What to expect: 5-7 minutes
*If you're on the fence about Home Health, I highly encourage you to read my previous post before you dive into Your Home Health Starter Guide - So, You're Thinking Home Health?
“You’re Hired!”, said my future boss.
I was ecstatic! A new job, new setting, new freedom! I was breaking away from the monotonous clinic job into the unknown arena of Home Health.
But reality began to slowly set in. Panic ensued as I was realizing I had NO CLUE what I was doing.
I've struggled to find the place of manual therapy in my patient population. That's why I dedicated a whole Senior Rehab Podcast episode to the topic. Thankfully, Andrew Rothschild (@ARothschildPT) was so gracious enough to write a lovely post regarding manual therapy to bring some clarity. I know you'll enjoy reading this! -Dustin
I was recently asked by Dr. Mark Cucuzzella to provide his medical students with some insight from my experience as a PT working with the elderly. The following is my response...
Dear Future Physicians:
I am writing you to offer some observations that I hope to be helpful for you in caring for people. I am a physical therapist (PT) who works with adults who are homebound. PT's help people be as mobile, functional, and independent as they can be. There are many factors that can limit patients' abilities, and it is our job (along with yours) to figure these out and provide ways to optimize their abilities and their participation in meaningful life activities.
This is not an easy task, especially from the medical standpoint. I have seen what your life is like second hand. My wife is an Emergency Medicine Physician. I have been alongside her at every step of her career. I recognize that being a physician is very challenging. People aren't getting any healthier, Dr. Google "knows" more than you do, and patient gratitude can seem like something of the distant past.
As my callouses have healed and my body has recovered, I've had some time to reflect on my recent Russian Kettlebell Certification (RKC) experience. This is not a traditional certification sought after by a physical therapist that mainly works with the homebound elderly. Yet, the more I straddle the line of fitness and rehab, I am seeing how complimentary both fields are to each other. In particular, I am seeing great value in the RKC for PT's who work with the elderly. I think my patients would agree with me as well.
In my last post, I discussed about the power of the kettlebell for older adults. The tool that builds elite athletes is the same tool that can improve strength, balance, and posture for someone in their 80’s+.
Now, I want to take the time to discuss something that can be even more powerful for older adults than the kettlebell...getting on the ground. I ask most of my 80+ year old patients, “When was the last time you were on the ground?” I typically get two responses…“I have no idea.” or “When I last fell.” These responses may seem innocent, but they can indicate two things: a lack of familiarity with the ground and fear.
Lack of Familiarity
If a person hasn’t lowered themselves to the ground in a controlled manner, doubt can easily creep in as to their ability to get to the ground. Along with doubt, comes fear…fear of the unknown.
Falling is the leading cause of injury death in the elderly. For many older adults, a simple fall is the difference between living independently at home and living in an assisted-care facility. This brings fear for many. As this study demonstrates, as fear goes up, performance goes down.
Most of us have experienced this. I often experience it when I go hiking in the woods. For example, if a fallen tree is flat on the ground, I can walk on it with no problem. Yet, if that fallen tree is three feet over a stream, I feel like I’m walking across the Grand Canyon on a tightwire. The only thing that’s different between the two scenarios is perception, and perception drives behavior. For someone that’s fearful of falling and being on the ground, walking can feel like a tightwire act.
To improve the situation, embracing the very thing that causes the fear may be necessary.
The more I share my love for kettlebells with people, the more I'm realizing how intimidating this ball of iron can be. Many people associate kettlebells with intense fitness fanatics or meathead strongmen. Yet, that couldn't be further from the truth.
With that in mind, I wrote a post to show just how adaptable the kettlebell can be. This tool that forges elite athletic bodies is the same tool that can help grandma/grandpa be able to get off the recliner, out of bed, and off the toilet.
I hope you enjoy - Using Kettlebells with the Elderly.