Part 1 · Moving and caring for the body
Walking and gait
Content under professional review before publication.
1Before walking: standing and steady
The problem
Many falls happen in the first seconds of standing, before the first step: the person rises, gets dizzy, and starts walking before being steady.
What is happening underneath
On standing, the blood pressure may drop and bring a few seconds of dizziness. Walking requires the body to be balanced and the gaze forward. If the person is dizzy, unsteady, or very weak that day, it is not the time to walk.
Step by step
- Have them stand up well first (see the Transfers chapter): at the edge, nose over toes, pushing with the hands from the seat, not from the cane or walker.
- Once standing, have them wait a few seconds to find their balance before moving.
- Have them look forward, not at their feet, with a straight back.
- Closed shoes with a non-slip sole, never barefoot or in loose slippers.
- A clear path: no loose rugs, cords, or wet floors.
What you must never do
- Never rush them to walk the moment they stand, without waiting for balance.
- Never let them walk dizzy, very weak, or on a wet floor.
- Never use the cane or walker to pull them up when standing.
When to ask for help
If they often get dizzy on standing, or walk less steadily each day, consult the doctor or physiotherapist. Before walking someone who has been in bed or after surgery, ask how much weight they can bear and how much help they need.
2The cane
The problem
The cane helps only if it is at the right height and in the right hand. Used wrongly, it unbalances instead of supporting.
What is happening underneath
The cane gives an extra point of support and widens the base, but it bears little weight: it is for mild unsteadiness, when one hand is enough. It goes in the hand on the side opposite the weak leg, to share the weight as in a natural step.
Step by step
- Height: standing straight, the top of the cane should reach the crease of the wrist, with the elbow slightly bent.
- Hold it in the hand on the side opposite the weak or injured leg (if the weak leg is the right one, the cane goes in the left hand).
- Carry it at the side, not in front of the body, a few centimeters out from the foot.
- To walk: advance the cane and the weak leg together, then the strong leg.
- To stand up or sit down, do not lean on the cane: use the chair's armrest with the other hand.
What you must never do
- Never hold it in the hand on the same side as the weak leg.
- Never use it to push yourself up to stand or down to sit: balance is not reliable that way.
- Never use it if the rubber tip at the bottom is worn or loose.
When to ask for help
If the person is still unsteady with the cane, or develops pain in the back, shoulder, or wrist, consult the physiotherapist: they may need a different height, a four-point cane, or a walker.
3The walker
The problem
The walker gives more stability than the cane, but also more ways to use it wrong: stepping too far in, pulling on it to stand, advancing it too far ahead.
What is happening underneath
The walker is used when both hands are needed to walk safely. It gives a wide base, but it only supports if the four legs or wheels are on the ground when stepping and the person stays inside the walker, not hanging forward.
Step by step
- Height: same as the cane, the handles at the crease of the wrist, the elbow slightly bent.
- To stand: the walker in front, with the open side toward the person and the four legs on the floor. Have them lean forward and push up with their arms from the seat, without pulling on the walker.
- The four legs or wheels must touch the floor before taking a step (with a standard walker, set it down first, then walk).
- The person walks inside the walker, without stepping too far in or advancing it too far ahead.
- Look forward, not at the feet, and go slowly.
What you must never do
- Never pull on the walker or lean on it to stand up: it can tip over.
- Never advance it so far that the person hangs forward.
- Never use it on stairs (see the Stairs chapter).
When to ask for help
To choose the walker (standard, with wheels, with a seat) and adjust the height, consult the physiotherapist or whoever supplied the equipment. If the person hangs from the walker or drags it, the technique should be reviewed with a professional.
4Walking with the walker, step by step
The problem
Walking with the walker has an order. Doing it backward, advancing the strong leg first or stepping outside the base, throws off balance.
What is happening underneath
The walker goes first, then the weak leg, then the strong one. That way the body always has the base of support ahead before bearing weight. The weak leg goes first because the walker protects it.
Step by step
- Advance the walker a short distance, with the four legs or wheels on the floor.
- Step first with the weak leg, toward the center of the walker, not past the front bar.
- Then step with the strong leg, bringing it to where the weak one is or a little ahead.
- Repeat: walker, weak leg, strong leg.
- To turn, take small steps around, without crossing the feet or twisting the body suddenly.
What you must never do
- Never advance the strong leg first.
- Never step past the front bar of the walker.
- Never turn suddenly by pivoting on the feet: take small steps.
When to ask for help
If they tire quickly, run out of breath, or their legs buckle while walking, stop and consult. The physiotherapist can set safe distances and rests.
5Walking alongside someone
The problem
Accompanying badly, grabbing the arm or walking in front and pulling, takes away the person's stability instead of giving them security.
What is happening underneath
The person walks more safely if they set the pace and you accompany them from behind and on the weaker side, ready to steady them without pulling. The transfer belt gives a firm point if support is needed.
Step by step
- If the person is unsteady, put the transfer belt on them before starting.
- Walk half a step behind and on the weaker side, with one hand near the belt or the waist.
- Let them set the pace and the distance. Do not rush them.
- Keep the path clear and warn them of level changes, steps, and wet floors.
- If they tire, find a safe place for them to rest seated.
What you must never do
- Never lead them by pulling on the arm or by walking in front of them.
- Never let them walk alone on a wet floor or with obstacles.
- Never let go of the belt on a difficult stretch, like a ramp or a step.
When to ask for help
If they need you to hold them with both hands to walk, accompanying is no longer enough: ask the physiotherapist whether a walker or more help is appropriate.
6If they lose balance or start to fall
The problem
The reflex of holding the person up by force so they do not fall is what injures you both the most. It is not about preventing the fall at any cost, but about making it controlled.
What is happening underneath
No one can suddenly stop the weight of a body that is going down. If you try to hold it up, you hurt your back and the person falls anyway, but worse. The safe thing is to accompany the descent slowly and protect the head.
Step by step
- If you have them with the belt and they start to go, do not lift them: bring them close to your body and let them lower slowly, sliding against your leg to the floor.
- Guide them toward clear floor, away from furniture, tables, or the edge of the chair.
- Protect their head: that is first. Keep them from hitting anything hard.
- Once on the floor, do not rush them to get up. Stay with them and check whether they are hurt.
- To get them up again, follow the After a Fall chapter: if they hit their head, cannot move, or have severe pain, do not move them and call emergency services.
What you must never do
- Never try to stop their whole weight by force so they do not fall.
- Never let them fall toward furniture or the edge of the chair.
- Never lift them up suddenly from the floor without first checking whether they are hurt.
When to ask for help
If they hit their head, cannot move, have severe pain, or you cannot get them up safely, call emergency services or ask for help. Never lift them off the floor alone by force.
What about the home?
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