Dear MDs, Physical Therapists, and Us All

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By Guest Blogger Vanessa Kettler

Most people don't really understand what it is like to be old until they become older. Some of the things younger people, professionals or friends do can affect older people significantly in unintended ways. Understand the impact of what you do. Try to put yourselves in our shoes.

• When we tell you about our aches and pains, please do not say "It's just because you are getting older." Instead, explain what our ailment is and enthusiastically refer us to exercise programs or other remedies that help reduce symptoms.
• Never say "There is nothing more I can do" or "There is nothing that can be done". These messages have a strong negative psychological impact and are also not true. There is always something that can be done about any situation. Improving breathing technique and increasing core strength are 2 possibilities that often help underlying symptoms. Of course sometimes nothing can be done about the physical progress of an illness but certainly other areas of growth are available to the patient. Spiritual for instance. The above comments close doors for those more vulnerable and frail for other reasons and are very depressing to hear. Give your patient an open window instead.

• Please place more emphasis on helping your clients establish a regular exercise routine for continuing at home after their therapy series with you is completed. Your wonderful work is often wasted because it so difficult for patients to keep motivated. Your support helps. Followup communication would be wonderful.
• Do not teach older clients to improve their balance by practicing high risk actions. For example, walking toe to heel, where the feet are directly in line and touching, is commonly used as an exercise to improve balance but it is a risky thing to do on your own. Supervised use of this exercise is ok, though safer and more reliable methods of balance could be taught instead. But, do not encourage older people to practice that type of exercise at home. It increases the likelihood of a fall significantly.

Get your residents into more activities. It is the answer to improving your client's lives while reducing falls dramatically, but aggressive salesmanship is needed. Informing your residents about organized activities is not enough. Do not expect your residents to attend. Convince them to. People often have to be motivated personally. More staff encouragement translates into improved health for your clients.

Many are concerned about their parents or clients having falls. The best way to prevent falls is to exercise on a regular basis but it is often difficult to motivate others to become more active. It will work out much better if you help them by exercising along with them. Do not expect them to get started on their own.

• Do not come up behind an older relative or friend to surprise them. They will turn their head and either hurt themselves or get dizzy and disoriented. Come around to the front of the person and communicate with them directly.
• Never call to an older person across a parking lot. It will distract them from the task at hand, walking. They will turn to look at who is calling to them and they will stop looking where they are going, a recipe for disaster.
• Do not walk and talk at the same time as you are helping older adults. If you need to talk, stop, chat, then continue walking after checking out for hazards. When a senior walks they need to use all their concentration on what they are doing.
• Do not shake hands vigorously with an older person. Often they have arthritis in their hands and it is painful for them.

• Make sure the recommendations for seniors that you make to the public are easy and safe enough for the elder population. For instance, a physical therapist wrote in a newspaper article that an older person could reduce their falls by standing up and sitting down 30 times in a row. It is a great exercise for strengthening the legs...but 30 times...! The senior hears this, tries it out and realizes that it is too much for them. They go away feeling older and less motivated to be active.
• Another example from the newspaper: An article describing whether a person would be healthy in older age recommended testing yourself by sitting cross-legged on the floor and standing up without using your hands. Again the senior realizes they can't possibly do this (I can't and I'm a professional dancer) and goes away with the feeling that they are too old and that nothing can be done to change their downhill trajectory.

About Vanessa: Vanessa Kettler is the creator, developer and producer ofBuilding Better Balance.Learn how to walk much more easily and in the process no longer shuffle your feet, dramatically reducing the likelihood that you will fall. Building Better Balance is a DVD based series of balance classes that teach you how to prevent having falls by improving your balance. The second in the series Legs & Feet: Walking Made Easier shows you how to walk properly and in the process makes your legs feel far lighter and easier to lift while eradicating the bad habit of foot shuffling.
Click here to find out more about Building Better Balance.