In a country with a growing aging population, the importance of specialists in geriatric care cannot be emphasised enough.
Geriatric care in brief
Like any sub-population, the aging community is afflicted with a range of conditions more specific to its members that need to be treated by specialists well versed in dealing with those illnesses and injuries. The field as a specialty has been practiced since 1989, and a large body of research and literature has been established since then.
Dementia is a progressive degenerative disorder that affects the elderly and seriously affects both their quality of life and their loved ones’. The condition begins with cognitive symptoms like memory loss, but progresses to a point where motor control is gradually lost, as are mobility and self reliance. Parkinson’s is another neurological disorder prevalent in the geriatric population, and has similar ramifications even if the underlying mechanism is dramatically different. Parkinson’s occurs as an important neurotransmitter (responsible for transmitting messages in the nervous system) called Dopamine stops being produced properly, and certain parts of the brain which depend on this chemical to work thus lose functionality. The result is the shaking characteristic of Parkinson’s and a loss of fine motor control and co-ordination.
Strokes affect the elderly population and can, depending on the speed and efficiency of treatment, result in paralysis to some extent which can only really be restored by both medical treatment and physiotherapy. Many cancers can have an effect on mobility, and as the likelihood of cancer increases with age, is a major issue in geriatric care. Pulmonary and cardiovascular disease are further considerations. After a lifetime of use your heart and lungs might not be in the best shape if you haven’t treated them well, with many smokers and obese people suffering the consequences of their lifestyle in old age. Smokers will have to contend with such conditions as emphysema and bronchitis, which limit mobility and hinder lifestyle as the effort taken to perform simple tasks increases as breathing becomes more difficult. Obesity in old age, particularly over the long term, causes serious problems in terms of blood pressure and risk of heart attack, both of which increase the likelihood of stroke.
Elderly patients also regularly suffer from conditions like arthritis, bursitis, and osteoporosis. These are often largely a consequence of a lifetime of wear and tear, but can be quite painful and limiting in terms of personal freedom and movement. Falls as a consequence of these or other conditions are a major concern, particularly in older people living alone. Lastly many elderly people suffer from depression of which they themselves might not be aware. The result of low mood can be irregular movement and exercise, without which muscular atrophy and stiffness can set in.
The elderly are treated much like anybody else in the sense that there is an initial treatment phase that will be medical or surgical, after which you will often be referred to a physiotherapist who will conduct their own assessment to establish how they intend to treat you. Their rehabilitation plan will vary hugely, depending on, for example, the condition itself, the patient and their mindset, their home and family situation, as well as previous family history.
For patients suffering from mobility issues, dementia, or with a history of falls, a physiotherapist is important in evaluating the home setting. Working as part of a multi-disciplinary team, your physio will observe your movement, posture, and gait, as well as your routine, habits, and family and social life before making recommendations as to how your home environment can be adjusted to make life as easy as possible. The goal of your therapist here is not to impose what they think is right on you, but rather to make adjustments that you are comfortable and happy with to allow you as much independence and safety as possible.
While rehabilitating mobility, a physio will use traditional tools such as strengthening exercises and hydrotherapy in the context of geriatric care. For example, as falls are a major issue in the elderly, emphasis is placed on balance and postural improvements to minimise the risk of further falls, each of which carries a risk of critical injury. Hydrotherapy is also an important tool in rehabilitation of the elderly as underwater exercises remove unwanted stress from joints that are very prone to damage.
A big and often underrated aspect of what a geriatric physiotherapist does is an element of community care. Many elderly people become depressed and thus disinclined to exercise frequently, in extreme cases they may become confined and essentially immobile as, over time, their muscles atrophy and joints stiffen without regular movement. A physio’s work here is often in conjunction with mental health professionals to motivate the patient and get them moving. Forcing exercise is not enough as the goal is to restore motivation and get the patient to move and stick to a regular regime of exercise and activity, which has the added bonus of causing improvements in mood and attitude.
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