Most of us would like to live a life without mobility aids, but as we age, we begin to realize that this wish can be unrealistic. We might need a cane or a walking aid for a short time while recovering from surgery, or we may eventually need to use a wheelchair, a walker, or a scooter to move around safely. In any case, a mobility aid that helps us get from place to place and avoid falls can mean the difference between an independent life and relying on others for our basic needs.
"When I see some of the newer mobility aids on the market, I immediately think: 'I wish this had been available for my mother.' My mother's options back then were a simple cane and later a rollator that I modified as best as I could so she could carry things with her. However, with the growing number of new devices and models, the confusion about which device is best suited and whether insurance will cover it is also increasing."
Expert advice is crucial.
"Too often, a well-meaning friend or relative buys a used cane or walker for a loved one, without realizing that one size does not fit all. The wrong device can negatively affect a senior's stability, cause posture problems, and even lead to pain. Mobility aids come in all shapes and sizes, so selecting the right equipment and achieving a proper fit usually requires the support and expertise of a professional."
"Nancy Froslie, certified Assistive Technology Professional and District Operations Manager for Sanford HealthCare Accessories in Fargo, North Dakota, says that the first step in selecting a mobility aid is to schedule a doctor's appointment. 'The doctor should conduct a physical examination and discuss any difficulties the senior has in managing activities of daily living at home,' she says."
"From there, the doctor can issue a referral to an occupational therapist or physiotherapist, especially for higher-quality and customizable devices. 'The therapist will conduct a one-time mobility assessment to evaluate gait and balance and perform muscle and strength tests,' explains Froslie. 'He will also have the patient try out different types of devices to document what is effective and what is not.'"
"At these appointments, a specialist in assistive devices from a medical equipment supplier is often present. It is not only important to choose the right type of walking aid, but also to ensure that the user is suitable for the device and is trained by a professional in its proper use. A certified Assistive Technology Professional (ATP) is someone who is trained to recognize the needs of people with disabilities, recommend appropriate technologies and devices to enable them to live independently, and provide instructions for the use of these assistive devices. "Assistive technology professionals like me help determine which devices best meet the needs of a senior, both medically and in terms of setting up their home," notes Froslie.
To find a mobility aid for a loved one, read the detailed list of common aids and how they are typically prescribed. Keep in mind that while some seniors may be able to purchase simpler aids like a cane or a walker without the help of a doctor, the fit may not be ideal and you may end up paying out of pocket for these items.
Mobility aids for ambulatory seniors
Walking sticks
Walking sticks provide seniors with an additional support point for more safety and stability. As a rule of thumb, a stick can support up to 25 percent of a person's body weight. It is best suited for individuals whose sense of balance is only slightly impaired or for those who have one leg that is significantly weaker than the other.
Sticks require moderate hand and arm strength and are available either with a hook ("C" stick) or a horizontal grip (functional grip stick). The horizontal grip is recommended for people with hand weakness, as it provides a secure grip and a larger surface area for the hand. The tip of a stick can consist of a single contact point or a four-foot base made up of four separate feet. The additional feet provide more stability, and the bases are available in various sizes. A four-foot stick can stand upright when not in use, but these models are generally somewhat heavier than conventional designs.
To choose the right length for a pole, the user should stand upright, wear shoes, and keep their arms at their sides. The tip of the pole should reach the crease at the base of the wrist, and the elbow should be bent 15 to 20 degrees when the pole is held while standing. An adjustable pole is a good choice for adapting to different types of shoes.
frame
A walking frame may be the next option when a walking stick cannot provide sufficient support. The use of a walking frame also requires moderate hand and arm strength, and depending on the design of the walking frame, it can support up to 50 percent of a senior's body weight. A standard model has two or four fixed legs and must be lifted and maneuvered with each step. This standard model is best suited for individuals with significant stability issues.
Rollators
Walking aids with wheels, also known as rollators, come in many varieties with three to four wheels and are generally easier to maneuver. Most models can be folded for easy storage, and some feature lockable hand brakes for added safety, a bench for resting, or a basket for transporting personal items. Rollators are typically made of lightweight materials like aluminum and resemble walking with a shopping cart. Compared to regular walking frames, rollators allow for a more natural gait and the ability to move with less fatigue. However, rollators may not provide sufficient stability for seniors with significant posture and balance issues.
