Recently I observed someone very close to me as she participated in Physical Therapy. She hadn’t had an accident, or a stroke as had many of the other people in the therapy room. She had just aged. She had some arthritis and other nonlife-threatening, but painful and exhausting, challenges but had resisted PT as this was just for “other old people or people with injuries”. However, within 10 weeks when a recheck was done, her scores were 50% to 100% better than when she started. She was walking with noticeably better posture and was moving more agilely. Her comments were, “I didn’t notice how I had been retreating within my pain and actually causing more stiffness and slowness as my window of function became narrower. I found that I had developed compensating movements that actually were hindering me and causing me to feel older and more frail.”
In addition to observing my friend, I also observed other older people who appeared to be recovering from strokes and falls and their progress was equally noticeable regardless of where I observed their functioning when I first arrived or how far they had come.
This has led me to become an advocate for the implementation of targeted stretching and strengthening exercises in our assisted living and memory care residences, as well as for many Seniors who are choosing to live at home. Could the subtle movements be implemented by care partners who have been trained and supervised by physical therapists?
Most of the progress made by my friend was from the on-going daily practice that was set up by the therapists and reinforced in written instructions and pictures. This allowed the participant to be certain that the exercises were done correctly. I also noticed an increased confidence and joy in my friend as old patterns of walking and posture returned. She said she was surprised that she was able to recover so much of what she had lost. The pain was not gone, hers is a chronic condition. However, she now has the goal to continue to gently stretch and build strength around the weak areas to continue to make her life more fun.
What surprised me, besides the improvements that I observed, was the gentleness and positivity in the therapists’ delivery. Everything was done with an attitude of meeting clients where they were and enjoying each accomplishment. It was not at all like a gym where clients are constantly urged to do more and which can be intimidating to older adults who have lost their fitness and zest.
In an interesting article in the Los Angeles Times (LATimes 2/11/19) Roy M. Wallace describes the journey of his 89 year old father, a retired aerospace engineer, during the first eight weeks of a Wellness FX program. His father joked that his previous exercise was “at Costco looking for free samples”. His son noticed that his gait had become shuffling and he was bent over “as if looking for coins”. The worst was his acceptance “of a future in physical decline”. After the first eight weeks of the program, measurements showed that his endurance more than doubled, his heart was stronger, and he was no longer in the “diabetic danger zone”. His ability to accomplish these results may not be typical and should not be the gold standard for all to follow as that alone can be discouraging. However, in the same article, Robert Forster, a physical therapist who runs a program that serves many Seniors, states that “movement is the best medicine”.
With an average life expectancy for someone who is 65 in 2017 to be another 19.5 years (CDC.gov). Isn’t it time to build in these preventative steps to encourage health, and minimize risks and health care expense? It seems that addressing this protocol of care should be a meaningful part of health-care programs for Seniors and integrated into personal care management protocols. Could gentle, regular stretching and strengthening protocols become a part of life-care management to prevent falls, improve balance, and promote the ability to continue to participate in fun, relaxing and rewarding activities? How can we as gerontologists and advocates encourage support for these types of preventative steps to encourage health and possibly minimize medical expense in the years to come for all our Seniors?