
Is it better to use a walker or cane?
Choosing between a cane and a walker requires considering the individual's needs, abilities, and lifestyle. A cane can help with minor balance problems but necessitates the user's ability to steady themselves if they begin to slip and coordinate the cane with their arm while walking.
-stable-foldable
Walkers, on the other hand, are more appropriate for those with a more significant balance impairment as they enable users to shift some or all of their body weight away from their lower body while moving. As the individual's strength and endurance improves, they can focus on putting more weight on their legs.
-no wheels-needs lifting with each step
When should I switch from a walker to a cane?
-for conditions that affect the function of muscles or nerves or for fractures
Determining whether to switch from a walker to a cane or vice versa is a personal decision that considers the user's physical improvements, their doctor's recommendations, and whether the user's daily routine is better suited to a walker or a cane.
$20-$60
How can I get a cane or a walker?
Certain medical devices like canes and walkers can be purchased directly from suppliers or obtained through clinics, hospitals, insurance companies, or non-profit organizations for older adults or people with disabilities.
-easier to move-may have a seat and basket for comfort
Are canes and walkers covered by Medicare?
-less stable than standard-not foldable
Medicare considers canes and walkers as Durable Medical Equipment (DME), and users can rent or buy a walker or cane through Medicare Part B if the devices are medically necessary and needed for home use. However, the user's doctor must write the prescription, and the device must be purchased from a Medicare-approved supplier.
-issues affecting the spinal cord, conditions that slow down mobility like heart or lung diseases
How do I use a cane and a walker safely?
$35-$100
Safety should always be a priority when using any mobility device. Ensuring the handle is at wrist level with relaxed arms, keeping arms slightly bent, and maintaining an upright posture are all essential when using a cane or a walker safely.
With a cane, the user should hold it with the hand opposite the injured or painful side while walking, place the cane ahead, step forward with the painful or injured leg, and then follow with the other leg. When going upstairs, step up using the stronger leg, hold onto the handrail, and place the cane on the landing. When going down, place the cane down first, place the weaker leg, followed by the stronger one.
Walker users should place the walker ahead, move the injured or painful leg to the middle, and then bring the stronger leg to meet it, taking small, slow steps. The safest way to sit down is to back up to the chair, feel for the seat, and lower yourself slowly. To stand, push up with your arms and grasp the walker's handgrips. It is generally best to avoid using a walker on stairs or escalators.
- A cane can help those with minor balance or stability issues, weakness in their legs or trunk, or living with conditions like arthritis, as it aids with balance and is adjustable.
- For those who have more significant balance and mobility issues, especially after total knee or hip replacement surgery, walkers might be a better fit. These devices provide more stability and require the use of both hands, allowing users to shift some or all of their body weight while moving.
- A broad comparison of canes and walkers can help individuals choose the best option based on their needs, with some canes having one to four legs and walkers offering different types like standard, two-wheeled, and four-wheeled options.
- Seniors with conditions that affect the function of their muscles or nerves, or those with fractures, may benefit from the use of a walker, providing more assistance than a cane.
- Balance and health-and-wellness through proper nutrition, fitness-and-exercise, and senior health are important factors in maintaining independence and managing chronic diseases and medical-conditions that can arise with aging.
