How to assist someone with walking? A guide for caregivers

Falls are a leading cause of injury among older adults, but learning how to assist someone with walking using safe, effective techniques can significantly reduce this risk and empower greater confidence and independence for those you care for. This guide offers authoritative, step-by-step advice for caregivers.

Quick Summary

Providing walking assistance involves using correct physical support techniques, leveraging appropriate mobility aids like walkers and canes, and ensuring the environment is safe and clutter-free to prevent accidents and boost confidence.

Key Points

• Proper Body Mechanics: Always use your legs to lift and support, keeping your back straight to prevent strain and injury.

• Stand on the Weaker Side: For manual support, position yourself on the side that needs the most assistance to provide stability and a safe center of gravity.

• Use a Gait Belt: This tool provides a secure, controlled handle around the person's waist, making standing and walking transfers much safer and easier.

• Clear Communication: Use clear, simple verbal cues before and during movement to ensure the individual is aware and prepared for the next step.

• Assess the Environment: Before moving, check for and remove tripping hazards like loose rugs, cords, or clutter, and ensure there is sufficient lighting.

• Choose the Right Aid: Select the appropriate mobility aid—cane, walker, or rollator—based on the person's balance, strength, and mobility needs, with a professional's input if possible.

• Plan for Falls: If a fall begins, guide the person gently to the ground rather than trying to prevent it, then assess for injuries and call for assistance.

Understanding the Fundamentals of Safe Walking Assistance

Before you begin, it is crucial to understand the foundational principles of providing safe walking assistance. This involves proper body mechanics for the caregiver, effective communication with the individual, and a comprehensive assessment of the environment. Proper technique protects both the caregiver from injury and the individual from falls.

Prioritizing Caregiver Body Mechanics

To avoid strain on your back, it is essential to use your legs to provide support, not your back. When assisting someone to stand or walk, keep your back straight, bend your knees, and pivot with your feet rather than twisting your torso. Staying close to the person you are helping minimizes the reach and strain on your arms and back.

Effective Communication and Cues

Clear, simple communication is key to a successful transfer or walk. Before you move, tell the person exactly what you are about to do. For example, “On the count of three, we will stand up together.” Use verbal cues during the walk, such as “Lift your right foot” or “Take a small step.” This keeps them engaged and aware of their movements.

Assessing the Walking Environment

Take a moment to scan the area before starting. Look for loose rugs, cords, or clutter that could be a tripping hazard. Ensure there is adequate lighting in all areas the person will be navigating. If possible, walk on even, non-slip surfaces.

The Proper Way to Provide Physical Support

For hands-on assistance, using a gait belt is the safest and most effective method. A gait belt is a special belt that goes around the person's waist, providing a secure handle for you to hold onto during transfers and ambulation. If a gait belt is not available, you can use the following technique:

1. Standing from a chair: Position yourself in front of the person, with your knees on either side of theirs. Instruct them to shuffle forward to the edge of the seat, place their hands on the chair's armrests, and lean forward. On your verbal cue, they will push off with their hands and legs as you guide them upward with your hands placed securely on their waist or torso.
2. Assisting with walking: Stand on the person's weaker side. Place your arm around their waist, holding them securely. With your other hand, you can hold their hand in a hand-under-hand grip, which provides stability without restricting their movement. Keep your steps synchronized with theirs, and allow them to set the pace.

Choosing and Using Mobility Aids

Mobility aids are often necessary to provide consistent support and stability. The right device depends on the individual's specific needs, balance issues, and strength.

Comparison of Common Mobility Aids

Feature	Cane	Standard Walker	Rollator (Wheeled Walker)
Support Level	Light support, for minor balance issues.	High support, for significant unsteadiness.	High support with mobility.
Maneuverability	Excellent. Ideal for tight spaces.	Low. Requires lifting with each step.	High. Wheels allow for smooth, continuous movement.
Key Feature	Good for short-term, low-impact use.	Excellent stability, but slow.	Allows faster walking pace and includes a seat.
Terrain	Best for flat, even surfaces.	Best for indoor, flat surfaces.	Good for both indoor and outdoor use.

Using a Cane

• Hold the cane on the side opposite the weak or injured leg.
• Advance the cane and the weaker leg at the same time.
• Bring the stronger leg forward to meet the cane and weaker leg.

Using a Walker

• Ensure the walker is adjusted to the correct height, with handles at wrist level when arms are relaxed.
• Step inside the walker, not behind it. Push the walker a short distance ahead.
• Step forward with the weaker leg, then follow with the stronger leg.

