Most of us would love to live our lives without the need for mobility aids, but as we age, we begin to realize that this wish may be unrealistic. We could need a cane or a walker for a short time while recovering from surgery, or we may eventually need a permanent mobility aid to get us through our daily lives. Either way, a tool to help us safely move from place to place can mean the difference between living independently and depending on others for our basic needs.
When I see some of the newer mobility aids now in in use, I immediately think, “I wish that had been available for my mom.” My mother was happy enough to have what was available at the time, but her options then were a basic cane and later, a stripped-down walker which I did my best to modify so that she could carry things with her. Fortunately, there are many more choices on the market now.
To update us on the growing selection of mobility aids and educate potential users about how to choose one, I contacted Nancy Froslie, a certified Assistive Technology Professional and Rehab Manager with Sanford HealthCare Accessories in Fargo, North Dakota.
Nancy told me that the first step is to make an appointment with your doctor. “Your physician should do a physical exam, and you should discuss what difficulties you are having within your home to complete your activities of daily living (ADLs),” she said.
“To determine which mobility aid is best for you, your insurance company will want you to start with the least costly option and work your way up until the best mobility aid is found.” She assured me that most insurance companies cover mobility aids when needed.
Mobility aids for those able to walk
- Cane: A single point cane is great for someone who needs just a little support with walking.
- Quad cane: A quad cane works well with someone who doesn’t feel stable enough with a normal cane. This option provides a larger, steadier base for added support.
- Walker with wheels: A walker is great if someone needs to rely more on the piece of equipment for stability. With a walker, both hands are used to help assist with balance.
- Walker with wheels, seat and handbrakes: Also known as a rollator, this type of equipment is probably the most popular in the family of walking aids. It serves the same purpose as a standard walker, but the seat allows individuals to sit and rest if they become tired. It also has a nice basket underneath the seat that allows the person to bring personal items with them such as a purse or phone.
“If someone is unable to ambulate with any of the walking aids due to inability or safety concerns, we then move into the world of wheelchairs,” Nancy said.
Mobility aids for those unable to walk
- Standard wheelchair: A standard wheelchair is just like what you see in the hospital. It is very basic and doesn’t feature much adjustability. The person’s height, weight and hip measurements will be used to determine what size wheelchair is needed. These models weigh about 40 pounds.
- Lightweight wheelchair: Lightweight wheelchairs weigh about 35 pounds. The only time insurance companies will consider covering a lightweight wheelchair is if the individual is unable to propel a standard wheelchair. The ability of the person’s spouse or caregiver being able to lift it in and out of a car does not matter. Both coverage and need are solely based on the individual that is using the equipment.
- Ultra-lightweight manual wheelchair: These types of wheelchairs are typically used by spinal cord injury patients. They weigh approximately 28 pounds or less. Again, in order for insurance to consider covering this device, it has to be medically proven that the person is unable to self-propel a standard or lightweight model. Ultra-lightweight wheelchairs are great because they can be customized to the individual. Body measurements are taken, and the chair is made by the manufacturer according to those specifications. Different types of armrests, tires and colors can also be selected to further help an individual self-propel.
Power Mobility Aids
If walking aids and manual wheelchairs are ruled out, then the next tier of assistance to consider is power mobility.
“Power mobility refers to scooters and power wheelchairs.” Nancy said. “Just like with the other mobility aids, we have to start at the bottom and rule out the least costly alternative.”
A scooter can have 3 or 4 wheels. They have a seat, and speed and steering are controlled using both hands. There are many reasons why scooters may not work for an individual. For instance, these devices have a large “footprint.” In order to safely maneuver and turn around, they need a considerable amount of room.
Insurance companies will consider coverage of equipment that is needed within the home. Devices intended for use outdoors or over long distances will not be covered. Therefore, medical documentation must show that the person needs to use their scooter within their home for all mobility. For most people, that is not the case.
The person’s ability to control a scooter’s throttle must also be taken into account. Not all people (especially those with arthritis) are able to keep their arms extended in front of them and hold onto the throttle to control it. Some individuals may experience aches and pains while doing this, depending on their diagnosis.
This piece of equipment performs well within the home and outside as well. It has a smaller “footprint,” so it is basically able to maneuver and turn within tighter spaces.
These devices come in a variety of makes, models and sizes. A person’s diagnosis will determine the type of wheelchair their insurance may cover. For example, if you have a progressive disease, such as Multiple Sclerosis, Muscular Dystrophy or ALS, you would qualify for a power wheelchair that can be modified to meet your needs as your condition progresses. People who only have the inability to ambulate or use a manual wheelchair would only qualify for a standard power wheelchair.
“No matter what type of equipment you may need, there is always a lot of paperwork involved for insurance companies to determine if they will provide coverage,” Nancy mentions. “Again, it starts with an appointment with your physician. For higher-end equipment, such as a custom manual wheelchair, a scooter or a power wheelchair, your physician will most likely make a referral to an occupational or physical therapist.
“The therapist will conduct a one-time mobility assessment. During this assessment, the therapist will determine your abilities by evaluating your gait and performing muscle and strength testing. They will also have you try the different types of equipment to document what does and does not work for you.
“Many times an appointment with a therapist will also involve an assistive technology professional (ATP) from a medical equipment supplier. An ATP is someone who has been trained and certified in all areas of assistive technology equipment. They will help determine what devices will best fit your needs both medically and within the layout of your home.”
I want to thank Nancy Froslie again for taking the time to educate us. When I look at some of the nicer walkers with built-in seats and baskets, I now realize that these individuals may have had to pay extra for these features. Most insurance companies, as Nancy said, will only pay for the basic necessities. However, in Mom’s case, we would have readily paid for the upgrade.
I also know that some of these items, especially wheelchairs and scooters, have huge price tags that would have made the out-of-pocket costs difficult for us. Those of you looking at available options will have to work with a professional to learn what works best for your situation, what is paid for by insurance, and what “frills” you can afford to make life better for yourself or your loved one.