Question: Dad’s afraid to get out and hit the streets now that he’s got a walker. I’m not sure if he feels embarrassed (he’s a very proud man) or afraid. How can I help assuage his hesitation and get him moving again?
Answer: Your question, concern and eagerness to find a solution are valid as this situation is complex and common. What your dad is experiencing is a very real social phenomenon and the best we can do is try to understand his vantage point objectively before pushing him to move.
First, let’s understand the commonality of walker use and then the emotional experience that comes with it. Learning these crucial aspects of mobility device use from scientific literature may bring more clarity and understanding to you and your dad, so let’s jump in!
Walkers are the most common mobility device in the US
In 2011 within the United States, approximately 6.8 million adults over 65 years old used mobility devices, with the numbers continuing to grow today. Walkers are the most commonly adopted mobility device and are used to assist with stability, mobility and fall prevention. The purpose of using a walker is to carry out more activities independently when baseline mobility has decreased. It may be the difference between being confined in the home or engaging within the community.
Research has gathered that most users welcome the increased security, mobility and independence a walker provides; however, it has also been reported that some users find them complicated, cumbersome and embarrassing. Although walkers are intended to keep users mobile and independent, some users may not initially recognize this benefit.
Most users welcome the increased security, mobility and independence a walker provides; however, some users find them complicated, cumbersome and embarrassing.
Understanding the experience and meaning behind realizing the need for assistance with a walker
The perceptions of using a mobility device have related to the shame of older age, often prompting an older adult to refuse to use an aid like a walker. Many older adults perceive the use of a walker as a sign of aging, increased disability and a significant loss of independence.
One study found the first device was the hardest to accept, as the participants realized that they were getting older. The image of the device itself was not the source of anxiety, but rather it was the self-recognition of becoming less physically able. It has been revealed that the decision to use a walker often follows a severe event (e.g., illness, fall, hospitalization) that forces an older adult to accept their vulnerability.
One study found the first [mobility] device was the hardest to accept, as the participants realized that they were getting older.
The experience of recognizing a walker as a permanent solution has been expressed as an initially distressing experience and may be viewed as a definitive sign of getting old by some. Adopting a walker means learning new skills, forming new habits and integrating a new body profile, which may be initially overwhelming. Pride is also a common problem among older adults who use publicly visible aids, in which feelings of embarrassment manifest as a definite sign of weakness.
Pride is also a common problem among older adults who use publicly visible aids, in which feelings of embarrassment manifest as a definite sign of weakness.
Solutions to help integrate, navigate and encourage your loved one
As we start to understand the emotionally complex layers that come with using a walker, it is essential to bring in compassion and encouragement to your dad. Since you mentioned he is a prideful man, you can now understand more in-depth potential reasons he is reluctant. Consider having an open conversation with him, if he is willing, to talk about the stigma and fear he may feel.
Many walker users learn to embrace their devices over time and decorate them to give them an identity. Perhaps showing him photos of others doing that can help. Anytime you can, attempt to get him to walk with you and encourage him along the way that the walker is there to support him, instead of being a burden.
The literature also suggests that older adults should be included in the decision-making process to choose a device that suits their best needs. Oftentimes, when they feel unincluded in a major decision (such as choosing to use a walker) it can add to their resistance. The main takeaway is the importance of older adults understanding that their walker can improve their functioning. When people understand their device’s helpfulness, aside from the negative stigmatization, acceptance and use can more readily occur.
A free user guide on how to choose the right walker, safely set it up, and how to properly use it is available at walkwithpop.com.
References
Aminzadeh, F., & Edwards, N. (1998). Exploring Seniors’ Views on the Use of Assistive Devices in Fall Prevention. Public Health Nursing, 15(4), 297-304. https://doi.org/10.1111/j.1525-1446.1998.tb00353.x
Brännström, H., Bäckman, M., & Santamäki Fischer, R. (2013). Walking on the edge: meanings of living in an ageing body and using a walker in everyday life – a phenomenological hermeneutic study. International Journal of Older People Nursing, 8(2), 116-122. https://doi.org/10.1111/j.1748-3743.2012.00334.x
Copolillo, A., Collins, C., Randall, N. R., & Cash, S. H. (2001). The Impact of Experience and Heuristics on Everyday Decisions to Use Mobility Devices: The Need for Control in Nine African-American Older Adults. Physical & Occupational Therapy in Geriatrics, 20(2), 57-74. https://doi.org/10.1080/J148v20n02_04
Edelstein, J. E. (2013). Assistive Devices for Ambulation. Physical Medicine & Rehabilitation Clinics of North America, 24(2), 291-303. https://doi.org/10.1016/j.pmr.2012.11.001
Hedberg-Kristensson, E., Ivanoff, S. D., & Iwarsson, S. (2006). Participation in the Prescription Process of Mobility Devices: Experiences among Older Patients. The British Journal of Occupational Therapy, 69(4), 169-176. https://doi.org/10.1177/030802260606900404
Karpman, R. (1992). Problems and pitfalls with assistive devices. Topics in geriatric rehabilitation, 8(2), 1-5. https://doi.org/10.1097/00013614-199212000-00003
Liu, H., Eaves, J., Wang, W., Womack, J., & Bullock, P. (2011). Assessment of canes used by older adults in senior living communities. Archives of Gerontology and Geriatrics, 52(3), 299-303. https://doi.org/10.1016/j.archger.2010.04.003
Pippin, K., & Fernie, G. R. (1997). Designing devices that are acceptable to the frail elderly: a new understanding based upon how older people perceive a walker. Technology and disability, 7(1-2), 93-102. https://doi.org/10.3233/TAD-1997-71-211
Skymne, C., Dahlin-Ivanoff, S., Claesson, L., & Eklund, K. (2012). Getting used to assistive devices: Ambivalent experiences by frail elderly persons. Scandinavian Journal of Occupational Therapy, 19(2), 194-203. https://doi.org/10.3109/11038128.2011.569757