Using a Rollator

• Stand close behind the rollator and roll it forward as you step.
• Engage the brakes before sitting down on the seat or stopping for an extended period.
• Remember to use the brakes on inclines or uneven surfaces to prevent the rollator from rolling away unexpectedly.

Making the Home a Safer Environment

Creating a safe and accessible home is paramount for fall prevention. Even with a mobility aid, a cluttered or poorly-lit home can pose a significant risk.

• Clear Pathways: Remove all clutter, loose rugs, and electrical cords from high-traffic areas. This includes securing the edges of any throw rugs or removing them entirely.
• Install Grab Bars: Add grab bars in critical areas like the bathroom, near the toilet and inside the shower or tub. These provide a sturdy handhold for transfers and balance.
• Improve Lighting: Ensure all rooms, hallways, and staircases are well-lit. Consider nightlights in bedrooms and bathrooms for nighttime navigation.
• Use Non-Slip Surfaces: Place non-slip mats or decals in the shower or tub. Ensure flooring is not overly slick, especially in kitchens or entryways.

Addressing Special Scenarios and Fall Management

Certain situations require special attention to maintain safety. Knowing how to handle these moments effectively is a crucial skill for any caregiver.

Navigating Stairs

If stairs are unavoidable, it's best to use a handrail. The person should lead with their stronger leg going up and the weaker leg going down. The caregiver should stand on the weaker side, ready to provide support. If a person is significantly unsteady, stairs should be avoided altogether by using ramps or assistive lifts if available.

Walking on Uneven Surfaces

When walking on grass, gravel, or cracked pavement, proceed with extra caution. Use smaller, slower steps and be vigilant for obstacles. A rollator with larger wheels can help, but extra care is needed on slippery or uneven ground.

Managing a Fall

If the person begins to fall, your immediate priority is to guide them down to the ground as gently as possible, rather than attempting to hold them up completely. Guide them to a seated or kneeling position to prevent injury from an uncontrolled fall. Do not try to lift them by yourself. Once they are safely on the ground, assess for injuries, call for help if needed, and encourage them to remain calm. Consult with a physical therapist for safe techniques to help a person get back up from the floor.

When to Seek Professional Guidance

While this guide provides valuable information, it is not a substitute for professional medical advice. A physical therapist can provide a personalized assessment of the individual's needs and recommend the most suitable assistive devices and exercises.

For more detailed information on assistive devices and rehabilitation, consider consulting expert resources like the Mayo Clinic guide on using walkers.

Conclusion: Empowering Safe and Independent Mobility

Assisting someone with walking requires patience, knowledge, and the right tools. By mastering safe techniques, utilizing appropriate mobility aids, and creating a secure environment, caregivers can provide invaluable support. This not only prevents falls and injury but also promotes the individual's independence and overall quality of life, allowing them to remain active and confident. Consistent attention to safety and regular communication are the cornerstones of effective assistance, making every step a safe one.

Frequently Asked Questions

What is the correct way to help someone stand from a chair?

Stand in front of the person, with your knees on either side of theirs. Instruct them to shuffle forward and use the chair's armrests to push up. As they stand, provide upward support by placing your hands firmly on their waist, or a gait belt if they are wearing one.

When should I use a gait belt?

A gait belt should be used whenever you need to provide physical assistance for standing, walking, or transferring. It offers a secure and non-slip grip, protecting both the caregiver and the individual from potential falls.

How do I choose between a cane, a walker, or a rollator?

The choice depends on the person's needs. A cane is for minor balance issues, a standard walker offers high stability but is slow, and a rollator provides excellent support with greater maneuverability due to its wheels. A physical therapist can help determine the best option.

What should I do if the person I am assisting starts to fall?

If a fall occurs, your primary goal is to guide the person down to the floor safely, rather than trying to lift or stop the fall completely. By easing them down, you can minimize the risk of serious injury for both of you. Never try to lift someone who has already fallen without trained help.

How can I make the home safer for someone with walking difficulties?

Start by clearing all clutter and loose rugs from walking paths. Install grab bars in bathrooms and hallways, improve lighting throughout the house, and use non-slip mats in wet areas like showers and kitchens. This reduces the risk of accidental falls significantly.

How do I help someone who needs assistance walking on stairs?

With someone who is stable enough to use stairs, stand on their weaker side and use a handrail. The person should lead with their stronger leg going up and the weaker leg going down. For those who are less stable, it's safer to avoid stairs entirely or find other accommodations.

Should I hold the person's arm or hand to help them walk?

Holding a hand can be acceptable for very light support, but a firm grip on the waist or using a gait belt is much safer. Holding an arm can pull them off balance or cause injury. The hand-under-hand grip mentioned in the article offers more stable support than just holding their hand.