About 93% of people living in residential aged care facilities and half of Australians living with disability use mobility aids (ABS 2017).
Therefore, as a healthcare worker, you are likely to interact with clients using mobility aids. Do you know how to appropriately care for these people and ensure they stay safe?
What Are Mobility Aids?
Mobility aids help to improve the functional capacity of people who have difficulty ambulating through one or more of the following:
Improving balance
Improving walking pattern
Increasing propulsion
Reducing the load on lower limbs
Transmitting sensory cues through the hands
Facilitating upright posture
Allowing the client to access to a variety of environments
Signalling to other people that the person requires special considerations
Improving overall safety during independent mobilisation.
(Musculoskeletal Key 2017; Physiopedia 2020)
Benefits of Mobility Aids
Greater independence
Ability to go about daily life
Ability to participate in the community
Greater quality of life
Increased confidence and self-esteem
Reduced pain and fatigue
Social inclusion
Improved end-of-life care
Reduced falls risk
Reduced risk of hospitalisation
Shorter hospital stays.
(Better Health Channel 2019; Musculoskeletal Key 2017; CECOPS 2014; Leonard 2017; Independent Living Centre 2019)
Who Uses Mobility Aids?
Mobility aids can be helpful for any person with a mobility issue. This includes, but is not limited to:
Mobility Aids Under the Strengthened Aged Care Quality Standards
Standard 4: The Environment - Outcome 4.1b: Environment and equipment in a service environment under the strengthened Aged Care Quality Standards (Action 4.1.3b) requires that equipment used in care and services for older people be safe, clean, well-maintained and appropriate for their needs (ACQSC 2024a).
Additionally, Standard 5: Clinical Care - Outcome 5.4: Comprehensive care (Action 5.4.2) expects that aged care providers identify and provide any equipment, aids, devices and products required by an older person as part of comprehensive clinical assessments (ACQSC 2024b).
Outcome 5.5: Clinical Safety (Action 5.5.10) also requires older people with sensory impairment to be given access to and supported to use assistive devices and aids to improve their independence, function and quality of life (ACQSC 2024b).
Types of Mobility Aids
Mobility aids come in a variety of sizes and styles. The person’s abilities, needs, environment and body shape should always be taken into consideration when choosing a mobility aid (Independent Living Centre 2019).
Larger mobility aids are usually more stable but may decrease walking speed and make it more difficult to access certain environments (CEC 2016a).
Generally, a physiotherapist or occupational therapist will be responsible for prescribing a mobility aid (CEC 2016a). This will be based on an assessment of several factors, including:
Gait
Balance
Cognition
Physiological systems (cardiovascular, musculoskeletal and neurological)
Comorbidities
Daily mobility requirements
Whether the mobility aid is required short term or long term.
(Physiopedia 2020)
The following table lists some of the mobility aids you might encounter when caring for clients:
Crutches, Walking Sticks and Walking Frames
Mobility Aid
Commonly Used for
Benefits
Limitations
Underarm crutches
Acute, short term injuries where the client can only put weight on one leg
Height adjustable
Improve stability
Widen base of support, reducing falls risk
Help to off-load body weight
Cause the client to lean forward, possibly affecting posture
Require good shoulder, arm and hand function
Forearm/elbow crutches
Long term support for clients who can put weight on both legs
Walking sticks/canes
Single-point
Three-point (Tripod)
Four-point (Quad stick)
Providing basic support
Assisting with balance
Decreasing weight on one leg
Range of handle shapes and materials available
Widen base of support (tripods and quad sticks)
Portable and lightweight
Tripods and quad sticks may be a tripping hazard
Quad sticks may slow walking
Only support one side of the body
Can increase falls risk if used incorrectly
Three and four-wheeled walking frames
People who can walk well but require extra support for long distances
Improve stability
Widen base of support, reducing falls risk
Foldable and portable
Height adjustable
Cause the client to lean forward, possibly affecting posture
Require good function of both arms
Two-wheeled walking frames (Rollator frames)
People who can stand with light support but require extra support for walking
People with reduced weight bearing on one leg and require more support than crutches
Best for indoor or short-distance use
Static walking frames
People who require support for standing and walking
Forearm support frames
When maximum weight support is required (e.g. following hip or pelvic fracture)
Clients who are not able to take weight through the wrists or hands
Height adjustable
Lack maneuverability due to larger size
(Independent Living Centre 2019; National Multiple Sclerosis Society 2013; CEC 2016a, c)
Correctly Fitting Crutches, Walking Sticks and Walking Frames
Underarm Crutches
The top axilla pad should be 5 cm under the armpit
The base of the crutch should be 15 cm from the foot
The client's elbows should be at a 15 to 30 degree bend
The handgrip should be at the height of the wrist crease.
