Remember What You Wrote
Things I’ll Do Differently When I’m Old
Steven Petrow of the New York Times wrote a great article, Things I’ll Do Differently When I’m Old. As a physical therapist that has guided thousands of 60 year plus individuals through the rehabilitation process, I have some suggestions.
I will work with a professional on developing a sustainable fitness program. The preventative against age related physical decline is a program of exercise. Consistent exercise reduces fall risk and maintains independence. No other modality has a greater impact on health. Blood sugar levels, respiratory capacity, mental health, and cardiac fitness all respond favorably to exercise. Do not be a fitness “do it yourselfer”. Older, deconditioned, and previously injured individuals get much better results when under the direction of a qualified professional. One way or the other, you are going to spend time and money on your health. Spend it up front–you will be much happier.
I will not let pain linger. Pain is not a “normal part of aging”. Chronic pain alters brain chemistry and destroys healthy movement patterns. Left untreated, pain has the capacity to weaken and spread damage to joints not involved with the initial pain provocation. See a physical therapist and find out what you can do to resolve pain issues before they become chronic.
I will exercise caution with medications that have an effect on the central nervous system. Many older people take multiple medications that impact brain neurochemistry. More brain real estate is devoted to movement than reading, writing, and arithmetic. A steady diet of pain medications, sleeping pills, and anti-depressants takes a toll on coordination, balance, and the ability to safely get around town. Add in a cocktail or three and you have a dangerous combination.
I will make a sustained effort to recover from any and all physical challenges. As we travel through our senior years, most of us will experience a health setback that requires rehabilitation. Full recovery of strength, mobility, and function takes eight to twelve months. Many physical therapy patients stop all rehab efforts way too soon. More of the rehabilitation battle is being fought in isolation as reimbursement for physical therapy care is shrinking. You may be done with formal physical therapy in four weeks, but you need to continue with a restorative exercise program for much longer.
I will not get fat. Physical therapy patients that are overweight have much more difficulty recovering from an injury or a challenge to their health. Sarcopenia is the medical name given to age related loss of muscle mass. Adding extra fat onto a body that is losing muscle creates an environment that makes movement more difficult and pain more prevalent.
I will listen and answer all questions from my health care provider to the best of my ability. The answers we get from the patient are the clues that lead us to the proper care. We need to know how your pain / symptom behaves and the effect it has on your life. Please do not omit any information that you feel is not important or unrelated to your condition. Do not lie about any aspect of your functional status, medications, mental health, etc… Your therapist, doctor, or physician assistant cannot help if we do not have all of the information.
I will plan ahead. In my dealings with older physical therapy patients, these are the three things that make life easier for both the patient and their families. Do what you can to manage these issues while you are healthy and clear headed.
- Have a Will with end of life directives.
- Insurance coverage that reduces the expense of long-term care.
- Pre-planned funeral services and insurance
Michael S. O’Hara, PT, OCS, CSCS
Read the NY Times article here: https://www.nytimes.com/2017/12/05/well/family/thing-ill-do-differently-when-im-old.html?_r=0
The June newsletter brings information on side planks and bird dog exercises for core stability. Watch the video for demonstration of the exercises given. Mike O’Hara gives some practical advice on preventing falls in his article, Fall Recall. Read one person’s story about his transition from physical therapy patient to gym member, and be sure to check out sled rowing.
Mr. V had pain in his lower back and right hip. The problem had been present for over a year and he had been diagnosed with spinal stenosis. He was sent for physical therapy by his family physician because he was having difficulty climbing the stairs and walking in his home. Mr. V was 78 years old and lived with his wife Miriam. Miriam reported that her husband had mild dementia and had fallen three times over the last month. Mr. V stated that he often felt dizzy when he got out of bed, but he was not sure why the falls happened. Miriam stated that they did not bother to tell the doctors about these falls.
One of the best reasons to develop the habit of fitness is that it can reduce your reliance on medications. It makes my day when fitness clients inform me that they have been able to discontinue a medication because of the improvement in their blood pressure, lipid, or sugar levels. Pain relief medications are no longer necessary when joints and muscles work more efficiently. Exercise has been shown to work as well or better for the treatment of depression. The quality of sleep is enhanced and brain neurochemistry improves when you exercise on a consistent basis. The habitual performance of exercise is the most effective method of reducing medications.