As the US population continues to grow, so does the aging population. The number of Americans aged 65 and older is projected to double from 46 million to more than 98 million by 20601. Staying healthy, active and productive are admirable goals for our nation’s older adults. However, society’s traditional view of “old age” has not always kept up with the reality of being old in America. Many older adults and others in society buy into the old myths of fragility, feebleness, forgetfulness, and senility2. Therefore, many are treated by healthcare providers as such and may and/or have been pigeonholed to those stereotypes. Physical therapists are in one of the best roles to dramatically change this practice and improve the aging populations health status and function. The goal in this article is to help the physical therapist incorporate the concept of resilience into the rehab process.
Resilience: The Game Changer
Resilience is described as the ability to achieve, retain, or regain a level of physical or emotional health after illness or loss3. There are multiple interventions as listed below that physical therapists can perform in clinic to help their older adult clients learn resiliency skills. Additionally, older adults can achieve greater outcomes in physical therapy as a result of learning these skills. This provides another avenue in which a physical therapist can be more effective.
Physical therapists can provide a quick written guide (pamphlet in their waiting room or as a parting gift provided at their first appointment) to their older adult population on local community and/or outreach groups that are specific to certain conditions or just for general social interaction. There a multitude of different national organizations in the government and NGO’s involved in improving the nation’s older adults.
For example: National Coalition on Aging created an Aging Mastery Program with reading materials and access to classes that are led by expert speakers who help participants gain the skills and tools they need to manage their health, remain economically secure, and contribute actively in society.
Education is key with the older population.
It is necessary to take time (even a whole PT session) to go over concept points on resilience and use client centered language that makes the client feel heard. Furthermore, it might be helpful to ask the client to bring in important family members that either help in their care or are essential to their social identity.
Physical therapy clinics can and sometimes do provide info-seminars. These seminars can bring together older adults with similar and/or different conditions in order to promote camaraderie and dissemination of knowledge.
Open floor clinics are sometimes a great setting for older adults to come in and use their session as a way to socialize with others with similar changes to their lifestyle. Many times this gives that older adult a glimpse into the future success they will incur with continuing their PT program.
It is not a form of defeat for a physical therapist to refer individuals who display symptoms of severe depression and or other mental health disorders to an appropriate mental health professional
Physical therapists who are owners of a brick and mortar clinic can provide fun and interesting group classes that target at risk older adults (dance, yoga, stretching, etc). Making it more of a recreational activity can boost self esteem and create a meaningful experience.
During the session focused activities to enhance happiness, with the conclusion that doing so can improve resilience. This can be done by creating positive goals (written in clinic or in a daily journal) related to previous activities that have made the client optimistic about the future or happy in the present.
Other effective interventions may emphasize the strengths of older adults, including the ability to establish and maintain social connections, willingness to help others, and desire to engage in the community. For example having a retired family law practitioner who just underwent a knee replacement to help get back to standing for hours on end in order to provide pro bono work for at risk youth3.
Clinicians must educate older adults about topic of resilience and the importance of physical activity in any form. It empowers older adults to play a more informed, active role in their own health. Clinicians can correct misconceptions that illness and disabilities are caused by activity or necessitate inactivity.
MacLeod S et al. (2016). The impact of resilience among older adults. Geriatric Nursing, 37, 4, 266-72.