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Problems with Mobility:
Wheelchairs, Walkers and Canes

We crawl and then we walk. We walk and then we run. We go from here to there without even thinking about it. Mobility is more than a symbol of freedom; it is an act of freedom. But while mobility helps give us independence, it doesn't always last a lifetime. When an accident or a disease chips away at a loved one's mobility or takes a sudden swipe at it, it's hard on both the caregiver and the care-receiver.

A parent may be forced to admit that he or she is getting old and there will be an end. An adult child can no longer deny what's happening to Mom or Dad.

Obviously, the best way for your loved one to stay moving is to simply stay moving. The adage of "Use it or lose it" remains true here. It's so much harder to go through physical therapy and make a comeback than it is to remain in relatively good shape. But that's not always possible. A person can be hobbled by any number of problems: an arthritic hip; a neurologically impaired foot; a leg, or two legs, that must be amputated because of complications brought on by diabetes; an entire side that is frozen by a stroke; and so on.

Here are some things to remember when caring for a loved one who has problems with mobility:

--Your care-receiver may intensely resist mobility aids. Your husband may deny any help is needed. He might "forget" a cane or walker and refuse to use a device in public. He's frightened, discouraged, and angry. Who wouldn't be? Coming face-to-face with a brace, a cane, a walker, crutches, or a wheelchair is hard.

--You need to encourage and you need to support, but you are not helping if you step in and do it all. Let Mom complete the task, even if it takes her longer. Be patient and let her do as much as possible. Keep in mind that in this situation, as in so many, you may find yourself performing a balancing act: your mom needs your help, but she also needs to be in control. Finding the proper balance can be difficult.

--It's hard to see someone you love struggle. Remember that many times a person has to work hard to gain new skills and new confidence.

Here are some ways to help a loved one who can't get around like he or she used to:

--When walking with your care-receiver, be sure to slow your pace. Hurrying will only lead to falls and frustration.

--Solicit the support of doctors, physical therapists, and other health-care professionals. Your loved one might be more likely to listen to advice when it comes from more than one person.

--Make sure your care-receiver has the right equipment and that it's properly fitted. He or she must understand how to use the equipment, as well as the correct posture, rhythm, and speed to adopt when using it. A physical therapist can make this easier. Make sure your loved one understands why the equipment is necessary.

--Take the training along with him or her. That way you'll know which leg goes where and where the cane needs to be when you come to a curb. You'll know how to get a wheelchair down a ramp. You'll know how to help him or her get into and out of a car. You'll learn new skills together

--Give your loved one time to adjust. The skills needed to use a device can't be learned in an afternoon. He or she may need time to practice at home before stepping back out into the world.

--If your care-receiver is recuperating after a loss in mobility, remember that things may never be the way they were before, but they can be much, much better than they are right now.

Wheelchairs, Walkers, and Canes

A wheelchair, walker, or cane can seem like a mixed blessing to the person who uses it. On the one hand, it offers security. On the other, it's a constant reminder of a disability.

Whether your loved one needs to use a wheelchair, walker, or cane only temporarily following surgery or an accident or has to depend on one permanently, there are things you can do to help make the transition easier for both of you.

--Get the piece of equipment that best suits your care-receiver's need. These days the variety is incredible: a cane can have a four-footed base or be lightweight and adjustable; a walker can have small wheels at the ends of two of its legs or be easy to pick up and maneuver; and wheelchairs can be electric or manual. Find out from your loved one's doctor or physical therapist what will work best for your care-receiver and--if there's options--ask your care-receiver which style he or she would prefer.

--Don't let cost make the decision for you. The most expensive option might not be what's right for your loved one. The cheapest might not get the job done. See what equipment your care-receiver's insurance will pay for. Check out what Medicare covers. Look into renting equipment or getting it on loan from the hospital or your local senior center. Renting or borrowing can make a lot of sense if the device is going to be used only temporarily, while your loved one regains the ability to walk unassisted.

--Make sure the equipment fits. Canes, walkers, and wheelchairs have to be the right size to offer the support a patient needs. The doctor or physical therapist can tell you if a particular device needs to be adjusted or if it simply can't be used in your loved one's case.

--Prepare the house for the new equipment. This might include building a ramp or replacing a textured carpet with one that's easier to walk on. It might be necessary to move or remove some furniture to make more space for maneuvering.

--Help your loved one get comfortable riding in a wheelchair.  If you're helping your care-receiver in a wheelchair, tell him or her what you're going to do before you do it. "I'm going to turn you around so . . ." "I have to tip back the chair to . . ." This will help your loved one build trust in you and your skills.

--Keep in mind that both you and your care-receiver need to learn how to properly use the equipment.

--Go slowly. It's going to take time for your loved one to become used to this new method of getting around. Often sadness, a sense of loss, comes with the realization that a wheelchair, walker, or cane is needed. And it can be frustrating, too. What used to be done so easily, without even thinking, now -- for a time at least -- takes hard work and concentration.