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There is no “one size fits all” answer to this question. When it arises all the pertinent factors should be considered, and a decision made based on physical grounds and not on emotion or pride.


Research on the use of walkers can be ambiguous, contradictory, and therefore may not be useful. My comments here are based on experience assisting my wife for four years and eight years living in a large senior community. That means my comments are anecdotal rather than scientific. This notwithstanding, I would not be writing this if I didn’t have strong feelings as a physician and longtime caregiver.

The walkers I will be talking about here have four six-inch wheels, lockable hand brakes, adjustable handles, a seat with storage beneath, and are with or without a basket. They are commonly referred to as rollators. A few people prefer eight-inch wheels especially for outdoor use and uneven surfaces, or simply as a matter of choice. I strongly disapprove of three wheeled walkers because they are notoriously unstable. Since walkers are used mostly indoors on a smooth flat surface I believe six-inch wheels are easier to manage. When any walker is used outside it is best to have a caregiver immediately at hand.

Non-wheeled walkers are less expensive, require the patient to lift and advance the walker, and have no seat. They are used mostly for short term post-operative rehabilitation.

Many people recognize when it is time for them to start using a walker. Others make the decision based on advice given by a professional or insistence of the family. In most cases the outcome is the same. It is unusual for a person to make the decision to use a walker on their own.

Some indications for considering use of a walker are overall weakness, shortness of breath on exertion, and difficulty with balance.

For persons who meet these criteria, using a walker should be the proverbial “no brainer”.  However, a person holding out because of pride or other emotional and psychological reasons may realize the value of a walker only when they are forced by circumstances including the insistence of family or other care giver or even after suffering a fall. In my experience, a person who has a legitimate need for a walker is almost sure to accept it and even be relieved when he or she starts using one. When this happens the peace of mind experienced by the family or care giver is another bonus.

Several tips for using a walker include: 1) handles should be adjusted, usually to the height of the hips, 2) look forward and not down while walking, 3) lock the brakes when sitting down or getting up from a chair and when standing. Failure to do so could result in the walker scooting off and leading to a fall, 4) use your walker for balance and confidence. Do not lean on it excessively for support 5) be sure the brakes are functioning properly. They are operated through a cable connection and these can become loose. Readjusting these is doable but should be done by a professional. The brake cables can reach the point where they are unrepairable signaling it’s time to install new brake cables or purchase a new walker. Any time you purchase a walker it is best to have a prescription from your doctor. This will lower the price you pay.

Two additional recommendations are: 1) seek the advice of a professional who will assist you in the initial use of your new walker and offer advice according to your special needs. 2) It is better to check out a walker too early and decide to wait rather than holding off for reasons of pride or lack of awareness and risk a fall.

 

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