An Overview Of Physical Therapy In Geriatrics

Will: Hi, My name is Dr. Will Dieter, and I am the Director of PT Clinical Services here at FOX Rehabilitation.

We’re going to take a few minutes to talk to you guys about the role of the geriatric physical therapist. And as I like to say, I think it’s the 21st-century physical therapist. This person is a true medical professional. They are part of the core of an interdisciplinary team.

The key concept here is that exercise is really appropriate for almost everyone.

The role of the geriatric physical therapist is to take an older adult who more than likely has many different chronic conditions and different medical influences happening, take all of that into account, and be able to prescribe some type of exercise program for that person. And I use that word, prescribe, purposefully because a physical therapist working with the geriatric population prescribes exercise.

It is different from other professionals that do exercise-based interventions. They don’t have that understanding of the medical conditions, how they interplay with what you’re doing, and making sure everything is safe and optimally effective. So, understanding that I’m able to prescribe the exercise is number one.

So, some of the things that the physical therapist will do are: We are proactive in our approach. We’re looking for issues before they become a full-blown problem. We’re looking for things like a little bit of weakness, some issues with balance. Maybe someone’s cognition is becoming a little bit different, and we will refer out to another professional to handle that sort of thing.

And once you identify those things – and there’s literature and there’s evidence and there’s science behind all of this – we have testing measures we use to identify these things. This is not just someone going in and saying, “You know, you look a little tight here. You seem a little weak here.”

And it’s a lot more than just coming in and saying, “Well, you have a difficult time getting out of the chair, so I’m just going to get out of that chair.”

So for instance, you might use something like a Time Up and Go test, which is an assessment, a fairly simple assessment: Someone gets up, they walk a certain amount of distance, they come back, they sit down, and you time them. And that sounds simple, but the skill in it is understanding what a good time is versus a poor time and being able to understand what the issues are and what needs to be worked on.

So the geriatric physical therapist not just understands that mom can’t get out of the chair or mom can’t walk very far. They dig deeper to understand what are the issues and why they can’t do those things.

And again, they prescribe exercise to be able to rectify those situations, remediate what they can remediate, and, when necessary, if something cannot be fixed maybe and it’s too far along, they work with everybody around that person: the caregiver, sons and daughters, whoever it is to come up with other things that can be used to modify the environment to change the way things are done to optimize function.

And that’s where again I go back to that interdisciplinary team. So you have your generic physical therapist as well as your geriatric occupational therapist and your speech therapist. Having that group together – that rehab team – really will get that person everything that they need. And each of those participants needs to be well-versed in geriatrics. So doing that and handling it that way – having the right team – will really help people be safe, optimize outcomes, and allow them to really age in place and be functional for as long as they can, into the end of life. Thank you.