Pt for Me?

It’s been about four years since I had my shoulder surgery.  It was by far not my first surgery, but it was the first procedure that I recall having intensive physical therapy.  Now granted, I’m in my 40s, but I truly believe that the success that I experienced with my shoulder recovery was due largely in part to my “buy in” to doing physical therapy. October is National Physical Therapy Month.  Physical therapy for the elderly can be such an important part of the healing process as well as a factor in continued health.

The following is helpful information for seniors and the advantages of physical therapy interventions per medicine.jrank.org:

  • Physical TherapyPhysical therapy has an important role in healthcare delivery and relates to maximizing function, preventing decline, decreasing pain, and treating physical illnesses. For elderly individuals, who often have decreased physical reserve, any medical illness or injury can lead to decline. Inactivity and bedrest, a common consequence of illness or injury, contributes to and intensifies muscle weakness, causing deterioration in walking and loss of function.

 

  • Illnesses, such as Parkinson’s disease, fracture, or stroke, can affect walking and balance directly. Chronic diseases, such as arthritis, may cause pain or restriction of movement. Exercise, activity, and other physical therapy interventions can, therefore, have a profound effect on overall health, restoring an individual’s ability to perform the daily activities required to live independently in the community.

 

  • The physical therapist typically works closely with other healthcare professionals, such as nurses, physicians, social workers, and occupational therapists, to refine both diagnosis and treatment. This interdisciplinary approach allows for the integration of all domains of health to more fully address the needs of the elderly.

 

If you or someone you know can benefit from physical therapy for strength and healing contact your primary care physician to see what options may be best for you.

 

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Keep It Clean

There are many reasons that family members become concerned that an elderly loved one is not doing well.  One issue that is a cause for concern is bathing or rather the lack thereof.  A parent not bathing is a topic that many families are reluctant to discuss as they may be uncomfortable bringing it up. But be assured that this is an issue that many people face.  It is common…but there may be multiple root causes.  It is important to understand why they are reluctant.  Only when you understand that the underlying reasons can you better approach and address successfully.  Let’s look at some of the more common reasons.

 

  1. Fear of Falling

The bathroom can be a very dangerous place. If you have every slipped in the shower, you can relate. Now you pair the environment with physical issues like foot problems, balance issues, arthritis and more…and you have a recipe for disaster and fear.

 

  1. Depression

Often elderly have issues with depression that can zap their get up and go. When you lack motivation, bathing and concerns for your grooming often go by the wayside.

 

  1. Cognitive Issues

Another reason that is very common are memory issues. If your parent has dementia or other cognitive decline, keeping up with a bathing schedule can be extremely difficult.  Realizing that you haven’t taken a bath is not something they may be able to keep up with easily.

 

While it may be a difficult subject to approach, you must develop a plan. For some simply adding grab bars or safety equipment may help. Some may be able to follow a chart.  But if it is a depression or memory issue, it may be time to consider getting help.  As always discuss your concerns with a doctor.  A physician may want to consider medications to help with depression.  It may be time to enlist the help of a caregiver or look into an assisted living community where your loved one can have daily assistance with their activities of daily life like bathing and grooming.  But don’t avoid the topic because it is messy and uncomfortable.  The health benefits of cleanliness are far too important to ignore.

Making Steps in the Right Direction

One of the highlights of the many varied activities that we have in our Assisted Living community has nothing to do with entertainment.  It does have everything to do with health and prevention.  When it comes to taking care of our feet, it is no small matter.  Yet many seniors lose the ability to safely trim their toenails or inspect their feet for other issues.  That is why the periodic visits from a podiatrist keep our residents feeling one step ahead!  Since the feet are closely tied to our overall health…here are some simple tips excerpted from GREAT FEET FOR LIFE: FOOTCARE AND FOOTWEAR FOR HEALTHY AGING by Paul Langer, DPM to keep your feet headed in the right direction.

loofahs-jpg-838x0_q67_crop-smartFoot Hygiene   The single most important thing one can do for foot health is good foot hygiene. This means washing the feet daily, wearing clean socks and caring for the skin and nails on a regular basis.

