Why Physical Therapy for Older Adults

Top five reasons grandma should visit a physical therapist:

  1. Reduce fall risk (J Geriatrics 2003, 2016, 2017)
  2. Improve bone density (Med Science Sport Exercise 2006, 2010)
  3. Improve posture (Physical Therapy 2009)
  4. Improve independence (New England J Medicine 2008, 2009)
  5. Reduce pain, especially in the back and knees (Archives Phys Med Rehab 2012)

 

A reader writes:

My 84-year old grandma is depressed after losing grandpa.  She lives in a retirement community but doesn’t socialize.  We try to get her out to be more active, but she seems to resent our attempts.  The only person she listens to is her doctor, who says that she’s “old and this is normal”.  What do you suggest?

 

why-physical-therapy-for-the-elderlyMany people (including health professionals) believe it’s normal to “waste away” as we age.  Consequently, many older adults become sedentary, use walkers unnecessarily, take an average of 11 medications per day (Am J Geriat 2006), fall more often and depressed.

First, get a new doctor for your grandma.  Studies show one of the worst things an older adult can do is stop exercising, as this often leads to falls, fractures, depression, arthritis, Parkinson’s, chronic pain, diabetes and heart disease (JAMA 1997, 2004, 2008).  In fact, studies show that “successful” aging is more affected by lifestyle than genetics (J Geriat, 1992, 1998).

While you and your family want what’s best for your grandma, it’s obvious she doesn’t seem to respond to you.  It sounds like she does listen to her doctor, so find a good one who is an advocate for healthy aging.  Robert Sandmeier, MD, an orthopedist from Tigard, says, “Physicians must nurture patients to accept personal responsibility for overcoming health problems regardless of age or health status.  Just because it’s common to have aches and pains with aging doesn’t mean it’s normal.”

Grandma should also connect with a physical therapist specializing in geriatrics, who will evaluate her to identify impairments (e.g., strength, balance, flexibility) that can be treated with effective exercise.  The physical therapist should be close to home and liked on a personal level by grandma.  She may also need counseling.

Grandma’s program should include balance training and strengthening, where she is pushed (within reason) to improve balance and strength (especially in her legs), as studies show this can significantly reduce fall risk while enhancing independence (J Geriatrics 2003, 2016, 2017; New England J Medicine 2008, 2009).  Pool therapy can also help, but should not substitute for balance and strengthening programs.  The key with an exercise therapy program is gradual progression to foster improvement without injury, which requires considerable skill on the part of the physical therapist.

The bottom line is that we have a choice in how we age.  Your doctor and physical therapist have a responsibility to encourage grandma to exercise daily.  The hardest part is getting started, but once this is achieved I’m confident grandma will be well on her way to getting her life back.

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