What is a walking belt – and are they legal?

Written by Caroline Egan, HelloCare, 10 June 2021.
View original article here

Though it is something most of us do without thinking, walking involves a complex range of balance, strength and motor skills, and can become more difficult as we grow older and our physical health and cognitive abilities begin to decline.

We lose our strength, which makes it more difficult to stand, and we may find it more difficult to balance and shift our weight from one foot to the other.

Yet, it is so important that older people remain mobile in order to keep their bodies strong and agile, but also simply as a means of moving from one place to another and maintaining independence.

Carers will often assist older people to help them walk, but sometimes this becomes difficult due to, for example, a mobility impairment or if the person has a history of falls.

What then?

One way to help older people continue to walk in circumstances like these is with the aid of a ‘walking belt’.

A member of HelloCare’s Aged Care Worker Support Group asked about using walking belts, and wondered if there are regulations that restrict their use, so we decided to take a look into the issue.

What are walking belts?

Simon Kerrigan, physiotherapist and managing director of Guide Healthcare, provided HelloCare with detailed information about walking belts.

“Walking belts are ‘assisted aids’ used during transfers or walking to assist with movement and stability,” Kerrigan explained.

“They are designed to prevent the carer or person assisting from holding onto the resident’s arm, under their shoulder or any other part of their body, which may cause injury such as bruising or skin tears to the person being assisted.”

When are walking belts recommended? 

Kerrigan recommends the use of walking belts in appropriate situations with certain residents.

However, he said any recommendation to use a walking belt should only be made after a thorough review of the person’s medical history and a comprehensive physiotherapy assessment. 

The decision to recommend a walking belt may also be affected by the type and ready availability of the belt at individual homes, Kerrigan said.

“Walking belts have their place,” Kerrigan told HelloCare. 

“Many people can be assisted into standing without using a walking belt. Similarly, most people can be assisted during ambulation with correct manual handling without use of a walking belt.” 

However, in situations where a person has a significant mobility impairment, is recovering  after surgery, has a neurological condition or a history of falls, a walking belt can help the carer keep the person stable and upright, while minimising the risk of injuries.

Kerrigan said he also uses walking belts during exercise classes or individual rehab sessions if the activity is particularly challenging. 

“This might be during dynamic balance, mobility or agility-based exercises,” he explained. “In these instances, walking belts can give the clinician and the resident a higher degree of confidence as well as ensuring safety.”

When a walking belt is used, Kerrigan stressed the importance of explaining to the resident why they think a walking belt may be appropriate and ensure the resident is comfortable with its use.

Are there risks?

“If fitted correctly and an appropriate type of belt, there aren’t any significant risks with using walking belts,” Kerrigan noted. 

“When compared to assisting a person to stand or ambulate without wearing a belt, walking belts allow for a greater level of control and assistance. 

“You can ensure a firm grip without the risk of bruising or skin tears, it allows you to stay closer to the resident, and potentially a greater level of comfort for the resident – it prevents the person assisting the resident from holding onto the resident’s trousers or belt, which is common practice.”

What are the regulations for use?

While there are no regulations specifically around the use of walking belts, Kerrigan has observed a “proliferation” of non-use of walking belts following the introduction of ‘no lift policies’ in aged care homes. 

“The thought is that walking belts encourage staff to ‘lift’ residents, due to the handles on the belt. 

“In my opinion, there will always be an element of ‘lifting’ in aged care, as many residents benefit from a level of assistance to stand and mobilise. This allows the person to maintain or even improve some functional capacity,” Kerrigan said.

“The reality is that once a resident moves onto a ‘lifting aid’, such as a stand-aid lifter or full-sling hoist, their mobility is almost guaranteed to progressively decline.

“I’d also argue that lifting aids are much less humane than being assisted by a person.

“Rather than ruling out a piece of equipment or focusing on ‘no lift’, the aged care industry would be better placed by focusing on education and ‘safe lifting’,” Kerrigan said. 

“There’s a real systemic fear amongst care staff around lifting and movement, which is driven organisationally. This really needs to change.”

Kerrigan also said manual handling has been reduced from 3 hours down to as little as 30 minutes, and the training is moving from being delivered face to face by professionals such as physiotherapists, to online Powerpoint presentations or generic online videos. 

This type of training does not address individual needs and challenges, Kerrigan said, and leaves carers without the necessary skills. 

Choosing the right belt

Kerrigan said it is important to choose the right belt. 

“There are many products on the market now. I would say choose a belt which is well padded, preferably soft [some are very rigid], has a non-slip surface to prevent it from riding up, and has a buckle over Velcro.”

And don’t just go for the cheapest model. 

“There are some really cheap options out there, but they usually use a Velcro fastener mechanism, which requires the belt to basically be removed to be tightened, which renders them useless. 

“I recommend the ‘pelican’ brand – it’s the best on the market and Australian owned and made!”

Training is vital

It’s also important to train staff how to fit the belt correctly.

“Belts should be fastened low on the person’s torso, around the small of the back and underneath the rib cage,” Kerrigan explained.

“This can be difficult with some residents due to different shapes and sizes – there are simple tips to get around these challenges. 

“Walking belts also need to be positioned tight enough that they don’t slide up during the transfer or ambulation.”

Training is also needed on correct use during transfers and mobility.

“Manual handling training is really important and needs to be prioritised,” Kerrigan said. 

“Effective manual handling training will cover all aspects of the use of walking belts and ensure they are used correctly, appropriately and safely.”

If in doubt or if you have any questions, a physiotherapist or occupational therapist can give you advice about whether or not a belt is appropriate for the situation you are in, and about the different types of walking belts available.