The ancient Greek tragedy of Oedipus and his wanderings includes the story of the riddle of the Sphinx. This monster with the head of a woman, the upper body of an eagle, and the lower body of a lion, would sit in waiting for travelers outside the city of Thebes. Oedipus wanders in and the Sphinx demands that he answer her riddle. And if he got it wrong, he would be cursed to die.
“What goes on four legs in the morning, two legs in the day, and three legs at night?” Oedipus, apparently smarter than any other traveler, told her it was a man. A baby crawls on arms and legs. A man walks on two feet. An old man hobbles with the aid of a cane, three legs. The Sphinx became so upset that someone had the answer, she committed suicide, making the citizens of Thebes very happy.
When we get to the three leg stage of life, many of us will need that extra device to maintain our independence. If you see your mom or dad struggling to walk, holding onto furniture, and especially having frequent falls, it is time to get a mobility device. But which device is the right one?
The first step in this process may be taking your parents to the doctor for an evaluation, focusing on problems with ADLs. Activities of daily living (ADLs) include basic care actions, such as bathing, toileting, eating, dressing, etc. If your parents are having trouble with these tasks that we do every day, his or her independence may be coming to an end.
1. People with the ability to walk with assistance can use canes or walkers.
The Cane
The simplest device is the cane, which can have either a C or a horizontal handle. The foot is either a single rubber tip or a four legged tip, which provides more stability. The cane should be able to bear 25% of the person’s body weight. Canes are easy to use and are intended for someone with minimal balance problems or with one leg weaker than the other.
The Walker
If your parent has more serious problems with balance and the cane is insufficient, a walker may be needed. The walker can generally support up to 50% of the body weight. The usual walker has two or four immobile feet and must be lifted with each step. Walkers, like canes, require significant strength in the hands, wrists, and arms.
Wheeled walkers, sometimes called rollators, have four or more wheels. They are easy to maneuver and allow a more normal gait. Some types have baskets and/or a seat for resting. But rolling walkers may not be appropriate for people with more severe instability.
2. For those people who are not ambulatory even with a walker, other devices will be necessary.
Manual Wheelchair
If your parent is markedly weak, falls frequently, and has significant balance problems, then you will need something more advanced than a cane or walker. A manual wheelchair is self-propelled with the arms. There are three types: standard (40 pounds), Lightweight (35 pounds), and ultra-lightweight (28 pounds). The only requirement that the insurance company considers is whether the patient can propel the chair.
Power Wheelchair and Scooter
Different types of powered chairs are available and many can be customized to meet the patient’s needs. In order for insurance to pay for the chair, your parents would have to be unable to use a manual chair. Power scooters are also available but only for those individuals who are unable to walk with assistance and who have the upper body strength to sit unsupported. Insurance will only pay for scooters designed for indoor use.
Your parents may need a device to assist with mobility. Picking the right device can make the difference between a nursing home and independence.
