Date Presented 4/20/2018
Community-dwelling older adults who use walkers were surveyed about their effect on safety and participation. Most walkers were obtained by family or friends. Walkers increased feelings of safety and aided participation in community activities; barriers were weight and bulkiness.
Primary Author and Speaker: Deborah Bolding
PURPOSE AND BACKGROUND: This study explored the perceptions of older adults about how walker use affects safety and participation in the home and community. One out of six older adults uses a mobility aid, and as the number of older adults increases, the use of mobility aids is projected to become more prevalent (West et al., 2015). Although walkers assist with gait problems caused by pain, weakness, endurance, and balance, they may pose problems when incorrectly fitted to the individual, if there is inadequate training for use, when it is too heavy or an incorrect device is used in the home or community settings, or if there are environmental barriers. The walker may then become a barrier to participation (Lam & Wong, 2009).
METHOD: For this survey study, a convenience sample of older adults was recruited from senior centers and independent living apartments for families and older adults. Respondents were aged 65+, had used a walker for ≥3 mo, and were able to read and write in English. The survey was developed for this study and was reviewed by two expert therapists working with older adults in fall prevention and safety. Questions included participants’ type of walker (or other mobility aids), reasons for use, how the walker was obtained, and ability to get the walker in and out of cars and public transportation. After piloting, the survey was revised for clarity. Surveys were administered over a 2-yr period and analyzed descriptively.
RESULTS: The initial phase had 63 respondents (81% female; M age = 85). Types of walkers used were four-wheeled walker (80%), two-wheeled walker (15%), and three-wheeled walker (3%). Distance routinely walked was 6+ blocks (18%), 1–6 blocks (66%), and <1 block (16%). The primary reasons for using a walker were pain (37%) and weakness (36%). Walkers were selected by family or friends for 50% of respondents and by 29% of respondents themselves; only 21% reported help from a health professional to choose the walker.
Regarding safety, respondents agreed that walkers helped them feel safer when walking in the home (70%), on sidewalks (87%), and in stores or theaters (75%). Respondents agreed that walkers helped them participate in activities in the home (55%), when walking around the neighborhood (78%), and in stores or theaters (80%). Barriers to using walkers were weight and bulkiness; 58% of respondents were unable to lift the walker in and out of a car, and 13% needed help getting the walker on and off a bus.
CONCLUSION: This exploratory study highlights gaps in education for older adults and families about walker selection and fitting and use of mobility devices; 80% of respondents obtained their walkers by direct purchase or from family or friends without the advice of a health professional. Additional research is needed about ways older adults can be aided by their equipment to participate in home and community activities, particularly with lifting walkers in and out of cars or using public transportation.
IMPACT STATEMENT: These findings demonstrate the need for occupational therapy practitioners and other health professionals to evaluate older adults’ functional mobility to determine whether devices are being used optimally for participation and safety in home or community-based activities.
References
Lam, R., & Wong, A. (2009). Canes and walkers: A practical guide to prescribing. Geriatrics and Aging, 12, 264–266.
West, B. A., Bhat, G., Stevens, J., & Bergen, G. (2015). Assistive device use and mobility-related factors among adults aged ≥ 65 years. Journal of Safety Research, 55, 147–150. https://doi.org/10.1016/j.jsr.2015.08.010
