Many older adults use a walker at one point or another as they age. It could be that they use it temporarily, occasionally or at all times. But many seniors and caregivers may not be aware of the downsides of using a walker.
The problems with walkers for the elderly are: that walkers are not appropriate for everyone. If the user has limitations with their upper body strength, if they have dementia / Alzheimer’s, if the environment they are in is small and/or cluttered or if they have limited vision – a walker may prove to be more dangerous than helpful.
(In a recent study released by the Center For Disease Control) Of the falls related to walkers and canes, you may be surprised to learn that most—87% of elderly falls—were attributable to walker use. – VeryWellHealth.com
Walkers can help some people with mobility issues but only if they are used safely. Cognitive, physical and environmental factors can impede the safe use of walkers.
As an Occupational Therapist, I would have to work closely with the Physical Therapist to assess if the patient we both were assigned to was able to comprehend the safety rules when using their walker and if they had the visual perceptual skills to use a walker.
Whether it’s a standard type of walker or a rolling walker – the safety rules and issues are the same.
Living in South Florida for 25+ years (where the elderly population is very high), I can tell you that driving by any grocery story or strip mall, I would often see seniors pulling their walkers or holding them up while they walked or dragging them by their side.
None of these are safe and I’m positive that their Physical Therapist did not instruct them to use that walker in that particular manner!
Problematic Issues With Using A Walker
I mentioned earlier that the main problems with walkers for the elderly can be caused by:
- lack of upper body strength
- the presence of dementia or Alzheimer’s
- if the walker is being used in a small or cluttered environment or crowded areas
- if the user has poor or very limited vision
Any one of these factors present problems for users with walkers but a combination of them makes the situation much worse.
Possible Solutions For These Problems
- Lack of upper body strength – it’s not always easy (or possible) to regain upper body strength when you are older and/or in poor health. But working with a Physical Therapist – your senior loved one may be able to regain enough strength to help them use a walker safely.
Note: rolling or gliding a walker requires less upper body strength. To make a standard walker “glidable” I can recommend adding walker gliding skis like these which work better than cutting and placing tennis balls on the feet of the walker.
- Presence of dementia or Alzheimer’s – if your elderly loved one is showing signs of cognitive decline, my recommendation is to assist them while they use their walker. It can be extremely difficult for someone with these issues to learn new skills.
- Small living environment – if the living environment where the walker will be used is too small to accommodate the width of the walker safely – it may be best to install grab bars / handrails throughout the area. The problems are normally with doorways and hallways.
- Cluttered living environment – as long as you are not dealing with a senior who is also a hoarder – it should be possible to declutter the living area of the home to safely accommodate the use of a walker.
- Crowded areas – when using a walker in outdoor areas, there may be times where avoiding a crowded area is not possible. But if your senior loved one demonstrates poor judgement (which is very common with cognitive decline) and is unable to decide how to avoid pathways that can be problematic – then I recommend that they be assisted by someone in these situations.
- Poor or limited vision – lighting of course is extremely important for anyone who is growing older but especially important for those who have problems with their vision. Making the living environment as bright with light as possible can help some seniors. But for those where their visual skills are too poor to be corrected with proper lighting – I recommend that they be assisted whenever they are using a walker.
Do Walkers Prevent Falls?
The use of a walker can very well prevent falls – but only if they are used properly.
My sweet elderly mom-in-law was hospitalized last year with a severe case of pneumonia and as a result, spent many months recovering from that illness. When she finally returned home, she continued her rehabilitation and used a walker every single day at all times that she was mobile. A year later, she has graduated to a rolling walker and only uses it when she is outside of her condo – which for her is very appropriate.
She feels that her walker helps to keep her from falling (and it does). But she uses it properly at all times. She is extremely careful and cautious as to where she walks, what she steps on and is very aware of her immediate environment – being careful to try to avoid very crowded areas which would make it difficult to maneuver her walker through.
If your senior loved one displays any of the following – I would recommend that if they must use a walker, to do so only with supervision. (That means someone by their side while they are mobile).
- If they are unable to learn how to properly use their mobile device (be it a walker, cane, etc.)
- If they demonstrate poor judgement as to when to use their walker and when not to.
- If they attempt to use their walker under poor conditions (muddy or sandy terrain or crowded areas that could be avoided).
- If they refuse to use the walker at all times (when their Physical Therapist has recommended that they do so).
- If (due to poor vision) they continuously bump into or roll over items with their walker.
Walkers (and any other mobility devices) can certainly help an elderly person from falling but they can just as easily cause the fall as well.
How To Use A Walker Properly
There are 2 types of walkers that we’re going to discuss here.
Using Standard Walkers Properly
Standard walkers have 4 legs and sometimes you will notice that the users have placed tennis balls at the foot of those legs to help the walkers glide a bit smoother.
The steps and instructions on how to use a standard walker are:
- Stand with both feet within the frame of the walker and firmly grip the side grips of the walker.
- Always wear non-skid shoes while walking. A walker can provide you with some stability to stand and walk but it will not prevent you from slipping – so the right shoes are important.
- Depending on your balance and strength, you will either glide your walker forward and then step back into it’s frame OR you will lift the walker and place it about 2 inches forward and then again, step back into it’s frame. It’s important to take small steps while using a walker.
- Step forward with your WEAKER leg first.
- Keep the walker close to you – do not place the walker so far forward from you because it could cause you to lose your balance.
- Never use the walker to pull yourself up from a seated position because it can tilt and cause you to lose your balance.
- Look forward (instead of at your feet) when using the walker.
- Make sure you are using a walker that will support your “leaning weight”. You should never put your full weight on a walker (it’s not meant for that). If you are obese, please use a Bariatric Walker which is meant for individuals that require support for extra weight.
- Have a Physical Therapist adjust the walker so that it is properly set for your height. To set the height:
a) Ask the user to stand comfortable with their arms hanging by their sides.
b) Measure the distance from their wrist to the floor.
c) The grips of the walker should reach their wrists.
- If possible – avoid using a walker over rugs or any surface that can get bunched up or caught on the feet of the walker. Rolling walkers should be able to maneuver over these areas.
- Unlike many rolling walkers – standard walkers do not generally come equipped with walker accessories such as trays. bags or cup holders. I would recommend to add these (if it’s appropriate for your senior loved one). It makes it much easier to place items in an attached bag then to try to use a walker AND carry that item.
Using Rolling Walkers Properly
The steps for using rolling walkers are the same as what I listed above for standard walkers except for:
- You won’t ever be lifting this type of walker when you are walking. It will always be gliding or rolling forward.
- If the rolling walker has a seat, it’s important to put the breaks on first before you turn around to use it as a seat to rest.
Walkers can be a great mobility device for seniors and they do help tremendously – but again – only IF they are used properly. Otherwise, they can very well present a danger and cause great harm to their users.