The other day a young (and affluent) patient asked me to recommend the “Best Possible” wheelchair as he wanted to present it to his father. Though my opinion on whether one is required was not sought, I couldn’t resist asking about what the present ambulatory status of his father was, and why the wheelchair was required. The answer was a shocker, and is the basis of this article…
It turns out that my patient wanted to gift this wheelchair to his father out of commendable but excessive, filial anxiety. The concerned parent was walking with a stick, albeit with an unsteady gait, and the son wanted to ease his father’s struggle with walking: An admirable, but slightly misplaced notion.
When a child learns to walk, he wobbles, falls down often, picks himself up again, concentrates on each step, takes support when he needs it, and quickly leaves it again as he regains balance. His gait may seem laboured, but is a part of his development, and he needs all the practise he can get while he learns to walk. When a sprinter tries to improve his speed, or a marathoner his stamina, both exert beyond their comfort zone to gain their target. What is it that makes us applaud all of these but distress over a parent’s laboured walking?
Exertion (or struggle as a loved one might see it), is essential to the human body’s growth, development, maintenance, and longevity. The challenges should certainly be achievable, and will definitely be different at different stages of life. But living a life without challenge is detrimental and can deteriorate function or retard growth.
In the elderly, ambulatory aides should be prescribed medically. A walking stick may be used to reduce forces on compromised knee joints, a walker may be used when balance is poor and there is a fear of falling, a wheelchair may be used to improve the quality of life of an otherwise bed ridden patient. But if an otherwise healthy individual walking well with a stick is given a wheelchair with the mistaken belief that it will benefit him, this is unwarranted and can actually be harmful.
As “cell-building” processes are slower than “cell-breaking” processes in the bodies of the elderly, deterioration sets in quickly, and dependence on whatever aides are offered is difficult to reverse. The effort of walking and the cerebral, cerebellar and musculo-skeletal challenges it generates helps to increase longevity and maintain physical and mental health.
Maintaining “ambulation” or “available mobility” in the elderly has several benefits. Walking maintains bone mass and prevents osteoporosis, improves cardio-respiratory health, regulates hormones and enzymes (Limits Diabetes etc.), Helps to maintain muscle strength and balance, Improves digestion and intestinal health, and brain functions. The very important psycho-social benefits of walking with minimum supports need no clarification!!
Our elderly need a supportive hand sometimes, and a lot of patience and understanding always, but when they need a wheelchair, you will know for sure!! Of course my patient left that day without any information on “The best-possible” wheelchair, but hopefully his father benefitted anyway!