The correct height of a walking frame or a walker is measured from the floor to the wrist, and the elbows should be bent in a range of 15 to 20 degrees. Ensure that the walking aid is large enough to encompass the user on three sides, so that they can use the device for both frontal and lateral support.
Mobility aids for seniors who can no longer walk
E-Scooter
An E-Scooter can be helpful for seniors who have a certain amount of arm strength and dexterity but are unable to walk long distances. However, the user must be able to sit upright for an extended period and operate the throttle of the scooter. Not everyone (especially those with arthritis) is able to keep their arms extended in front of them to control speed, steering, and braking. Some individuals may experience pain while doing this, depending on their diagnosis.
Scooters come in many different variations, including three- or four-wheeled models, those designed for indoor, outdoor, or both use, heavy-duty models designed for rough outdoor terrain and carrying heavy loads, and lightweight travel models.
Although a wide range of scooters for various purposes is available on the market, health insurance companies only cover durable medical equipment that is needed in a senior's home. Equipment intended for outdoor use or long distances is not covered. For example, Medicare Part B requires a personal examination by a doctor, whose prescription and notes must show that an electric scooter is medically necessary for the senior to remain mobile in their home. For most people, this is not the case.
Manual wheelchairs
Excessive fatigue, insecurity, difficulty getting up from a chair, and occasional falls are signs that a cane or walking aid may not provide sufficient support. If your loved one is unable to sit upright or lacks the arm strength or dexterity to operate a scooter, a wheelchair may be the best option to help them remain independent and participate in activities they enjoy.
There are three basic types of manual wheelchairs: standard, lightweight, and ultra-lightweight wheelchairs. A standard wheelchair is exactly what you see in the hospital. It is very simple and does not offer many adjustment options. The size, weight, and hip measurements of the person are used to determine what size is needed. The biggest disadvantage is that these models weigh about 40 pounds, so it is important that a caregiver or family member is able to assist with transporting the wheelchair for use outside the home.
Lightweight wheelchairs weigh about 15 kg.
"Insurance companies only cover the costs for a lightweight wheelchair if the person is unable to move a standard model by themselves. The ability of the spouse or caregiver to lift the device in and out of a car does not play a role in the insurance company's decision. Both the insurance coverage and the need are based solely on the person using the device."
Ultralight models are typically used by individuals who have suffered a spinal cord injury. They weigh approximately 12 kg or less. Here, it must also be medically proven that the person is unable to operate a standard or lightweight wheelchair independently for the insurance to cover this device. Ultra-lightweight wheelchairs are great because they can be customized to the individual. Body measurements are taken, and the chair is manufactured by the manufacturer according to these specifications. Different types of armrests, wheels, and colors can also be selected to support self-propulsion.
Electric wheelchairs
When selecting an electric wheelchair, you need to familiarize yourself with terms that are typically associated with buying a car, such as front-wheel drive and independent suspension. Each type of system has its advantages, and you must weigh the medical prescription against insurance coverage, budget constraints, and personal preferences to determine the best electric wheelchair for your loved one's needs.
These devices come in a variety of brands, models, and sizes. They typically have a smaller footprint for better maneuverability and are suitable for use both indoors and outdoors. A person's diagnosis determines the type of wheelchair that insurance may cover. Individuals with a progressive disease, such as multiple sclerosis, muscular dystrophy, or ALS, are entitled to an electric wheelchair that can be tailored to their individual needs as the disease progresses. Only individuals who are unable to walk or use a manual wheelchair are eligible for a standard electric wheelchair.
Costs and insurance coverage for mobility aids
"It may be tempting to buy a mobility aid online or at a local pharmacy or resale shop, but keep in mind that the experts in these matters are extremely knowledgeable. They will not only be able to recommend the best device and customize it for your loved one, but they will also be able to explain how to use it and help ensure that it is covered by insurance. 'No matter what type of devices you need, there is always a lot of paperwork for the insurance companies to determine whether they will cover durable medical equipment,' Froslie mentions."
"Keep in mind that most companies only cover the basic equipment, but some additional features and accessories can be added and paid for out of pocket. This not only keeps costs low but also ensures that seniors are not reliant on devices that provide more support than necessary. For example, choosing an electric scooter or wheelchair before it is truly needed can permanently affect a senior's mobility, activity level, and overall health."
"Taking steps to improve the safety and mobility of a senior is a turning point for many families. Just make sure to consult with a professional to find out what works best for your loved one's situation, what is covered by insurance, and what "frills" you can afford to enhance the functionality of a mobility aid."