Skin Care  The skin of the feet must be resilient enough to withstand thousands of footsteps each day. Bathing the feet daily, applying moisturizing lotions to dry skin and managing calluses with lotions and a pumice stone helps our skin hold up to the demands of an active lifestyle. Never ignore rashes, painful calluses or skin that is red or tender as this can be a sign of infection. For those whose feet sweat excessively, foot powders and socks with less than 30% cotton are best for keeping the skin dry.

ca5c5fa4-12a5-404b-86bc-05c404b1a623Nail Care  Toenails tend to become thicker, discolored and more brittle as we age. This can make it more difficult to trim the nails and contribute to painful nail conditions such as ingrown nails or fungal nails. Nails should be trimmed straight across and rough edges or nail thickness should be reduced with a nail file.

Footwear   For those who are vulnerable to foot pain whether from arthritis, previous injuries or toe alignment issues such as bunions or hammertoes, it is imperative that you wear shoes that fit well, provide proper support and are not excessively worn. Poorly fitting shoes contribute to many of the most common causes of foot pain. Take the time to visit a reputable footwear retailer and spend the time necessary selecting a comfortable, supportive pair of shoes.fuzzy-socks

Falling Risk and Your Feet  Risk factors for falls include: poorly fitting shoes, shoes with elevated heel height, excessively worn shoes, sandals or shoes with an unsecured heel.

April is Foot Health Awareness Month.  So step up and make good choices for your foot health!  It will help keep you feeling footloose and fancy free!

If the Shoe Fits

As I continue my discussion about falls, I thought I might provide a little comic relief to share my most embarrassing fall.  Picture this.  It’s my little girl’s dance recital dress rehearsal.  Mamas, Grandmas, and some Dads are all up in arms trying to make sure they have their little Susie’s right shoes with the right costume and heaven knows we must have on ENOUGH makeup to be “stage appropriate” too.  Well amongst all this chaos we had a routine (or at least a performer) that was about to be cut because one of our senior level dancers was sick and was not able to partner with the junior performer for this cute little number.  Well as they say “the show must go on” and our ever improvising and quick thinking director called out from the curtain…” Is Heather Bradley in the building”?  SAY WHAT??  Oh dear woman, you do jest.  Nope, she was quite serious.  And within moments this child with big crocodile tears that was about to have to sit out was being twirled and tossed by yours truly.  So I fell on my face on the stage during the routine right?  No…wait for it.  We got through the routine and I was feeling pretty good for a washed up former tap dancer.  So as I slipped back into my wedges and started bounding down the stairs…it happened.  I fell down the steps with such graceless effort that I literally fell flat on my face.  Well, I fell on my hands to be more specific.  My friend Renee said I jumped back up so quickly though that I looked like a cartoon character.  So as I jump up to quickly assure everyone that I am truly okay, I make a discovery.  My shoe is broken, my watch is broken and I soon discover at the ER (where my friend Sam insisted I get checked out when she sees blood coming from my wrist) that my hand is also quite broken.  So when I speak to you about falls, trust me I am a professional.  It takes a pro to fall off a stage in front of an auditorium packed full of people.

shoes

So the shoe.  Let me tell you it was the source of the fall.  So when I tell you that ill-fitting shoes can be a hazard, I know from first-hand experience.  Now granted most elderly adults are not bounding down the steps of a stage.  But if your shoes don’t fit properly you can be stepping off a curb or standing up for that matter and the shoes can become a fall hazard.  Another important thing to consider is foot care.  Many seniors don’t have the ability to trim their toenails anymore.  Throw in the fact that many are diabetic and this adds additional risk and you can see how toenails can wreak havoc and up the ante in the fight against falls.  Foot pain and poor footwear have been cited by the Center for Disease Control as one of the major contributing factors for falls in the elderly.  So be sure that you check your loved ones’ shoes and make sure that they fit well and are in good condition.  Also, check their toenails and see that they are trimmed regularly by someone that knows what they are doing and especially if they are diabetic.  Regular checkups are important, right?  It is equally important to get your feet checked out too!

foot-exam_thumb

Be an advocate if Mom’s feet have been missed in the examination.  Most physicians include this in a comprehensive check.  But believe me, I have seen it be missed.  Don’t be afraid to speak up and make sure that foot health is a consideration.  While my middle aged broken hand healed up nicely after my fall, a fall for a senior can be much more devastating because as we age we become more frail.  Taking proper precautions can help your loved one from being one of the 2.8 million older Americans that is treated in the ER annually for falls.  So be smart and evaluate these issues and it will help everyone keep one foot safely in front of the other.

