How old is too old?

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Shelly Mesure, MS, OTR/L
Shelly Mesure, MS, OTR/L
"They don't need rehab, they're too old!" How many times have we heard or even asked this question? Did you know that Regis Philbin turned 80 on August 25? The Dancing with the Stars cast has included Cloris Leachman, age 85, Florence Henderson, age 77, and Buzz Aldrin, age 81. Celebrities are the easiest to spotlight, but many of us have relatives, friends, and neighbors that exceed the norm.

While teaching seminars last month in New York, I heard a therapist share a success story of rehabilitating a 103-year-old resident to independent level with a discharge plan to return home alone. This facility followed up with the resident and physicians several months later, and the resident was continuing to do well and had resumed all of her involvement in the community.

So my response to the "too old" question is twofold. To the therapist, I ask, "What type of goals are appropriate for this resident?"╙; "How will it impact her quality of life?"; and "Is the treatment approach clinically appropriate to improve or prevent further declines with the resident's functional status?"

To the caregiver, I ask, "What is your perception of therapy?"; "Why do you feel therapy is inappropriate for this resident?"; and "If rehab can improve her quality of life or enhance her functional outcomes, why should age matter?"

Did you know George Bush Sr. celebrated his 85th birthday by skydiving in 2009?

There are always exceptions to the rule, but my point is to highlight the fact that there shouldn't be a rule or a norm. Therapy services are often thought of in narrow terms, but the scope of practice for physical, occupational, and speech therapy exceed well beyond most non-therapy practitioners' understanding.

The ultimate goals of therapy are to enhance physical, mental and psychosocial outcomes of their current limitations. This is accomplished by improving functional status, prevention of further declines and/or enhancing quality of life.

Physical therapy is often thought in terms of mobility. While this is its primary focus, did you know they also can provide services to improve balance, contracture management, positioning and trunk control, wound care, pain management, scar tissue management, edema management, coordination, strengthening, flexibility and range of motion, and enhance endurance (to name a few)?

Occupational therapy is thought of in terms of ADLs. However, occupational therapists also provide services similar to physical therapy with contracture management, positioning, pain management, scar tissue management, edema management, coordination, strengthening and endurance. But, OTs also can address declines with leisure tasks, visual impairments, and provide modifications and adaptive equipment to achieve goals.

Speech therapy is thought in terms of swallowing difficulties; however, speech therapists also work with language issues such as aphasia, communication goals, and cognitive goals to enhance independence.

When sending a referral to therapy, consider these possibilities before you consider the person's age. Another way to consider all of this is this way: Did you know Ozzy Osbourne is only 62? Betty White, on the other hand, is age 89 and dances circles around him (when she's not hosting "Saturday Night Live" or chasing men, that is).

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Rehab Realities is written by Shelly Mesure, MS, OTR/L. She is the senior vice president of Orchestrall Rehab Solutions and owner of A Mesured Solution Inc., a rehabilitation management consultancy with clients nationwide.

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