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3 Pitfalls to Avoid when Choosing Safety Equipment for Aging in Place

December 6, 2022

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When a loved one is beginning to have trouble accessing part of their home, getting up or down, or showing signs of mobility issues, it is usually family or friends who first notice the problem. It’s a rare day when a healthcare provider is involved before something has already gone seriously wrong, and so family and friends are often left to their own devices to figure out stop-gap measures for protecting the people they love. 

One common response is to purchase mobility equipment or specialized furniture to support their loved one’s safety or independence. Without a healthcare provider to offer guidance, people usually turn to other family, friends, the internet (hello!), and their own common sense for help. And though these can be valuable sources of information, it’s also easy to find misinformation, limited information, or shortsighted (though well-meaning) advice. 

If that situation sounds familiar, then let me share some common pitfalls caregivers often face when choosing equipment on their own. We’ll take a deeper look at 3 of the most common below.

Pitfall #1: Inappropriate powered mobility.

Powered mobility devices (power wheelchairs and scooters) can be absolutely life changing for those who need it. My own grandfather-in-law, who had inclusion body myositis, would tell me every time I saw him how much his power chair meant to him (this was after a 9-month journey of advocating on his behalf and working with his healthcare team to get it approved). But, this equipment is also, well… powerful. Which means that when it’s used incorrectly, the consequences run high.

I’ll share a specific example of inappropriate powered mobility, based on a scenario I’ve seen more than a few times. Let’s say you’re a family caregiver who is taking care of a loved one with dementia. Recently, the person you care for has had trouble with walking. A well-intentioned family friend who has an old power scooter that was once used by a relative with severe arthritis suggests using the scooter, and drops it off at your home. 

The problem? You now have a cognitively impaired person using what is essentially a small motorized vehicle around your house. You or someone else could get run over or hit, the person with dementia can also be injured, and I can almost guarantee your home will take some damage. 

Powered mobility solutions can be appropriate in many scenarios, but when people choose powered mobility options without an assessment and recommendation from a healthcare provider, there is significant risk. Instead, if your loved one is having a hard time getting around, talk with their physician and request an evaluation from a physical therapist. 

Pitfall #2: Seats with “stand assist”

Common sense dictates that if someone is having trouble standing up from a chair, then the solution is to make standing easier, right? Wellllll….. not exactly. While using a seat with stand-assist can be appropriate under some circumstances, I more frequently see them used in scenarios where they result in increased physical weakness and fall risk. 

The reason? When we decrease the amount of physical effort required for a task, we make the muscles involved weaker. In the case of using a seat with stand-assist, this leads quickly to weakening of both the front and back musculature of the legs (as well as the pelvis, core, and even upper body). Whereas someone might only need a little boost to get up before they start using their lifting chair, in short course they can no longer get up from the shower… or the car… or the bed… or the toilet. It’s not a natural, normal, or unavoidable course of decline caused by lack of muscle use. 

Instead, early signs of weakness (like having some trouble standing up) are usually key moments where healthcare providers can intervene to remediate the underlying problem. A physical or occupational therapist can also help you to identify the correct supportive equipment (or technique) for immediate use to increase safety. And, if the chair or seat with stand-assist really is the right solution for your loved one… they can tell you that too. 

Pitfall #3: Add a step

This pitfall actually refers to a very specific, and extremely common, solution that folks use to solve the problem of a high bed height. If the person who sleeps in a bed cannot comfortably place their feet on the floor while seated at the edge of the bed, the person’s bed is too high. When I’m asking people about fall risks in their environment, whether it’s in rehab, acute care, or out in the community, I ALWAYS ask about bed height. When it becomes clear that a bed is too high, people almost always suggest getting a step to place at the edge of the bed to help the person in question. 

The problem is that adding a step also adds a layer of complexity to entering/exiting the bed. Even a completely healthy person would have an increased risk of falls when using a step to get into or out of bed. When you add on a layer of difficulty for someone who already has a mobility issue, it’s a dangerous proposition. 

Instead, I usually recommend a solution that lowers the height of the bed. This can be done using a variety of simple, low-cost strategies – most of which don’t change the aesthetic of the bed itself. For example, if a bed is very high, replacing the box spring with plywood significantly reduces height by creating a platform bed. Keep in mind that the right method will depend on the height of both the existing bed and the person in question.

In short, if you’re noticing the person you care for is needing more assistance, speaking to their healthcare provider and getting the right equipment recommendations is crucial. If you think the person you care for needs to be seen by a licensed occupational or physical therapist, ask their doctor for a referral. Always talk with your loved one’s doctor about safety or functional concerns you have*. In the long run, getting the right recommendations will save you time, money, and help to keep your loved one (and you) safe.

*If your health plan doesn’t cover therapy, or if you are uninsured, calling 311 or your local area agency on aging is a good place to begin finding out what resources are available in your area. If your area has a county safety net health system, getting connected can help meet a variety of healthcare needs. 

Guest Author: Emilia Bourland, OTR, ECHM
Occupational therapist and the owner of Higher Standards Caregiver Training. She specializes in quality education and practical training to help keep caregivers and their loved one’s safe. Visit her website to find more practical family caregiver resources, link to her podcast, subscribe to her free YouTube channel @higherstandardscaregiver, and follow her on social media.

Disclaimer: Consuming this content is not a substitute for health or medical advice, and does not constitute a therapeutic relationship. People should seek medical advice from a licensed health care provider if they feel they have a medical condition, impairment, disability, safety risk, or other needs related to health, wellness, and prevention. Neither the Author, nor any connected company or affiliation is providing medical advice or treatment of any kind in this document. No guarantees of specific results are promised or implied. Author/connected companies/affiliates are not liable for any injury or harm resulting from persons implementing tips, strategies, or information shared here.

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