M10 · Difficulty using a walking aid
Actual Movement and self-care
Definition
The person struggles with a frame, crutches, stick, or wheelchair.- New equipment
- weakness
- poor technique
- pain
- Wrong height
- leaning
- tripping
- avoids using the aid
📋 Scenario
A patient uses crutches that are too long and nearly falls.
Subjective (S): "The crutches feel too long."
Objective (O): Crutches too tall; leans forward; trips; unsteady on stairs.
Assessment tools for this scenario: CP-MOVE Movement & Self-Care Score CP-SAFE Safety & Falls Score
Validated scales to consider: Barthel Index, Katz ADL, Morse Fall Scale
**CarePath diagnosis:** Difficulty using a walking aid related to new equipment, as evidenced by wrong height and leaning.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Check the fit. | Crutches of the wrong height cause leaning, poor balance and strain on the shoulders, so correct fit must come first. |
| Teach technique. | Correct technique, such as the right gait pattern, keeps weight where it should be and lowers the chance of a fall. |
| Practice with supervision. | Supervised practice lets the nurse correct mistakes at once, so he learns before he tries alone. |
| Watch for tiredness. | Tiredness makes technique worse and raises the risk of falls, so he should rest when needed. |
| Reinforce safe use. | Reinforcing safe habits builds confidence and keeps him using the aid properly, including after discharge when no one is watching. |
**Expected outcomes**
- Within 24 hours: uses crutches safely with correct fit and technique.
- No falls.
- Completes stair practice with the therapist.
**Linking the data to the diagnosis**
A patient says, "The crutches feel too long." The crutches are too tall, he leans forward, trips and is unsteady on stairs, and he nearly fell. These problems are already present, so an actual statement fits and a risk statement does not. The wrong fit and new equipment are the cause. The plan aims to correct the fit and teach safe technique with supervised practice. Within 24 hours the expected outcomes are using the crutches safely with correct fit and technique, no falls and stair practice completed with the therapist.
CarePath diagnosis
Difficulty using a walking aid related to new equipment, as evidenced by wrong height and leaning.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Check the fit. | Crutches of the wrong height cause leaning, poor balance and strain on the shoulders, so correct fit must come first. |
| 2. Teach technique. | Correct technique, such as the right gait pattern, keeps weight where it should be and lowers the chance of a fall. |
| 3. Practice with supervision. | Supervised practice lets the nurse correct mistakes at once, so he learns before he tries alone. |
| 4. Watch for tiredness. | Tiredness makes technique worse and raises the risk of falls, so he should rest when needed. |
| 5. Reinforce safe use. | Reinforcing safe habits builds confidence and keeps him using the aid properly, including after discharge when no one is watching. |
Expected outcomes
- Within 24 hours: uses crutches safely with correct fit and technique.
- No falls.
- Completes stair practice with the therapist.
Linking the data to the diagnosis
A patient says, "The crutches feel too long." The crutches are too tall, he leans forward, trips and is unsteady on stairs, and he nearly fell. These problems are already present, so an actual statement fits and a risk statement does not. The wrong fit and new equipment are the cause. The plan aims to correct the fit and teach safe technique with supervised practice. Within 24 hours the expected outcomes are using the crutches safely with correct fit and technique, no falls and stair practice completed with the therapist.