It’s not uncommon for older adults to face mobility challenges, particularly if chronic conditions or injuries affect their joint health. In fact, studies suggest that about one-quarter of older adults in the United States experience mobility challenges.
Not being able to stay physically active affects your muscle strength and bone density and may prevent you from getting the social interaction that is associated with mood and memory benefits. It also impacts your personal independence.
If you’re not able to get up and out as often as you would like, you might want to consider mobility aids. Mount Sinai social worker Sheila Barton, LCSW, says that these assistive devices can be key for helping you move about your environment independently.
“Try not to be put off by any fears that using an aid will somehow signal that you are declining,” she urges. “Instead, see them as helpful tools. In choosing to use one, you are being proactive when it comes to helping yourself avoid the deconditioning and social isolation that can result from a sedentary lifestyle.”
Here are Barton’s tips for choosing the mobility aid that best suits your needs and using it safely.
What Are Mobility Aids?
Mobility aids are assistive devices that help people with physical impairments remain mobile. They’re designed for individuals with injuries or disabilities who have difficulty moving around on their own and/or who are at increased risk of falling.
Assistive devices like canes, walkers, wheelchairs, and others help people walk, keep their balance, complete everyday tasks, and, as a result, maintain greater freedom and personal independence.
Types of Mobility Aids
Canes
A cane can be an ideal solution if you find it difficult to walk steadily because of a minor issue with balance, weakness in your legs or trunk, an injury, or pain. But while a cane is the simplest and least expensive walking aid, there is more to purchasing one than you might think. Barton points to another concern, too. “Many older people will opt for a cane because they think that it will make them appear less frail,” she says. “But if they actually need more support than a cane provides, they may become so fearful of falling while using the cane that they end up getting less physical activity.”
If a cane is likely to meet your needs, it is important that your chosen cane “fits” you. “The top of the cane should line up with the crease of your wrist when you’re standing up straight, so that your arm is slightly bent at the elbow when you grip the cane,” Barton advises. “Most canes are adjustable—just make sure that yours adjusts enough.”
If you are likely to use the cane for extended periods of time, you’ll be more comfortable if it has an ergonomically molded rubber or foam grip. It also should have a rubber tip at the bottom to prevent slipping. Think about whether you need the cane to fold when not in use, and check its weight limits, too. “Most wooden and/or aluminum canes can support up to about 250 pounds, but a stronger graphite or fiberglass cane is the best choice for heavier people,” says Barton.
When using your cane, hold it in the hand opposite the side that needs support, so that the cane and your weaker leg contact the ground simultaneously. “When climbing stairs with your cane, lead with your ‘good’ leg, but when descending the stairs, put your cane on the step first and then step down with your weaker leg,” Barton adds.
Walkers and Rollators
Walkers let your arms do some of the load-bearing work and provide more support than canes, so these devices may be a better option if you have a moderately severe balance and/or gait disorder, arthritis in your hips or knees, or generalized weakness in your hips and legs.
Most standard walkers have a weight capacity of 300 pounds and are height adjustable. As with a cane, you’ll need to have your arms slightly bent while using a walker. “Move it forward about one footstep ahead of you, and set it down firmly before you take a step,” Barton says. “Always take small steps, and lead into the walker with your weakest leg.”
If you lack the upper body strength needed to lift the front legs of a walker, opt for a model that has front wheels or choose a rollator. “The latter have three or four wheels, making them a good solution for people who tire easily when walking for longer distances, and for moving about outdoors,” Barton notes. “If you think one of these would be your best option, be sure that you are clear on how to use the brakes.” You also might want to consider models that incorporate a seat so that you can rest if you need to (always engage the brakes when doing so).
If your home is on two levels, it’s worth purchasing two walkers: one for upstairs and one for downstairs. Medicare will help cover the cost of one of them if you meet certain criteria (see the section “Paying for Mobility Aids” for information on Medicare coverage for mobility aids).
Power Wheelchairs
If a power wheelchair is the best option for you, there are several issues you need to consider before choosing one. Size is the main consideration—the wheelchair needs to fit easily through your doorways, and you also need adequate space in which to turn it around to change your direction of travel.
Battery power also is key. Most wheelchair batteries will keep you moving for 10 to 20 hours, depending on your weight. Heavier individuals will get less battery life than lighter people, so if you are on the heavy side, you probably will need a model with a larger battery. This inevitably will mean the wheelchair itself will be fairly heavy—something you need to keep in mind if you intend on using your car to transport it.
If you cannot afford to upgrade to a larger wheelchair-accessible vehicle, you’ll probably need to invest in a hitch-type wheelchair lift that fits to the back of your car. “How you use the wheelchair also impacts battery life,” Barton adds. “If you’re using it on a slope or on grass or rough ground, or executing a lot of turns, this will drain the battery faster than using it on level, smooth ground and traveling in one direction.”
How to Choose the Right Mobility Aids
If you need support to walk steadily, it’s important to discuss your needs with your doctor or a physical therapist with expertise in choosing mobility aids. They will be able to evaluate which assistive device is the best match for your degree of physical function, activity levels, fall risk, and personal independence needs.
“You’re using a device to help you overcome some degree of functional incapacity, but you need certain functional capacities and skills to effectively use some aids,” Barton says. “For example, impaired cognition and vision can make it harder to safely use any mobility aid. You need some degree of knee strength to use a cane, upper body strength is needed to maneuver a standard nonwheeled walker, and you may need a strong grip to operate the brakes on a wheeled walker [rollator] and operate a power wheelchair.”
Paying for Mobility Aids
Medicare Part B provides coverage for medically necessary canes, walkers/rollators, and wheelchairs. Keep in mind that it does not cover mobility scooters (larger, heavier power wheelchairs that are designed to be used outdoors).
“Medically necessary is defined as needing the device to be able to move around and complete the usual activities of daily living within your home, and your doctor will need to provide a prescription or written order to this effect,” Barton says.
Medicare Advantage plans are required to cover the same mobility aids as traditional Medicare, but prior authorization may be needed—be sure to check with your plan provider before purchasing an aid.
After you have used your Part B coverage, you’ll need to wait five years before using it again unless you experience a significant change in your physical function. As an example, you may have been covered for a walker but then need to start using a wheelchair due to a stroke. If this happens, Barton reiterates that it is vital to work with a physical therapist to ensure that you choose the right wheelchair—otherwise you may be stuck using an unsuitable model while you wait for your next Medicare reimbursement five years down the line.
One last thing to keep in mind is that there may be others who can use a wheelchair you have replaced, so don’t toss it if it is in good condition. Instead, donate it to your local senior center so that it can be recycled.
