Getting a Parent to Use a Cane or Walker

Transcript of Interview: “Getting a Parent to Use a Cane or Walker”

Kim Barnes: If you have a parent that you feel is a little wobbly and might benefit from using a walker or a cane, but they’re a little resistant, we’re bringing in Alison Starkey today, who is a physical therapist. She’s the CEO of Gaitway of Charlotte, North Carolina. Thanks so much for being with us.

Alison Starkey, PT: Thanks, Kim, for the invitation. Glad to be here.

Kim Barnes: I know personally, I would feel much better if my mom was using a walker just to give her some stability, and she’s not really that keen on the idea. What do we do if we have parents who we feel could benefit from that, and maybe are just resistant to it?

Alison Starkey, PT: Well, the problem with canes and walkers is that only old people use them. So when you have an active adult as a parent, there is always going to be a lot of resistance—“I don’t need it. I’m fine. I don’t know what you’re talking about.” If you see your parent having some balance issues, and very often what we’ll see is that someone will kind of cruise around furniture. They’ll get up from their chair, take a little longer standing up, and then grab a hold of the furniture as they go by. Certainly in the kitchen, they’ll grab a hold of the counter while they’re doing something else, just to stabilize themselves. That’s a sure sign that someone is having a balance problem or is not confident standing.

If you can get them to their doctor, the doctor can refer them to a physical therapist for a fall evaluation. I think that’s the best way because it’s always better coming from someone else rather than their child. Essentially, parents can be very resistant to recommendations from their children. Just so you know, my parents too—and I’ve been doing this for a very long time—so yes, having an independent person share that information is an easy way to get out of it. I would highly recommend that you go that route.

If you feel like your parent might be open to it, certainly there are different types of canes. I think the ones you get in the hospital are a little clinical-looking, if you will, and there are some nicer canes out there. There are a number that have a little wobbly foot on the bottom, which is great if you’re going on uneven ground. Another thing I tell seniors is that if you have a cane and you’re in a public place, like at the mall, people subconsciously give you more room so nobody’s going to run by you and knock you over. Just carrying a cane out in public is always a good idea if you’re not so steady.

Kim Barnes: Gotcha. Right, because somebody’s gonna give a kind of warning area around you, if you will. I hadn’t thought of it that way.

Alison Starkey, PT: If you see somebody with crutches or a cane at the mall, everybody just immediately gives them extra space, subconsciously. It’s not even something you think about.

Kim Barnes: Is there any reason why you would want somebody not to use a cane or a walker? I would imagine that once you start using it, you become a bit more dependent on it. So you’d want to continue. Is there any reason why you wouldn’t want an older adult using a cane or a walker?

Alison Starkey, PT: There are very few instances where we wouldn’t recommend it. The thing with a cane is that if somebody really needs a walker and they’re trying to use a cane, it might actually make the situation deteriorate. As far as being dependent on it, that’s certainly not our experience. If you have someone that’s sitting down a lot because they’re scared of getting up and walking or they’re scared of falling, they’ll actually be able to do an awful lot more with the appropriate device, and they’ll gain strength because they’ll be more confident getting up and moving throughout the day.

There are a couple of instances where I don’t feel it’s appropriate. If you have someone with mild to moderate dementia, learning a new task may actually be quite difficult. If in the house you have a number of rugs or changes in flooring—like from hardwood to carpet or tile—or if you have higher thresholds that you need to lift the walker or cane over, people with moderate dementia may not have the capacity to learn how to do that. They end up carrying the walker, and the walker becomes a hazard in itself. Again, very important to have a physical therapist evaluate the situation, check that they’re safe with the device, ensure that the device is safe and the right type, and make sure it’s set at the correct height. It’s very important to get that prescription from a physical therapist.

Kim Barnes: Okay, and that’s something that you can do through their primary care doctor?

Alison Starkey, PT: Absolutely.

Kim Barnes: How do you have those conversations? As you mentioned, many independent people, my mom included, think, “Oh, I’m fine.” But it makes me really nervous sometimes. I know she’s not getting around in the way that she could. Are there any things that we can say to them that might help them feel like it’s okay? I do feel like where my mom lives—in independent living—there are a lot of people with walkers, so maybe the stigma is lessened. It allows you to get out and do things and feel more confident. What are those things we can potentially say that might help get their attention and make them more open to it, besides it coming from the doctor?

Alison Starkey, PT: With walkers, there’s a lot of variety on the market. There are a number of walkers that have integrated baskets. If you have someone who likes to carry their purse around the house, or likes to take tea from the kitchen to the living room, having something that can carry items while they push it—especially if they’re a little unsteady—could be appealing. They come in different colors, so you can choose a favorite color or maybe your favorite football team’s color. There are ways to ease people into the thought of it.

Another thing I recommend is to try it out in open spaces. For example, if you go for a walk in the mall, ask them to try it there and see how it feels. Very often, you’ll see people in the grocery store who really need a walker, but they’re very happy to push the grocery cart. If it’s easier for you to walk and push the grocery cart, then maybe you would benefit from a device.

Kim Barnes: Gotcha. So I think the idea is for us as adult children to keep our eyes open for some of the signs you mentioned, like cruising on the furniture or relying on the grocery cart, and then think about whether this is a conversation we can bring up or if we should get the primary care doctor involved so that we can bring in a physical therapist to help figure out the best next steps.

Alison Starkey, PT: Yeah, absolutely. In some states, physical therapy doesn’t require a doctor’s prescription, and you can pursue that directly. In others, you do need a prescription. Just important to Google that for your particular area. I think that would be helpful.

Kim Barnes: And I think approaching it from the standpoint that this, in some ways, allows extra independence.

Alison Starkey, PT: Yes, absolutely. You’re going to be able to do so much more, go see your friends, go out for lunch, and all those sorts of things—and be safe. Also, if they have a friend that’s using a cane or a walker, point out that you’ve never criticized the friend. Surely, it’s okay. Again, just really using that: “I want you to be safe. The last thing I want is for you to have a fall and end up injured.”

Kim Barnes: Yes, it’s figuring out what will appeal to them and what will hopefully get them to take action. Everyone’s different, and you know your relationship with your parents.

Alison Starkey, PT: Exactly.

Kim Barnes: Thanks for sharing some tips on ways that we can potentially approach this subject and help keep our parents as safe as possible.

Alison Starkey, PT: Thanks, Kim. I just wanted to say one more thing. It’s Physical Therapy Month this month, and we’re celebrating physical therapy across the country. So happy Physical Therapy Month, and thank you for the opportunity.

Kim Barnes: All right. If you have any other topics you’d like us to discuss, let us know. Parenting Aging Parents.

*This transcript is auto-generated. Please excuse any typos or mistakes.