The right support
Walking aids are great for a senior to gain independence. However, improper use of them can cause him to fall and injure himself. Here are some things to keep in mind when looking for a walking aid.
BY: Eleanor Yap
Not many seniors are aware of this but they may be using their walking aids incorrectly. According to The New York Times article, a US study published in the Journal of American Geriatrics found that about 47,000 older Americans are treated in emergency rooms each year from falls associated with walkers (these are U-shaped, with two legs on each side) and canes/walking sticks. The study found that 87 percent of fall injuries were associated with walkers and 12 percent involved canes/walking sticks. Said the study’s lead author, Judy A Stevens, “It’s important to make sure people use these devices safely. It gives them greater independence, but at the same time it can be a hazard if not used properly.”
Bad height & wrong side
In the local context and in speaking to two geriatricians in private practice, they confirmed that injuries such as fractures, bruises and abrasions associated with the falls are commonly found at their clinics. Keep in mind, not all walking aids are the same, they come in many different shapes and sizes. Dr KM Chan of Chan KM Geriatric & Medical Clinic said he has noticed people using their walking aids on the wrong side. The walking sticks/canes should always be used on the hand opposite to the afflicted limb and not the same side.
He said, “For those using a quad stick or the stick with four legs, if you use it on the wrong side, it can cause the person to trip on the legs.” Also, Dr Chan added the height of the cane is sometimes wrong. “If too short, they tend to bend down really low, causing backache. If too tall, it causes them to constantly lean backwards and risk falling backwards.” So how do you choose the right height? On the side of your wrist and an inch above the base of the thumb joint, you will find a sharp bit of a bone. Stand in your natural position with your arms by your sides, wearing the shoes that you normally would walk in. The distance between the sharp bone and the ground is the correct height for any walking cane/stick.
Dr Sitoh Yih Yiow of Age-Link Specialist Clinic for Older Persons said to pay special attention to the handle of the single-point walking stick and quad stick. “The handle should generally be at the crease of the wrist with the arms hanging down by the side.” And when choosing a walking aid, be sure to try the aid and don’t go by looks alone. Make sure that your entire palm and hand rests comfortably on the handle.
Umbrellas as a substitute
And what about the common sight of using umbrellas or umbrellas-cum-walking sticks as substitutes of the real thing? Dr Sitoh said, “Many people choose to use umbrellas in lieu of sticks because they are embarrassed about being seen with walking aids. This is not ideal as standard umbrellas are not built to withstand the weight of the person and may break.” Dr Chan added that umbrellas also have pointed metallic tips, which tend to be slippery, causing possible injury to the user.
Noted Dr Sitoh, “Walking stick-umbrellas are a fair substitute but they become problematic when it rains. If older persons are adamant about using umbrellas, they should choose the larger, sturdier ones that have the tip fitted with a rubber stopper.” And be sure to check the rubber regularly as it can wear out and not provide a good grip, advised Dr Chan.
Now that we have passed what to use and not use, having a walking aid is only good if you know how to use it properly. Here’s how to get the most out of your walking aid. Dr Chan said: “When using a cane, say you have a weakened right hip or knee, hold the cane with your left hand. When you place your right leg out, swing the cane out with the leg. When placing pressure on the right leg, also place pressure on the cane with the left hand. This would reduce pressure over the weakened side and increase stability because of a wider support base.”
And what about when it comes to stairs? He advised: “Walking up and down stairs is slightly more tricky. Remember that ‘good goes up to heaven’ and ‘bad goes down to hell’. While holding onto the rail with one hand, advance the stronger leg first placing it on the step above where you are standing. After this, the unaffected leg is appropriately placed on the step, advance the weaker leg up to the same step that the stronger leg is on. If there is no rail to hold onto, the cane is placed on the upper step at the same time or after placement of the weaker leg.” Other important advice: Keep your walking stick clean and in good condition and do remember when outside, wear shoes that have non-slip soles to prevent slippage. Now you can go out with peace of mind and enjoy your independence safely!
** Special thanks to Dr KM Chan and Dr Sitoh Yih Yiow for vetting this article.