Owning a cane, wheelchair or walker is a little bit like owning a car, says Brad Barnhart, a physical therapist at North Oaks, a senior living community in Pikesville, Md. Skip maintenance, and it could lead to unsafe conditions. Barnhart, with more than 25 years of experience in senior living settings, provides some tips on keeping medical devices in good shape.
Q: How often do you see patients who aren't maintaining their cane, walker, wheelchair or other medical device, and how big of a problem is it?
Answer: Like any mechanical device, with use, canes, walkers and wheelchairs may need adjustment of broken or bent parts. So we are constantly on alert to notice how the assistive devices are working. We rely on any source of information - this can be the patient, family or companions - that something seems different or doesn't feel right.
Q: What kinds of safety problems does it cause when these devices aren't maintained?
Answer: If the device isn't working properly, it may take extra energy to get around. A poorly adjusted cane or walker can affect body alignment and result in pain. Of even more concern is the risk of falls and injury if the height adjuster on a cane or walker slips.
Besides requiring extra energy, worn bearings can cause a wheelchair to steer to one side or another. Or worn brakes could allow the wheelchair to slide out of position when the patient attempts to sit or stand. Worn or missing cane tips can allow them to slip on smooth or wet surfaces. Worn skis on walkers can catch on carpet and result in a fall.
Q: What is the worst accident you've seen because a patient didn't maintain the wheelchair, walker or cane?
Answer: Falling is the greatest risk, but ill-adjusted devices can create body aches and irritations. A cane that slips or brakes that fail can cause injury to the patient or to someone nearby.
Q: How often should these devices be maintained?
Answer: Rarely is there a recognized maintenance schedule. In general, greater maintenance results in better safety and greater service life. It is like a car - if you never change the oil, or wait for the brakes to fail, it won't last nearly as long, and repairs will be more expensive than if problems are addressed immediately.
The device should be looked at by an expert whenever there is a change in operation or how it feels. Listen to someone who raises a question or notices something - don't wait a month to get it looked at. Are there squeaks or funny noises? Is it more difficult to handle? Does the walker go forward just fine, but not backward? These are all signs that something needs adjustment. Ultimately, every device has a useful service life; they won't last forever. At some point, adjustments and parts replacement no longer make sense - get a new one. In most cases, Medicare and insurance plans will cover the cost of a replacement after a reasonable period of use.
Q: What kind of maintenance should be done on these devices?
A: The most common sorts of repairs involve cane tips, walker skis and brake adjustments on rollators and wheelchairs. Patients can usually go back to the place where the device was obtained to have them looked at it. Take advantage of tune-up clinics. Many adjustments and parts can be adjusted or replaced very easily and inexpensively.