Mention dementia or Alzheimer’s and the next thought associated with this diagnosis affecting more than five million people aged 65 or older in the US, is decline. Dementia is the leading cause of disability causing memory, language and decision-making problems along with increased mood changes. But the most physical harm comes from dementia and Alzheimer’s ability to cause poor co-ordination, balance problems and resulting falls. These harmful effects create havoc for an individual’s quality of life as well as for their caregivers/family members. Healthcare costs are immensely impacted by Alzheimer’s and dementia’s risks—costs are not in decline, but on the contrary, rapidly rising as the population ages.
Exercise is a lifestyle factor that has the potential to reduce or delay the progression of dementia’s onset and symptoms.
The ability to move increases the ability to function and to be as independent as possible. Recent research has yielded multiple studies world-wide delving in to whether physical therapy could improve dementia’s declines. The most exciting results include:
- People diagnosed with dementia who received physical therapy at home after hospitalization were more likely to have improvement in their daily functioning; in fact, there was a positive correlation between number of visits by a therapist and increased improvement. The more therapy received, the more improvement was noted.
- Disruptive behaviors also decreased for dementia and Alzheimer’s patients who had physical therapy.
- Physically-active people, as compared to less active, are less likely to have cognitive decline as they age; mobility slows down progression of dementia and Alzheimer’s.
Physical therapists’ expertise is movement. Their job is to help patients reduce the barriers to movement, and help keep mobility an important priority in healthy aging and/or reducing the devastating effects of dementia and Alzheimer’s. Early stage dementia or Alzheimer’s is the best time to include the PT as an integral part of the healthcare team. This will help patients continue daily activities. In later stages, PTs can help patients continue to perform the functions such as dressing and other daily activities we take for granted until someone else has to help. Not only does this help reduce the caregiver’s burden, but the therapist is there to help instruct family and caregivers on how to best manage safety in the home environment.
Aging and dementia and Alzheimer’s brings other physical conditions affecting movement—arthritis, falling, or broken bones. Having a relationship with a physical therapist can help identify problems early so fall risks are reduced.
What are the unique approaches used by physical therapists when they work with dementia and Alzheimer patients?
Physical therapists are key to preventing decline for a variety of health conditions including dementia and Alzheimer’s. Getting to know the patient is essential, not only in their current circumstance, but also throughout the adult life span. PTs want to know about the patient’s likes and dislikes, sleeping and waking habits “then” as well as now. Lifestyle matters! Was he a steel worker spending years dealing with shifts? Was she an avid gardener who also loved crafts? What are the current family dynamics? Who is the responsible caregiver and how is he or she coping? What activities have declined that once were enjoyed? The physical therapist is like a detective; answers to questions lead to the best visits and treatments. Therapists talk to their patients about what they have learned about the individuals they will visit in order to form a bond and trust to encourage patients to participate.
A great example is encouraging someone who is usually sedentary to walk. What will it take to communicate? If he has been a golfer, the therapist may invite him to walk together to the next green to putt. If she has been a homemaker, perhaps a trip to the kitchen to get supper started will encourage a walk.
Physical therapists have to break the cognitive barrier by using sensory techniques:
- Sight cues such as raising both arms to encourage a person to stand up; acting as a “mirror” by showing a person how to move.
- Using short and simple instructions in a pleasant and calm tone of voice.
- Taking a person by the hand to begin walking.
- Using simple step-by-step approaches to show a person how to achieve a simple task like moving from lying in bed to sitting in a chair.
Caregivers and family members will also need to learn these approaches as well as how to safely move, lift, or transfer dementia or Alzheimer patients. This includes staff in short and long-term care environments. Physical therapists often provide these training sessions to instruct caregivers on how to prevent injury to patients as well as themselves. Residences Senior Living staff have training using appropriate and safe techniques to support residents.
The power of group settings: research has also indicated that together, dementia and Alzheimer patients tend to respond better to exercise.
Our Life Enrichment Team initiates daily exercise for residents; many residents take charge of the group. They may use pool noodles to bat balloons to each other even while seated, among other activities. During warm weather they enjoy exercise in the outdoor courtyard. A stroll around the courtyard is also standard fare and enjoyed by family as well. Tai chi and other seated specialty movement approaches are also popular.
Residences Senior Living Wellness staff helps families with referrals for physical therapy as need arises. The optimal well-being of each resident is always our top priority!
We work with each person one-on-one to design a rehabilitation therapy program that suits their individual needs. We offer the latest equipment, knowledgeable staff and exercises that maintain and optimize overall health and flexibility. Our physical therapists are experienced in geriatrics and know the challenges seniors face in preserving their mobility.
