Mobility Matters

By Caroline Tapp-McDougall

The physical and cognitive changes that occur with aging are often exacerbated by inactivity. A sedentary lifestyle can lead to muscle weakness, joint problems and neurological difficulties that add up to walking discomfort. The result: Unsteadiness when walking, falls that cause bruises and broken bones and, in many elders, fear of straying far from home. Sometimes, a number of minor functional limitations build up to create more serious mobility issues.

Fit, form and function

All of us require tools to enhance and facilitate our passage through the twists and turns of our daily lives. Nowhere is this more evident than for those with mobility restrictions resulting from aging, illness, injury or disability. Purchasing mobility equipment can be a difficult and even overwhelming process, but there are a few small steps you can take to make things easier.

The first thing to do is to assess your elder’s medical needs, and determine how any new equipment will improve their mobility and lifestyle. When choosing a mobility aid, make safety and ease of use your top priorities. It is always wise, also, to ask the advice of health professionals and knowledgeable home healthcare retailers. When you have access to these valuable individuals, don’t be afraid to ask questions!

Prevent trouble in advance—keep your eyes open!

Look out for certain conditions in the home that might cause problems for your loved one, whether or not they are using a mobility aid. These include household hazards, mess and clutter on commonly used routes, slippery or wet floors, loose rugs or scatter mats, poor lighting, thresholds that create an obstacle and unsafe bathrooms.

Selecting the right equipment

In addition to thinking about what equipment might help your loved one physically, you should also consider their current and future needs and goals, budget, availability, type of use (indoor/outdoor) and the length of time the equipment will be needed for. It’s also a good idea to find out about warranties and servicing. And remember, safety should be at the top of the list!

Include the user in decision-making. Ask questions and discuss how, when and where they want to use the equipment. For some, passive indoor use without a lot of transferring and dismantling is acceptable. In my mother’s case, her equipment needed to be easy to fold for when we wanted to take her out of the nursing home. I thought about whether her wheelchair would be suitable in a walkathon, a parade and at a family picnic, and what equipment would have to come along when she stayed for a few days at my brother’s cottage.

Take note of colour and style. Today’s equipment manufacturers offer finishes and accessories that give us choice. Purple walkers and red wheelchairs are for those with a certain taste; more neutral shades suit others. Ask your loved one which they prefer.

One size doesn’t fit all. Make sure the product meets the specific needs of the person who will be using it. Just because something is on sale or available second hand, that doesn’t mean it is right for your parent. Also, make sure the correct adjustments are made to ensure the “best fit” is obtained. (Most equipment allows for some personal adjustments, especially bigger-ticket items.)

Beware of false economy. Price shouldn’t always be the deciding factor. Quality, durability, safety and function are what matter in the long run. Style and brand might also be a consideration for some elders. Look for products and manufacturers with a good history and a sure future. Ask for testimonials and reviews. Remember your teenager—they’ll only use something if they like it.

Buy or rent from a qualified retailer. Finding a reliable equipment supplier is part of your job as a caregiver. In the case of wheelchairs and similar products, it is vital to purchase the device from a qualified, expert dealer who specializes in home and healthcare products. Online doesn’t always work. Most dealers can speak the language of the physician and therapist, but still communicate clearly with you. Look for fast, efficient service and a support network that will make repairs easier.

Loaner/trial or rental equipment is sometimes a good way to get started. Try to arrange a visit from the dealer to your parent’s home or facility. In smaller centres, try to find experts who are willing to travel to you, or ask your local occupational therapist or physiotherapist for a referral.

Ask about delivery timelines. Depending on your location and the product you select, you may find yourself waiting for delivery. Funding approvals and paperwork, rather than a shortage of equipment, often cause delays. Check with the home healthcare dealer and therapist for their advice on speeding up the process.

Should you customize? Customizing isn’t as onerous as it sounds. Sometimes, a few modifications or special combinations can make all the difference. Today’s equipment is generally versatile and adjustable, and experienced home healthcare professionals can often reduce the risk of pressure sores, accidents or discomfort with a few well-thought-through alterations. This is especially important for “high-needs” individuals, where skin integrity issues and deteriorating conditions should place seating and mobility issues top of mind.

Don’t expect immediate enthusiasm. Given human pride, social situations and a fear of losing independence, many elders are reluctant to admit their mobility is decreasing. It’s often a struggle to obtain what the industry calls “compliance.” Many well-intentioned adult children have told me that the brand-new walker they just bought their mother is sitting in the corner of the dining room—untouched.

My advice. Give it time and ask a professional to help your loved one understand the benefits of their new equipment and how to use it. All the nagging in the world won’t get your parent going before they’re good and ready.

Assessing needs

As a rule of thumb, a needs assessment for a wheelchair should consider the following questions.

What is the user’s physical and cognitive ability?
What are the user’s lifestyle requirements?
Is the chair for permanent or temporary use?
Is it for self or assisted mobility?
Do any environmental issues/regulations and limitations need to be taken into account?
What seating and positioning options are available?
What is the seat to floor height?
Will the user’s needs change over time?
Are their any pressure-reduction needs?
What is the user’s eligibility for funding?

Questions to ask

When selecting new equipment for yourself or a loved one, ask the following questions.