Forearm/elbow Crutches
The client's elbows should be at a 15 to 30 degree bend
The handgrip should be at the height of the wrist crease
The forearm cuff height should be set by measuring from a clenched fist to 2.5 cm below the elbow crease.
Walking sticks/canes
The client should stand upright with shoulders relaxed and arms by their sides
The client's elbows should be at a 15 to 30 degree bend
The handle should be at the height of the wrist crease
The base of the stick should be 15 cm from the foot.
Walking frames (Three and four-wheeled, two-wheeled and static)
The client should stand upright with shoulders relaxed and arms by their sides
The client's elbows should be at a 15 to 30 degree bend
The handle should be at the height of the wrist crease.
Forearm support frames
The client's shoulders should be relaxed
There should be a 90 degree bend at elbow
The gutters of the frame should rest under the forearm.
(Independent Living Centre 2019; CEC 2016a, c)
Note: Fitting measurements may vary depending on your organisation. Always refer to your organisation's policies and procedures.
Wheelchairs and Scooters
Mobility Aid
Commonly Used for
Benefits
Limitations
Manual wheelchair
People who are unable to walk functional distances independently, safely or efficiently
Enhances mobility
Decreases falls risk
Can be transported in vehicles
Can be tiring to operate
May be difficult to propel over certain surfaces
Requires wide and accessible spaces
Pushrim-activated power-assist wheelchair (PAPAW)
People who have difficulty propelling a manual wheelchair
Easier to propel over difficult surfaces
Conserves energy
Allows long-distance mobility with less physical effort
Faster than a manual wheelchair
Heavy
Difficult to lift and stow
More difficult to propel if the system is turned off or the battery is not adequately charged
Wider than a manual wheelchair
Power wheelchair
People who have difficulty propelling a manual wheelchair
Easier to propel over difficult surfaces
Conserves energy
Allows long-distance mobility with less physical effort
Easier to manoeuvre indoors than a scooter
Heavy
Can not usually be disassembled
Requires maintenance and repairs
Requires wide and accessible spaces
Motorised scooter
People who have difficulty walking but can sit down and stand up from a chair safely and independently
Conserves energy
Allows long-distance mobility with less physical effort
Can usually be disassembled for stowing
Can be difficult to manoeuvre due to length
Requires good balance
Can be unstable during turns
Requires wide and accessible spaces
(National Multiple Sclerosis Society 2013)
Caring for Clients who use Mobility Aids
The following are some practical tips for ensuring clients who use mobility aids are able to ambulate safely and effectively:
Check client notes for any instructions about mobilisation.
Ensure you know the client’s capacity (i.e. whether they can get out of bed on their own, how far they are able to walk, whether they need assistance).
Always ensure the height and size of the aid are correctly adjusted to suit the client.
Ensure any tripping hazards such as mats and power cords are cleared from walkways. There should be enough unobstructed space for the client to move around safely using their mobility aid.
Ensure the client’s bed is a suitable height and the brakes are on.
Ensure the client’s mobility aid is able to fit through walkways.
Look out for wet or uneven flooring.
Ensure the lockable brakes on the mobility aid are engaged properly.
Check brakes, wheels and rubber tips regularly for damage (protruding or missing screws, split or loose hand grips, worn rubber tips etc.).
Consider the weight and size of the mobility aid when transporting the client.
Ensure the client’s footwear is well-fitting, flat and non-slip.
Ensure the client never uses the mobility aid to pull themselves into a standing position.
Consider administering pain relief (if required) around the time of mobilisation.
Refer the client to a physiotherapist if required.
(Independent Living Centre 2019; CEC 2016b, 2017)
Conclusion
In order to ensure the clients in your care are able to ambulate safely, it is important that you understand and are familiar with the various mobility aids they might be using. This will help you to better understand their needs, be able to support them in a range of daily activities and tasks, and appropriately address any hazards or problems they might encounter while using their mobility aid.
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