| These problems can be solved by taking the following
precautions:
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Removing slippery rugs.
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Installing handrails near bathrooms and bedrooms.
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A shower or tub chair which will prevent a weak
or unsteady person from having to stand in the shower, or get up
from a sitting position in the tub.
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If the house is multi-storied, it is advisable
to have the entire living space of the elderly person on a single
floor which will ensure that the elderly person does not have to
climb stairs too often.
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If this is not possible then additional railings
can be installed to enable the elderly person to hold the railing
with both arms as they go up and down the stairs.
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Another option for multi-storied houses is to
install a stair-glide, which is a motorized chair that rides up
and down a rail attached to the stairwell. These chairs have their
own safety features, including safety belts, seats that swivel,
and back-up power.
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If the elderly person has to use a wheelchair,
navigating through the house becomes very difficult. The doorways
have to be wide enough to fit the chair. Barricades have to be put
up at stair landings to prevent accidental falls. Other adjustments
will have to be made in the design of the house to make it accessible
by a wheelchair.
What can a Physical Therapist or Occupational Therapist
do to help?
Physical Therapy
A Physical Therapist can often be referred to, to
check the physical condition of the elderly person. The therapist normally
checks the patient's walking abilities, how difficult it is for the
patient to get out of bed or do other activities like getting up from
a chair, picking up objects like pillows form the floor, etc. The general
physical strength of the patient is evaluated and accordingly exercises
are suggested. These exercises can be performed at home or the patient
may have to visit the doctor to perform certain exercises which may
need use of special equipment. Normally, the doctor and the physical
therapist work together to ensure proper and effective exercises which
will HELP in improving the patient's health faster.
A home visit from a physical therapist can be extremely
helpful. A physical therapist can evaluate your living space and
can make recommendations on how best to make it safer and easier for
an older person to negotiate. When I do home therapy prescribed by a
doctor, I usually schedule visits 2 to 3 times a week to do strengthening
exercises, practice transfers in and out of bed, and exercise to improve
balance and coordination.
Occupational Therapy
Occupational therapy evaluates the elderly person's
ability to manage everyday activities, like getting dressed, bathing,
grooming, and preparing meals. Certain medical problems like arthritis,
paralysis, etc. can prevent the patient from performing tasks like buttoning
shirts, tying shoelaces which we tend to take for granted. Occupational
therapy is useful to provide alternative ways of doing these tasks by
using simple devices. A long-handled grasper, for example, can be used
to pull on socks that one can’t reach. Occupational therapists also
suggest home safety measures to make the home a safer place.
How important are physical exercises?
It is very important for the elderly person to remain
active in whichever way possible. Even for bedridden patients it is
important to have some degree of physical activity. Ask the doctor to
suggest an exercise schedule to ensure that the exercises are performed
at the right time and in the right quantity. It is important that the
patient does not strain himself/herself by performing more exercises
than he/she is capable of.
Most people who are unable to get out of bed have
difficulty moving around in the bed as well. Changing positions
can be difficult, and lying in one position for too long can lead to
pressure sores and ulcers. Turning them or helping them turn onto their
back or side every two hours can help prevent pressure-related problems.
Other simple exercises like bending and straightening the arm at the
elbow, moving the limb gently through it's normal movement, etc. prevents
the muscles from becoming stiff. A typical, full body range of motion
regimen, starts with the shoulders and works toward the feet, moving
each joint in turn. It is important that these exercises are performed
in the presence of a trained therapist, nurse or doctor initially.
Once the family members get accustomed with the ability of the patient
to perform the exercises, presence of a therapist is not essential.
These exercises should be performed carefully and slowly and it must
be ensured that the patient does not strain himself/herself, while performing
these exercises.
For mobile patients, walking is the most beneficial
exercise. It helps in increasing circulation, maintaining strength of
the bone structure, etc. It is very easy to perform this exercise with
the help of a walking stick and other aids. Walking can be done within
the premises of the house, or in some nearby parks depending on the
physical condition of the elderly person. This simple task can give
the person both a daily dose of exercise and a sense of accomplishment.
What are the types of walking aids available?
Certain physical disabilities can make walking a very
difficult or even an impossible task. To overcome these obstacles doctors
recommend various walking aids to their patients. Some of the common
walking aids are:
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Walkers: A walker is useful for patients with
a severe balance problem. An arm rest and other accessories can
be used with a walker for additional protection and support. If
walking for long distances is difficult, use of a wheelchair can
be considered.
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Canes: Canes are of two types. Single Point Canes
are useful for patients with a slight balance problem. On the other
hand Quad Canes, with four feet, provide more support and stability
for patients than Single Point Canes. Handles for these canes are
available in a variety of forms and shapes to suit the needs of
the patient. Special handles called 'Ortho-Ease' are molded according
to the patient's grip and this makes the use of cane more comfortable.
Medical supply stores and some large pharmacies will
have many of these items on display. Special adaptations and sizes
are available from medical supply catalogs. If prescribed by a
doctor, most walking aids are covered at least in part by Medicare and
supplemental insurance.
Who can I turn to for support?
You should not feel alone when it comes to thinking
about what’s best for your loved one. Whether you have a question about
where to install a grab bar, what kind of exercise is safe, or which
kind of walking aid is appropriate for a given disability, there are
people who can help. If your family member’s doctor does not have experience
with the special needs of older persons, ask for a referral to a local
geriatrician or gerontologist. These doctors have special training and
interest in the medical, physical and emotional needs of older persons.
Also ask for a referral to the local or state home health service. If
your family member is coming to live with you after a hospitalization,
speak to the hospital social worker about visiting nurses and home care
services. Although services vary greatly from region to region, many
are able to provide home nursing, in-home attendants and home physical
therapy. A good social worker will work with the visiting nurse service
to determine the amount of help you need based on the physical limitations
or medical needs of your loved one.
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