Assistive Devices: Mobility Aids, Prostheses, Hearing and Vision

Mobility Aids: Canes, Walkers, and Stair Navigation

Mobility aids promote independence and reduce fall risks when they are sized and used properly. The registered nurse (RN) conducts the initial comprehensive assessment of mobility and establishes the client's care plan. The practical nurse (PN) collects focused data on client mobility, reinforces the educational techniques originally taught by the RN or physical therapist, and verifies that equipment fits the client correctly. When measuring for a single-point cane, proper height is confirmed when the top of the cane aligns with the client's greater trochanter or wrist crease. When grasping the cane, the client's elbow should maintain approximately 15 to 30 degrees of flexion. The client must hold the cane on the stronger, unaffected side of the body. To walk safely, the client advances the cane forward first, follows with the weaker leg, and then advances the stronger leg.

A walker provides broader stability for clients who require bilateral balance support. To confirm proper walker height, verify that the walker's hand grips are level with the client's wrist crease when the client stands upright with relaxed arms. Just like cane use, the client's elbows should flex approximately 15 to 30 degrees while grasping the walker hand grips. To ambulate, the client advances the walker a short distance, steps forward with the affected leg, and then follows with the unaffected leg. An everyday transfer error occurs during the transition from sitting to standing: clients often attempt to pull themselves up using the walker frame. The practical nurse reinforces that the client must never pull up on a walker from a seated position. Instead, the client safely pushes up from the chair armrests first and secures their balance before grasping the walker grips.

Stair navigation with an assistive device requires strict adherence to a specific stepping sequence to prevent falls. When ascending stairs with a cane or crutches, the client steps up first with the stronger leg, utilizing that unaffected limb to bear body weight before advancing the rest of the body and the device. Conversely, when descending stairs with a cane or crutches, the client steps down first with the assistive device and the weaker leg, ensuring the stronger leg remains on the higher step to control the descent. The practical nurse monitors the client closely during these movements to reinforce safe technique.