Myths About Geriatric Care: Two Perspectives

By Mary Callens, PT, DPT, CVT, and Nadia Wyrsta, PT, DPT
FOX Geriatric Residents in Physical Therapy

FOX Rehabilitation: We provide clinicians the tools to be successful in their careers. The American Board of Physical Therapy Residency and Fellowship Education accredited FOX Geriatric Residency in Physical Therapy is one example of the FOX mission in action.

In this article, we had our two current residents, FOX physical therapists Mary Wiseman, PT, DPT, CVT, and Nadia Wystra, PT, DPT, offer their perspectives on misconceptions on working with the older adult community.

Let’s begin with Mary’s story:

Mary Wiseman, PT, DPT, CVT

Most Doctor of Physical Therapy students are unaware of the array of potential practice settings in their field. Upon graduation, one is often left weighing the pros and cons of those settings in choosing a first job. Those with a deep understanding of each setting are able to embark on a career instead of a “job.”

In my case, I was leaning toward sports therapy. I had dabbled in a variety of fields and environments.

One of my clinical instructors in the outpatient clinic told me that I had a special knack for working with older adults. My CI admired my ability to go from the high energy necessary to treat the younger population to a softer, more understanding approach with the older adult community carrying with me plenty of patience in all cases.

These words stuck with me as I continued to challenge myself in rather difficult settings, trying to find my niche. I finally chose geriatrics because I enjoyed the one-on-one treatment time.

In general, my mind jumps from one thought to 20 in 2.2 seconds. Having the opportunity to work with someone and focus on them made the “job” more enjoyable. I get to know the person and connect with them.

In my mind, I thought to work in geriatrics I would have to be in a nursing home or somewhere that the compassion fatigue of working with these individuals would quickly burn me out.

This is not the case at all.

Yes, it is a challenging field. Yes, the patients can be complicated with multiple comorbidities, caring for them often makes us more aware of our own mortality, and resources are not always available.

However, working with FOX, there are more than enough resources to help me treat to the best of my ability. This includes, but is not limited to unlimited Continuing Education Units, mentors, friendly clinicians very willing to take the time to discuss treatment options and share their knowledge, and by signing up with the American Physical Therapy Association, you can get the most up-to-date research articles.

I was also jaded by the thought that older adults are limited in their improvements and abilities to get better.

Frequent comments you hear are, “don’t get old,” “at my age…,” and “I’m too old for this.” One thing I have learned is that we as clinicians can unlock the inner strength of our patients and help them improve.

Over and over again, they have shown me that age truly is just a number. To watch someone go from being unable to get out of a chair alone to being able to get out of bed and walk up two stairs to the kitchen for breakfast is so rewarding.

Growing old does not have to make us invalid.

As PTs, we have the opportunity to help those who feel and think this way. We have the power to show not only what positive thinking can bring about, but also how exercise and treatment can empower our patients to take control of their lives again.

There is increasing research compared to years past to improve the vitality and quality of life for individuals as we age. The evidence is constantly growing and researchers are diligently working to bring their colleagues the newest evidence and best approaches to treatment.

In truth, we all age differently.

In geriatrics, we as PTs face the most intriguing challenges to improve the quality of life of our patients than in any other field. Caring for these older adults is not about changing Depends and watching people whither with each passing day: Geriatric PT is about returning to them a sense of purpose, more independence in their daily tasks, and overall better quality of life as they age.

Nadia Wyrsta, PT, DPT

What do we think of when you hear geriatric PT?

Geriatric PT is much more than cleaning up bowel movements. Geriatric PT is much more than grumpy dispositions and crocheting sweaters.

Let’s change the way we think about working in geriatrics.

They’re people looking to improve their quality of life. Don’t assume wrinkles and age defines their functional capabilities.

Some of the hardest-working people I’ve dealt with were my geriatric patients. People well into their 90s are still able to tolerate vigorous exercise programs that’ll maximize their functional potential, furthermore, giving the clinicians the ability to achieve clinical excellence.

Prior to graduation, I was very interested in women’s and pelvic floor therapy, so much so that I decided to get my pelvic floor certification. I realized at that point that I liked it, not loved it.

In my final year of school, I did a three-month clinical focusing on geriatric and neuro rehabilitation.

That clinical changed everything for me.

I realized how much I loved older adults.

Picture this scenario: You get a physician’s referral for a woman, 93 years old. The diagnosis is gait dysfunction; do you assume the age determines the functional capabilities of the patient? Do you assume 93 means seated exercise only and not push them past their current actual or perceived limits?

I had a patient with the same age and same diagnosis when I first graduated. I was in awe when this patient met me at the door walking device free, pleasant, completely coherent and excited to see me and what I was going to be able to do for her.

You probably assume that this woman was on numerous medications.

Well, she was not.

She only took multivitamins. Based on our initial conversation, it was evident she had a strong knowledge base of exercise, stretching and nutrition.

I was able to go right into dynamic standing exercises, intermediate abdominal exercises and yoga stretching poses. She was an amazing person and one of my all-time favorite patients. She became a friend.

This experience gave me the confidence as a new clinician that I needed to start my career.

Relatedly, why would we forget about those who are someone’s parents and grandparents? They took care of us. Now, it’s our turn to take care of them.

Every person is unique and different and poses different challenges. You will continuously learn new methods based on the ever-changing needs of patients as they live longer lives. We are experts in the movement of the body for all stages of life.

The gentleman featured in this image is not referenced in this article.