Rehab for seniors
In ten months working together I helped an 89 year old man to stop falling, feel more confident in his body, and reduce his pain.
At 88, CM had heart failure (HF) and constant oedema in his lower legs and feet. As he got more frail he moved less, his legs got weaker, and he was at risk of falling - often - and falls bring the danger of broken bones.
Rehab is not a word we often associate with older people, or those of us who just want to get a little stronger in our bodies. We think of it as a process to go through after surgery or injury, when we are trying to repair and restore something that has been broken or damaged. But making our bodies stronger, or more flexible, is something that many people can benefit from at any stage in life - it is purely a case of identifying what you want to achieve, and finding a few simple exercises to help you get there.
CM’s niece contacted me and asked if I would take him on as a regular client. In a fall 12 months prior, he had broken his humerus in two places, and was increasingly nervous about falling again. He was moving around the house with the aid of a walker, but fairly sedentary. He was only leaving the house for medical appointments, and had limited social contact. His niece was looking for someone to work with him with three aims:
Improve leg strength to reduce risk of falling
Increase confidence in walking - maybe work towards walking outside occasionally
Regular social contact from a weekly visit.
At our first meeting, CM also complained of pain in his lower left back. He noted that he sleeps curled to his right, and slumped to his right when sat in his chair. His left shoulder and arm were still a little restricted in movement after the break, so we added these elements to our list of things to look at and improve.
We agreed on a weekly session which would last 20-30 minutes. For the first couple of weeks we included some in-seat massage on his back and side to ease the pain, we learned a ‘side-slide’ stretch that would help stretch the right hand side and strengthen the left hand side, and I challenged him to try and sit up straighter in his chair. After two weeks, the pain had gone.
Meanwhile we worked on the other rehab work - strengthening legs, and shoulder / arm mobilisations.
A wise woman once said that the best exercise is the exercise that you actually do, so this is what we focussed on.
In week one we learned three simple exercises. I got CM to describe them to me and wrote them down on a piece of paper in his words: he then had a record of what we’d done, which he could understand. I asked him to try and do the exercises once each day until our next session. Exercise 1 was for shoulder mobilisation, and exercises 2 and 3 for leg strengthening. Because of a lack of balance, these were seated exercises.
Two weeks later, we swapped out exercises 2 and 3 for three new leg exercises - now standing and holding onto a grab rail.
Over the proceeding 2-3 months we tweaked the exercises, making the existing ones a little harder, trying new ones, discarding what didn’t work or he didn’t enjoy, and keeping the best ones. We ended up with a routine of six exercises in total which he was comfortable and confident with, could happily and safely do by himself, and which he could remember.
Fast forward nine months, and he hadn’t had a fall in all that time, there was no recurrence of his back pain, and he was sitting straighter in his chair. Doing the three standing exercises, he was now resting one hand on top of the grab rail to do them - rather than holding tight with both hands - demonstrating that his balance was greatly increased from when we started.
Working with CM was a particular treat. We would run through each of the exercises together, and we would sit and have a little chat. Rehab sessions like this can be useful for people of any age and in any circumstance. They don’t need to take long (I would be 20-30 minutes, pending how much we chatted!), so they can fit into most schedules.
I was going to say that the key is doing the exercises daily, but in this case that isn’t exactly true. He almost certainly didn’t do the exercises daily, in fact I think he usually only remembered to do them the morning I was coming!! But doing them consistently, each week, the effect built up steadily over time, and we could both really see the difference. He could stand on one leg with his other knee in the air without wobbling. He stopped falling over. And this is aged 89.
It doesn’t matter what age we are, or what state of health we are in. There are almost certainly a couple of things we can do which can help us to feel better, to move more easily, to live happier. If you know of an older person who could benefit from some regular sessions of adapted massage or gentle rehab, please get in touch.