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How to Care for a Loved One With Mobility Issues

The strength and balance needed to prevent falls are important for staying independent

spinner image Man walking with a cane outdoors
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Falls are by far the leading cause of injury among older adults. In fact, 1 in 4 older adults take a tumble every year. This led to more than 3 million emergency room visits and more than 32,000 deaths among Americans age 65 and older in 2020, according to the most recent data available from the Centers for Disease Control and Prevention.

“I use the phrase, ‘Fall is a four-letter word,’ ” says Lisa Caruso, a geriatrician at Boston Medical Center who also has a master’s degree in public health. “Falls are definitely something we ask about and want to prevent.”

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That’s because mobility is key to independent living.

When people begin to have balance issues or to fall frequently, not only is a hospital visit possible, but they’re often no longer able to do the daily activities that used to come easily. “The important message to always give is that we want you to maintain your independence,” Caruso says.

If you notice your parent or spouse is beginning to have some trouble standing up and walking, here are some steps you can take to turn things around.

How to talk to your loved one about their mobility issues

Deb Hallisey remembers the first time she noticed her mom’s mobility problems.

“We were actually at a family gathering and she was walking out, and she fell. And she was so embarrassed,” says Hallisey, a writer, eldercare advocate and founder of Advocate for Mom and Dad, an online resource for family caregivers.

Hallisey realized she had to change the way she broached difficult subjects with her mom. “I call it the ‘drip method,’ ” she says. “I bring it up multiple times, in multiple ways, in different situations where there’s an opening.

“And it’s always not a ‘you should, you must’ statement,” Hallisey says. “It’s a ‘I noticed this. I’m concerned. Would you like me to look into this for you?’ — keeping the control with her.”

Causes of mobility problems

Once you’ve started the conversation, making a medical appointment is the next crucial step, says David Reuben, chief of the Division of Geriatrics at the David Geffen School of Medicine at the University of California, Los Angeles.

Get an evaluation,” he says. “See where you’re starting from.”

A physician might do a strength, gait and balance evaluation or order a bone density scan. The doctor will check things such as blood pressure and heart rate after standing, and look for underlying conditions. Hearing and vision should also be checked.

The physician may suggest ways to improve function; prescribe physical therapy, which Medicare covers when it’s deemed medically necessary; or discuss surgery options or medicines that might help.

Other actions to take:

Do a pharmacy review. The doctor can also check your list of prescribed and over-the-counter medications to see if anything may have side effects, like dizziness or sleepiness, that could lead to falls.

Get an eye exam. The right glasses prescription can do more than help people see where they’re going. A 2023 study found that those with vision problems such as glaucoma, macular degeneration and cataracts are more likely to experience falls.

Pay attention to diet. Dehydration can lead to weakness, so make sure your loved one stays hydrated and limits their alcohol use.

If your loved one’s vitamin D level is low, the doctor might encourage taking vitamin D every day. Or to improve bone density, a suggestion might include eating more calcium-rich foods, such as milk and yogurt.

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How to prevent loss of mobility

“The best and most robust data that we have is that even increasing your physical activity a small amount every day can really have very powerful effects on older people’s physical function and also prevent them from becoming disabled,” says Roger Fielding, a senior scientist with the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University.

It’s never too late to start exercising, says Fielding, who studies how skeletal muscle mass functions as people age.

“Even trying to walk 10 to 15 minutes, just at a comfortable pace, every day seems to help prevent mobility decline,” he says.

Add strength training. Your local senior center or YMCA might offer classes like resistance exercise or strength training.

“The biggest thing we know is that even in very old people, the capacity of your muscles, your skeletal muscle, to adapt and respond to exercise, it doesn’t appear to be lost,” Fielding says.

Try tai chi. “They’ve ... done studies on what kinds of exercises help, and the number one exercise is tai chi,” says Suzanne Salamon, associate chief of geriatric medicine at Beth Israel Deaconess Medical Center in Boston. “And a lot of senior centers have tai chi classes. It builds up your muscle, and it helps balance.”

Exercises that boost leg strength and balance are effective in helping prevent falls in older adults, confirms a 2024 study published in the Journal of the American Medical Association.

Use it or lose it. Whatever you do, keep moving, Caruso says. “Stay as active as possible, whatever that means for you. If that means taking a walk down your hallway three times a day and back, or if that means going out to a gym and working on cardio machines — whatever that means for you to maintain your level of functioning, stay active.”

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Try a device. If your loved one already has mobility problems and function can’t be restored, it’s time to talk about using a cane or walker, Reuben says. It can be a difficult discussion.

“These are big psychological issues,” he says. “We’re used to being on two legs. There’s an old, very famous riddle from ancient times: What walks on four legs in the morning, two legs in the afternoon and three legs at night? And it’s man: All fours as a child, two feet as an adult, and with a cane as an elderly person.

“What I frequently try to do,” he continues, “is frame it with patients [that] the purpose of these is to keep you out, keep you active, keep you mobile, but doing so safely.”

Make it fashionable. If the idea of a cane is a hard sell, you can appeal to your loved one’s sense of style.

“It’s starting to be fashionable now to use walking sticks, the kind you use for hiking,” Salamon says. “And you can use either one or two, just like the hikers do. And I’ve had a few, not a lot, but a few patients who kind of perked up at the idea of using a walking stick instead of a cane. Somehow, it doesn’t have the same connotation.”

Consider a walker. Medicare covers medical equipment, including walkers. Modern walkers are both more attractive and more stable than older varieties, Salamon says. Some come with seats and baskets, four wheels and even hand brakes.

Video: Using a Walker or Cane and Navigating Stairs

Make modifications at home to lessen the chance of a fall

You can make things safer around the house by getting rid of clutter and taking other precautions. For example:

  • Remove tripping hazards from the stairs.
  • Repair loose railings.
  • Remove or secure loose rugs.
  • Add task lighting.
  • Put a nightlight in the bathroom, and keep the floor dry.

“My mother and father were very smart,” says Hallisey. “They took out the tub and put in a walk-in shower with a bench years ago. They put up grab bars. I put up a higher toilet because she was struggling even with the grab bars. We did a lot more task lighting.”

Remote control. “One of the best things I ever did was buy [my mother] an Alexa because we have smart plug-ins. She can turn things on and off at will,” says Hallisey.

Get a medical alert system. Salamon tells her patients that their best insurance may be to get a medical alert device that they can wear on their wrist or around their neck.

The devices are waterproof, so they even work in the shower. And if the wearer falls, the person can at least call for help. They come with a monthly fee, but “it’s extremely reassuring,” Salamon says.

Smart tools. There are new devices on the market that can help your loved one stay safe at home. And if they use a smartphone or tablet, there are medical alert apps available for both Apple and Android devices. They often have additional features, such as fall detection and GPS tracking.

In case your loved one does fall and their device isn’t within reach, teach them a few safe ways to get up from a fall.

Don’t be afraid to use scare tactics. If other approaches aren’t working, Salamon isn’t afraid of using scare tactics with her patients, who range in age from 65 to 104.

“I say, ‘Don’t you know anybody that’s broken a hip?’ And they almost always do. And, you know, it can be really devastating.”

So she appeals to their desire to say on the safe side.

“Most people, even if they’re 90 on the outside, they’re 40 on the inside, and they like to think of themselves that way,” Salamon says. “I think all of us think that we’re younger than we actually are. So I just try to appeal to their staying independent more than anything else.”

Editor’s note: This article has been updated with recent studies.

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