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Palliative Care Platform

Palliative Care Platform

Caring Tips >Use of Walking Aids and Wheelchair

About Use of Walking Aids and Wheelchair

Walking aids and wheelchairs can help improve patients’ stability in walking and mobility, but they should be used correctly to avoid accidents.

Walking Aids

Walking stick

Lightweight, easy to carry, suitable for people with poor strength and balance.

  • Healthy side: normal arm and leg
  • Affected side: arm and leg with poorer mobility
When you stand up
  1. Hold the armrest of the chair on the affected side
  2. Hold the walking stick on the healthy side
  3. Move the centre of gravity forward, move the arms forward
  4. Stand up firmly
When you sit down
  1. Slowly move backwards until your feet touch the side of the chair
  2. Bend your body forward, hold the armrest of the chair on the affected side and slowly sit down
When you walk
  1. When you start, hold the walking stick on the healthy side and take one step forward
  2. Take one step forward on the affected side
  3. Follow with the healthy side
When you walk upstairs
  1. When you walk upstairs, stand near the side of the stairs and put your stick one step up. If there are handrails, you can use them
  2. Follow with the healthy side
  3. Step onto the same step with the affected side
When you walk downstairs
  1. When you walk downstairs, stand near the side of the stairs and put your stick one step down. If there are handrails, you can use them
  2. Take one step downwards with the affected side
  3. After that, take one step downwards with the healthy side

Four-legged walking stick

The bottom part of the four-legged stick is larger than that of a walking stick and thus more stable. Its use is similar to that of a walking stick.

Walking frame

With a big and stable bottom, the walking frame is suitable for patients with weaker physical strength, balance or hand and foot coordination.

When you stand up
  1. Hold the chair with one arm
  2. Use another arm to hold the walking frame
  3. Move the centre of gravity forward, move the arms forward
  4. Stand up firmly
When you sit down
  1. Slowly move backwards until your feet touch the chair
  2. Bend your body forward, hold the armrest of the chair on the affected side and slowly sit down
When you walk
  1. When you start walking, put the walking frame one step forward
  2. Take one step forward on the affected side
  3. Follow with the healthy side catches up
Key points of walking exercise
  • After the patients have learnt to use the walking aid for walking, they can develop the habit of doing walking exercise to maintain physical strength. Here is the progression of walking exercise
    1. Walk by the bed/chair
    2. Walk from the side of the chair to about 10 metres away
    3. Increase the walking distance indoors
    4. Take a walk outdoors
  • Consult the physiotherapist if the patient feels unwell (such as rapid heartbeat, shortness of breath, pale face)

Maintenance of walking aids

  • Check if the rubber caps at the bottom have hardened, the corrugated pattern has reduced to less than half a centimetre, or the bottom is uneven. You will need to replace it if any of these is found
  • Do not modify the walking aid yourself
  • Check to see if the accessories (handle, adjustment keys, folding keys or screws) have loosened or been damaged
  • People who buy walking aids themselves should keep the relevant receipts so that they can follow up with the supplier on the walking aid or accessories when necessary in the future
  • Avoid hanging heavy objects on the walking aids
  • Do not use the walking aid to open or close doors and gates, pick things up or as a weapon
  • The handle area can be wrapped with anti-slip rubber pad to increase the comfort of the grip. Do not adjust the height of the walking aid
  • Try to avoid water or use in humid environment to prevent rusting. If it accidentally gets wet, dry immediately. You can tap it on the floor gently to see if there is any water dripping out from the small holes on the walking aid

Use of Wheelchair

If patients have poor tolerance or limited mobility, they should need a wheelchair to enhance such function. It is important to use a wheelchair safely.

Structure of a wheelchair

Seat, Seat belt, Push handle, Back cushion, Brake, Armrest, Frame, Pedal, Front wheel, Rear wheel, Tipping lever

Common types of wheelchair

Self-Propelling Wheelchair
Attendant-Propelling Wheelchair

Smaller rear wheels and the overall width is narrower

Other types of wheelchair include heavy-duty/ light-weight/ reclining/ tilt-in-spacewheelchairs. Therapists will recommend the suitable model and accessories based on the needs of patients.

Reclining/ tilt-in-space wheelchair, back cushion, seat cushion, lap tray

Some cancer patients may have spinal cord compression causing lower limb paralysis, and for some this may even extend to their upper trunk. Therapists will assess the sitting posture of the patients and recommend appropriate wheelchairs with reclining / tilt-in-space features, back support, and seat cushion to improve mobility and sitting tolerance.

Here are a few things to pay attention to:

  1. When opening some wheelchairs, you need to press on the seat frame and lock the wheelchair in the open position. Otherwise, it will close up when the patient sits on it and cause danger to the patient
  2. Check to see if the locking system can lock the wheelchair properly
  3. Fasten the seat belt after the patient has sat down in the wheelchair

There are many points to note for the safe use of wheelchairs, and it requires practice to achieve more proficient use of this mobility aid. Wheelchair users tend to forget the above three points which in turn causes danger. If you have any difficulty using a wheelchair, please consult your therapist.

Steps to Transfer the Patient from the Bed to a Wheelchair

  1. Use your palm to press on the inner edges of the two sides of the wheelchair seat, stretch out your elbows and press down on the wheelchair to open it; be careful not to hurt your fingers when you open a wheelchair
  2. Remove the pedals and armrests facing the bed and park the wheelchair at a 45° angle by the bed, close to the unaffected side of the patient. Lock the wheelchair brakes
  3. Help the patient to sit up on the bed and move slightly to the edge of the bed to facilitate transfer
  4. Help the patient lean forward, put his/her hand on the further armrest and use the leg closer to the wheelchair to move his/her body into the wheelchair; or using your shoulder to support the patient’s head, move the patient’s buttocks forward
  5. Help the patient lean against the seatback, install the armrests to their original positions and lock the pedals. Put the patient’s feet onto the pedals and his/her hands on the thighs. Do not stretch the arms out of the wheelchair to avoid injuries. Fasten the seatbelt before pushing the wheelchair
  6. To avoid friction from dragging the patient on the surface of the bed, use auxiliary devices such as transfer board or patient lift
    Transfer board
    Patient lift

When outdoors

It is more difficult for the carer to handle a wheelchair in an outdoor environment. Apart from the basic forward/ backward movement and turning, they will also need to deal with going up and down slopes and steps.

Going down a slope
  • Go down the slope backwards
Going up and down steps
  • Step on the tipping lever and tilt the front wheels when going up steps
  • Let the rear wheels go down first when going down the steps
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