Despite the pandemic and the risk of contracting COVID-19, our physical and occupational therapists still make a big difference in lives of older adults in the East Bay. They make phone calls, home visits and arrange for group exercise outside at senior housing apartments. It’s a matter of going to where the seniors are rather than having the seniors come to a central location.
Doctor of physical therapy Lauren Fleisher explains how getting physical therapy is essential to maintaining or even improving function. “We all need regular physical activity for our bodies to thrive. The body needs it and even a small amount can have big pay offs.”
Lauren is a physical therapist. She specializes in working with older populations at Center for Elders’ Independence located in Alameda and Contra Costa Counties.
“We approach physical therapy from a functional point of view. While knowing the ‘why’ behind a specific issue is good and satisfying, the ‘what we are going to do’ about the injury or chronic pain is what truly matters. If your goal is to climb a small set of stairs, then we can work on the functional components, help you put it together, and hopefully get you up those stairs.” Lauren works as floating physical therapist for CEI. She goes from site to site, and has been part of the recent community-based exercise groups and home health therapy. She gets to know many seniors that way.
Relearning how to walk
One senior she’s been working with closely is Mr. C who recently relearned how to walk after an extended hospital stay. “His legs, knees and back became very stiff after being bedridden for several months. To get walking again, we started with mobility, bending his ankles, knees, and hips, increasing the bend slowly over weeks. Then we incorporated more and more strengthening as he was able to tolerate more motion and time out of bed. I’m thrilled to report that after many months of digging deep, Mr. C can walk around his house again.” He still has more to work on, such as climbing stairs and walking outside, but he’s made tremendous progress. “Recently, he said walking is the easy part now!” At age 74, Mr. C was determined to live his life to the fullest and not let a recent illness get in his way.
“It was his willingness to put in the time and effort that got him standing and walking again. I might create the most effective, theoretical plan but without the person actually doing the exercises regularly, progress won’t happen,” Lauren continues.
Esther Akiba, an occupational therapist at the Berkeley PACE Center, helps Gwendolyn Duncan work on her balance.
Preventing Falls With Exercise
Exercise can actually ease the fear of falling and strengthen balance. Falls are a major event many seniors experience often with bruises and possible broken bones. By working with a physical therapist at Center for Elders’ Independence, seniors learn which exercises they can do at home. Seniors then gain additional empowerment and the freedom to live in their homes longer.
Lauren explained how collaboration and compromise makes a huge difference in working with older adults in the East Bay. With some seniors, “I’ll hear ‘it hurts’ or ‘I’m tired’ or bingo is happening. If bingo is happening, forget it. No one is going to stop their game to do a straight leg raise. So we come with up a plan together that will work for them. It could be about positioning, equipment, or it could be doing an exercise per commercial while watching TV. It’s meeting them where they are and engaging them to reach their goals. Even doing a few exercises to keep the function they have could be vital to their quality of life and independence.”
What's the difference between physical and occupational therapy?
Physical therapists work very closely with occupational therapists. While physical therapists use equipment typically found in a gym, occupational therapists use all kinds of gadgets to help with daily activities. Daily activities include bathing, getting dressed, going to the bathroom and feeding oneself. Physical therapists help you get from point A to point B (i.e. mobility). Occupational therapists help you when you get to your destination (i.e. activities of daily living).
Occupational therapy is helpful if a person is:
- Feeling they don't have the strength or dexterity to open food containers
- Finding it difficult to grip their toothbrush or fork, knives and spoons
- Experiencing difficulty with buttons and zippers, and avoids wearing clothes that are "hard to get on"
- Have frequent falls
- Lonely at home because they can't move around easily to get out of the house
- Finding bathroom toilets and showers difficult to use
Health is about more than "diagnoses." Good health is about living life the way you want to. PACE is recognized as an innovative health plan that includes physical therapy and occupational therapy.
Even tossing a ball back and forth helps strengthen eye-hand coordination. Here a San Leandro PACE Center physical therapist works with a wheelchair-bound senior.
Darlyn San Jose is an occupational therapist at the Center for Elders’ Independence Berkeley PACE location. She works hard to keep seniors at a sustainable level to remain safely at home for as long as possible. “I work closely with physical therapists, home care aides, home care nurses, the senior and the senior’s family. We work to determine what OT intervention equipment will work best for the situation. Let’s say that someone needs additional help with bathing. Is it getting in and out of the tub that is difficult or standing under the shower that is the challenge? By breaking this down, I can provide grab bars, a shower chair and/or teach a family member how to help their senior into the tub. All of us work together to reach the goal of maintaining the senior’s functional abilities.”
Small Adjustments Give Big Results
Older adults who start to have physical or cognitive impairments benefit the most from the occupational therapist’s tool chest. A small adjustment can make the difference between staying at home or moving to a residential care facility.
“For example, if a senior forgets the stove is on, we can either supply a simple kitchen timer as a reminder or install a more complex system that will automatically turn the stove off after a period of time. This system provides a great deal of peace of mind for family members that a fire is far less likely to happen,” explains Darlyn. “It really makes a difference for everyone.”
Before COVID, many seniors would exercise together as part of their daily activities at the PACE centers.
Teaching is a Big Part of the Job
Something else that makes a big difference is education. Occupational therapists and physical therapists do a big amount of teaching both the senior and their family members. With education, outcomes are more positive and adherence increases. “When someone understands the why or the purpose, they are more willing to use the walker or shower chair or whatever the equipment happens to be,” shares Darlyn. “Compromise and collaboration are essential too. Sometimes the equipment is a visual, constant reminder that someone is aging. They either flat out refuse or offer different ideas. And that’s okay. We can get creative to meet the goal of staying in the home as long as possible. We have many, many options in the tool chest.”
Both women are highly passionate and enthusiastic about working with East Bay seniors. Their dedication is evident as they spoke about their work. Darlyn and Lauren love the PACE model of senior care as “it gives me so much freedom to actually make a difference. I can team up with others to ensure that someone has enough food or work with home care aides to keep things off the floor. I can see how my work directly makes a difference for someone and that is very fulfilling,” says Lauren.