Falling For You

Before I began working in the senior living industry the word FALL didn’t strike fear into my heart.   No on the contrary it would spark images of leaves turning to brilliant hues of gold and crimson and the sound of them crunching under our feet as me and the neighborhood children would play flag football in the yard.  It would spark memories of the delicious smells of the season from my favorite pumpkin spice candles to Mom’s homemade chili brewing on the stove.  Ah yes, the innocence and tranquility of it all.  But I digress.  And who am I kidding that football usually turned into an all-out brawl anyway.  But seriously FALLS as we know them and how they relate to our seniors are a very big deal!

By the numbers…

  • According to the CDC “each year, millions of older people—those 65 and older—fall. In fact, more than one out of four older people falls each year, but less than half tell their doctor. Falling once doubles your chances of falling again.”  The CDC also reports that “adjusted for inflation, the direct medical costs for fall injuries are $31 billion annually.  Hospital costs account for two-thirds of the total.”

It is imperative that we take measures to try and help prevent falls if at all possible.  Sure this seems very idealistic!  But it is also helpful if we take a practical approach.  You may not can prevent all falls.  But you can take appropriate measures to keep someone safe.  So where do you start?   This is an important question no matter where you live.  Today we will start with the first thing you can do.

Keep your area safe…

I remember a friend from church once asked me to come over and look at their parents’ home and see if anything jumped out at me as to why their parent kept falling.  Walk with me if you will….we start up the concrete steps to the home that has no handrail.  This takes us to the kitchen where a cute blind dog nips at your knees.  We cross down to the living area that is situated on the split level property across from the bathroom.  In the tiny bathroom there is a sliding glass door shower/tub with no handrails and a towel bar that is dangling from the wall.  I can’t make this stuff up.  Did I mention that the home was also poorly lit?  I really couldn’t see why they needed my help discerning the safety issues within this home.  The entire place was a hotbed for concussions and broken hips!  So always ASSESS your FALL RISKS within your living space.

Key things to pay attention to include:

Clutter-get rid of it!  Make sure you don’t have junk making an obstacle course for you to maneuver around.

Lighting-make sure you can see!  Also make use of nightlights.  What you CAN’T see CAN hurt you.

And also watch for HOME HAZARDS such as:

  • broken or uneven steps,
  • throw rugs or clutter that can be tripped over, and
  • no handrails along stairs or in the bathroom.

There are absolutely multiple risk factors and reasons for falls to occur.  But if you do your best to make sure your space (or your loved one’s space) is as safe as possible, you are increasing your odds of NOT becoming a statistic in the fight against FALLS.

What Can I Do To Keep My Senior Parent From Falling?

senior-fall-prevention

As the adult child of a senior parent, we live in fear of the day we get that phone call telling us that something has happened to one of our parents.  Sometimes it’s a medical emergency, but most of the time it’s that our parent has fallen.  Falls occur in one out of every 3 adults over the age of 65. Each year, more than 1.6 million senior adults go to the emergency department for fall related injuries.  Among older adults, falls are the number one cause of fractures, hospital admissions for trauma, loss of independence, and injury deaths.

Hip fractures are one of the most serious types of fall injury. They are a leading cause of injury and loss of independence, among older adults. Most healthy, independent older adults who are hospitalized for a broken hip are able to return home or live on their own after treatment and rehabilitation. Most of those who cannot return to independent living after such injuries had physical or mental disabilities before the fracture. Many of them will need long-term care.

What can I do to prevent my Mom or Dad from falling and breaking her hip? While falls in senior adults are common, there are things we can do to reduce the risk of falling for our parents.

Do a walk thru at your Mom’s home and ask yourself these questions:

  • Are there clear pathways throughout the house?
  • If your Mom or Dad uses a walker or a cane, make sure there is enough room to maneuver without tripping or bumping into furniture.
  • Are there steps or variations in floor height inside the house?
  • Is there adequate light, especially at night when Mom or Dad may get up to go to the bathroom?
  • Make sure there are night lights in the bathrooms, hallways and in the bedroom.   De-clutter the house.  Let’s face it; we all like to hang on to things.  Clutter, especially when it makes it difficult to maneuver with a walker or cane, can lead to falls.

If your Mom or Dad has an unsteady gait or has fallen in the past ask her physician if she can get physical therapy to improve her gait and help with endurance.  Medicare and most insurance cover the cost of physical therapy and it can even be provided in the home if necessary.  Ask your Mom’s physician to check her Vitamin D level.  Vitamin D deficiency has been linked to falls in senior adults and if the level is low, ask about a Vitamin D supplement.

Remember, falls can be serious and often have other serious consequences or complication down the road.  But you can be pro-active now and take the necessary steps to prevent fall risks today.