Apr 25, 2011

A Different Take on Walkers - Alzheimer's and Dementia

The results are astounding. They walk more often than you’ve seen them walk in some time because they feel better, safer, more independent and more EMPOWERED than they did...

A Different Take on Walkers - Alzheimer's and Dementia
This article is not only for older adults who have Alzheimer’s or another dementia, but for all older adults and their caregivers.

While writing this, I realize I have a different take on using walkers than most older adults, and maybe even most caregivers. If you are bound and determined never to have your loved one use a walker, PLEASE STOP READING NOW! There’s no need to aggravate yourself unnecessarily.

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By Carole B. Larkin
Alzheimer's Reading Room

Do you know why many older adults (with and without Alzheimer’s) take little tiny steps, try to walk by keeping their feet underneath them and shuffle their feet, not picking them up off of the ground (Parkinson’s patients exempted here)?

There is one reason: FEAR OF FALLING.

It is the older adult’s attempt to cope with that fear. Note that I didn’t say that it was an effective or particularly useful way to cope with their fear of falling.

In actuality, it’s counterproductive to what they are trying to accomplish, which is of course, to not fall. By keeping their feet close together and taking tiny little steps, they believe that they are keeping their center of gravity in the middle of their body thus keeping themselves in balance. By not picking their feet up very high off of the ground they believe that gives them less chance to misstep and fall.

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Walking with balance is really about weight distribution and the ability to counterbalance the weight distribution in a timely manner. Older people can’t always take the second step fast enough to redistribute the weight displaced when they took the first step. (When you take a step forward your weight shifts to the foot you have put in front of you, the counterbalance is, of course, then moving the opposite foot forward the same distance and putting your weight on that foot) Using little steps means to an older adult that it is easier to move the second leg on time because it is less distance to move it.

In actuality, using tiny steps, gives the older adult a much smaller foundation on which to base their balance. The bigger the foundation the greater the ability to handle uneven weight distribution by forces upon an object. In walking that means taking bigger (longer) steps like a person takes in their younger years. Caregivers: try it. Take tiny little steps trying to keep your feet beneath your body at all times, and then take much longer steps. Which feels more stable to you?

Imagine turning a pyramid upside down. All the weight is at the top (between your shoulders and hips) and you are trying to balance it on the tip of the pyramid. Put a little uneven weight distribution on it; like the force of movement and see what happens. BOOM, SPLAT!

What’s the answer to remaining balanced? It’s simple. Increase the area of the foundation. How? You really can’t increase the speed of an older person’s stride easily, so you must increase the number of legs of the older person to increase their foundation. Using a cane gives the person 1 more leg. Holding on to someone else gives them 2 more legs. Using a walker gives them 4 more legs.

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What’s the greater foundation? Where’s the greater safety? What’s the greater good?

Many times not thought about in this equation by the older adult and sometimes their caregivers, is the fact that with a walker (especially a Rollator type) not only gives the older adult the extra 4 legs for stability (thus over time reducing the fear of falling) it also allows them to get about on their own INDEPENDENTLY.

They are no longer constrained by having to wait for another person to hang on to so that they can go where they want, and accomplish what they need to. With a Rollator type people eventually begin to use larger strides and even walk faster than before because their fear is reduced and they accomplish their goals quicker and with less effort.

For the Rollator type the person must be able to be trained to set the breaks every time they stop the walker. With persistence and continuous cues from the caregiver when the walker first is brought into the household many older adults can be trained to set the break automatically every time.

Those Alzheimer’s patients not too far into the disease can be trained. I have seen it over and over with my own eyes.

The success lies in the caregiver’s hands. If they put the time in to cue their loved one every time the person walks with the Rollator/walker to put on the brakes (It might take a couple of days, or up to a week for the real tough cases.) and to constantly remind the person how safe they feel using the walker, that they can sit down on the seat whenever they are tired and need to rest, that they can carry things with the rollator (on the seat or in the basket if purchased)and how fast they are walking now (in other words praising them).

The results are astounding.

They walk more often than you’ve seen them walk in some time because they feel better, safer, more independent and more EMPOWERED than they did. They get more EXERCISE and all the benefits (cognitively and physically) that come from that.

The older adult’s "NO! I won’t use that” is all about appearances and how it is perceived as being old by everybody. Yet, did you ever notice how common walkers are in assisted livings and nursing homes? It’s because it’s become the new normal in there. A caregiver’s job is to create the new normal outside of those communities by praise and promotion of independence. If they keep at it, and choose to do it, the benefits far surpass the initial resistance.

Try it!
Carole Larkin MA,CMC,CAEd,QDCS,EICS,
is a Geriatric Care Manager who specializes in helping families with Alzheimer’s and related dementias issues. She also trains caregivers in home care companies, assisted livings, memory care communities, and nursing homes in dementia specific techniques for best care of dementia sufferers. ThirdAge Services LLC, is located in Dallas, TX.

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