Most of us take walking for granted. But there's a good chance that at some point in your life you'll have trouble walking. The cause may be an injury, an illness, or recovery from surgery, but you're likely to need a cane, a walker, or some other mobility aid.
These aids often provide support for people who are on the mend from surgery or an injury. Other walking problems stem from impaired balance - often because of neurological disorders such as a stroke or neuromuscular ailments such as multiple sclerosis. Those people must look for walking aids that help them keep their balance.
None of us is happy to learn that we need a mobility aid. We see canes and walkers as a badge of advancing years and frailty, and many of us go to great lengths to resist using them.
But vanity can carry a lot of risk. Avoiding the use of a mobility aid can result in a fall. And since our bones become more fragile as we age, a fall can do serious damage.
Still, you can postpone or avoid the need for a walking aid by staying in good shape and bearing in mind that you are neither as limber nor as agile as you used to be. Regular exercise can help offset the risks caused by slower reflexes and failing balance, but you must still avoid pitfalls. Try to get rid of the hazards in your home that can lead to falls, and watch for other hazards wherever you walk.
Each type of mobility aid has its pros and cons.
Canes are useful for someone with minor problems with balance, instability, injury, pain, and/or weakness in a leg or trunk. The top of the cane should be high enough to reach the crease in your wrist when you're standing. When you hold the cane, your elbow should be able to bend a little. You should hold the cane in your right hand if your left side needs support, and in your left hand if your right side needs support. A single prong cane suits a person who has good balance. If your strength, balance, or coordination is poor, you may benefit from a cane with a wide base and three or four prongs.
You can use a cane to decrease weight on a leg, but you'll still put some weight on it. If you use a cane because of weakness on one side or both sides, experiment until you learn how to hold the cane for the best support.
Make sure your cane has a rubber base. Other options include a loop on the handle to provide more stability, and a fold-down, ice-gripping prong or base.
You usually use crutches when you need to keep your weight off a leg or foot, such as when you're recovering from a lower-body injury or operation. Crutches require upper-body strength and a strong sense of balance, so they may not work well for many older adults. To determine the correct fit, the top of your crutches should be high enough to come within 1 to 1-1/2 inches of your armpits when you are standing. The handgrips should line up with the level of your hips, and your elbows should be bent some when you use the crutches. Your hands on the handgrips should take your weight, not your armpits on the tops of the crutches.
If you need more help with balance and walking than you can get with crutches or a cane, you may need a walker. Walkers are helpful for people with balance problems. They support both arms at a fixed distance apart. Walkers provide a resting point for people who tire easily while walking or for those rebuilding their walking skills. They provide more stability than crutches.
Walkers come in a wide range of heights and weights, with a variety of handle styles. You can choose among several features, including materials, size (most have adjustable legs), and base (some have wheels, some have rubber tips only). The most stable model has four solid prongs on the bottom. For travel, choose a collapsible model that folds flat. Select handles that provide a good grip but that don't tire your hands. When sizing a walker, the top should be at the same level as the crease in your wrist when you stand.
Wheelchairs are really armchairs on wheels. They can be prescribed for temporary use or for people who are unlikely to walk again. They are designed for people with impaired mobility and diminished strength.
Modern wheelchairs have hollow metal tubes, solid seats, and detachable side arm supports. In portable wheelchairs, the seat is made to fold and the unit can collapse to fit in a car trunk. More sophisticated types include hand-propelled three wheelers, battery-driven wheelchairs, and even stair-climbing wheelchairs.
When choosing a wheelchair, the critical factor is that it is comfortable. A chair that doesn't fit correctly can cause bruises, pressure ulcers, and other problems. Talk with your health care provider or occupational therapist for recommendations.