Assisting another person with walking, whether due to temporary injury or a long-term mobility challenge, requires proper preparation and technique. The goal is to ensure the safety of the person being helped while protecting the helper from injury. Consulting a physical therapist or medical professional is the best way to establish a safe, individualized plan. This plan involves careful assessment of the person’s physical state and the immediate environment before any movement is attempted.
Essential Safety Preparations Before Attempting Movement
Before a person attempts to stand or walk, the environment and the individual’s readiness must be assessed. Assessing the person begins with checking for signs of dizziness or nausea and establishing their current pain level, which affects balance and strength. Appropriate footwear, such as sturdy, non-slip shoes or treaded slippers, is necessary to prevent slipping during the transfer and walking process.
The immediate area must be clear of potential trip hazards, including loose rugs, electrical cords, and misplaced furniture. If the person is moving from a wheelchair or bed, all brakes must be fully engaged to prevent unexpected movement. Adequate lighting helps the person orient themselves and recognize any remaining obstacles. The helper should also confirm the person’s ability to bear weight, often by asking them to extend a leg and resist a light downward push, which indicates sufficient strength for the transfer.
Techniques for Providing Physical Support
The helper’s body mechanics are important to prevent strain and injury. Safe assisting involves keeping the back straight and utilizing the muscles of the legs and hips, rather than bending at the waist. A wide base of support, achieved by standing with feet shoulder-width apart and one foot slightly ahead of the other, provides stability during the transfer.
A gait belt is a safety device that provides the helper with a secure grip on the person’s center of gravity without pulling on their arms or clothing. The belt should be fastened snugly around the person’s waist, over their clothing, allowing just enough room for two fingers underneath. During the transfer, the helper should grip the belt from underneath with a palm-up, underhanded grip, keeping their elbows close to their body for better leverage and control.
Assisting from Seated to Standing
To assist a person from a seated position to standing, they should first scoot to the edge of the chair so their feet are flat on the floor and slightly tucked under their knees. The helper should stand in front, maintaining the wide stance, and communicate the movement with a countdown so both move in sync. The person should be instructed to lean their trunk forward, bringing their “nose over toes,” and push off the armrests or chair surface. The helper then uses their leg muscles to lift and guide them into a standing position.
Walking Support
When walking, the helper should stand slightly behind and to the side of the person, typically on the person’s weaker side. Maintain a firm grip on the gait belt to quickly stabilize them if they lose balance.
Selecting and Utilizing Mobility Assistance Devices
Mobility assistance devices are selected based on the person’s specific needs, including balance, coordination, and weight-bearing status. Canes offer the least support and are appropriate for individuals with mild balance issues or weakness in one leg. A single-point cane provides a third point of contact, while a quad cane offers a wider base and greater stability. The correct height for a cane or walker is determined when the handle aligns with the user’s wrist crease while their arm hangs relaxed, allowing for a slight bend in the elbow when gripping it.
Walkers provide more stability than canes and come in several types. A standard walker requires the user to lift it with each step and is highly stable. Two-wheeled walkers are easier to move and better for individuals who need to lean on the device. Four-wheeled rollators are best for higher-functioning individuals who need minimal weight support, as they usually include a seat for rest breaks.
Crutches provide the most support and allow for a non-weight-bearing status on one leg, but they require upper-body strength and coordination. When a mobility device is in use, the helper should still position themselves slightly behind the person, ready to assist with the gait belt. Ensure the person steps into the walker rather than pushing it too far ahead, and encourage them to put their weight through their hands on the device, rather than leaning on the helper.
Next Steps: Promoting Independent Mobility
The journey toward independent mobility involves progression beyond immediate assistance. Setting small, achievable targets, such as increasing the walking distance by 10 feet each day, can maintain motivation and track functional improvement. This focus on improving the patterns and mechanisms of walking is known as gait training.
Simple, safe exercises can be incorporated into the daily routine to strengthen the muscles necessary for walking and balance. Chair stands, which involve moving repeatedly from seated to standing, effectively build lower body strength. Ankle pumps, where the foot is moved up and down, help to improve circulation and joint mobility in the lower extremities.
For rehabilitation, consulting a Physical Therapist (PT) or Occupational Therapist (OT) is recommended. These specialists can assess individual needs, recommend the most appropriate assistive devices, and provide specialized exercises. They are trained to help individuals retrain muscle memory and improve balance, especially after an injury or a neurological event.