Examining gait aid use and user safety by older people with dementia: Perspectives of informal carers to inform practice

Abstract

Purpose

To determine gait aid use and decision-making related to usage in people with dementia, and examine factors influencing (1) gait aid use or not; and (2) falls in past year.

Materials and methods

A survey of informal carers of older people with dementia in the community. Closed questions on gait aid use, falls, timing and sources of gait aid acquisition, and advice received to support use were used. Chi-squared tests (Fisher’s Exact) compared: (1) gait aid users vs non-users and carers’ report of (i) unsteadiness in walking/turning, (ii) dementia severity, (iii) falls in past year, and (2) fallers vs non-fallers and (i) timing of gait aid commencement relative to dementia diagnosis, (ii) whether health professional advice was received regarding use, and iii) regularity of use.

Results

Forty-seven completed surveys, 63.8% of care recipients used a gait aid; 56.9% had ≥2 falls in past year; 66.7% commenced use after dementia diagnosis; 25% acquired their aids from non-health professionals; and 37% did not receive advice regarding use. Gait aid users and non-users differed on carer ratings of unsteadiness in walking/turning (p = 0.02).

Conclusion

Carers reported important aspects regarding gait aid acquisition, safe gait aid use and benefits which warrant further investigation.

IMPLICATIONS FOR REHABILITATION

• In our small sample, use of gait aids by people with dementia was related to the level of unsteadiness in walking and/or turning, and not associated with falling in the past year.

• People with dementia do not routinely receive professional advice about how to use gait aids, highlighting the potential value of maximizing health professional involvement in gait aid prescription and training.

• Deterioration in the ability of gait aid use after the diagnosis of dementia indicates a need for re-assessment or re-training of gait aid use over time.

• Clinical guidelines to facilitate decision-making regarding under what conditions gait aids are beneficial, what duration and aspects require instruction to ensure effective use by people with dementia are needed.

Keywords:

• Dementia
• carers
• gait aid
• device
• walking
• falls
• safety
• mobility

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

Data for this study is available upon reasonable request to the corresponding author.

Additional information

Funding

This work was supported by the Dementia Australia Research Foundation. Dr Elissa Burton's time was supported by a National Health and Medical Research Council Investigator Grant.