Unit 9 Geriatric Physiotherapy II Task 1 Study the diagram below. What does the ageing of the population mean for health care systems of the affected countries? Výsledek obrázku pro ageing population Task 2 Reading Read the text below. What is the main point it makes? What is frailty? The nature of the physiotherapy profession is to help restore movement and function in someone affected by illness or injury. Physiotherapy input in the treatment for frailty is not a new concept. However, the delivery of care is evolving in order to better meet the needs of this population. Physiotherapists are expanding their service and moving to several different settings; for example, within day hospitals, in the patient’s home and in community clinics. Task 3 Can you identify the conditions described below? A) A form of dementia that is characterized by gradual and progressive mental deterioration. Symptoms can start with mild forgetfulness, difficulty remembering names and faces or recent events and progress to memory failure, confusion, disorientation, speech disturbances, motor impairment and aggressive behaviour. There is yet no effective treatment. B) A disruption in the normal blood supply to the brain resulting in damage of brain tissue. It may be caused by a blood clot or by a ruptured blood vessel. The most common symptoms are numbness, weakness or paralysis on one side of the body, etc. C) A degenerative disease of neurons that reduces the amount of dopamine. This affects the ability to control movement, posture and coordination and leads to the characteristic symptoms of rigidity (muscle stiffness), stooped posture, slowness of voluntary movement (bradykinesia), and resting tremor of the hands. The disease has a gradual onset and affects mainly adults aged between 50 and 65 years. Can you think of other diseases common in the elderly? Task 4 The comprehensive geriatric assessment What does each category include? Write down as many points as possible. Medical Mental health Functional capacity Social circumstances Environment Task 5 Case study http://www.physio-pedia.com/images/thumb/2/2c/Casestudy_heading.png/500px-Casestudy_heading.png Mr Smith is an 84-year-old man who was referred for physiotherapy by the community occupational therapist. Mr Smith had reported "I cannot walk very far anymore and my balance is just dreadful”. He stated “I’m scared to leave the house, I just do not want to fall and end up in hospital” He was happy for the referral to a community physiotherapist to be made. Based on this information plan your objective assessment. Task 6 Reading – Physical activity for older adults Which of the recommendations below is wrong? Functional capacity declines with age and this is further accelerated by low levels of physical activity. The recommendations for physical activity for older adults (65+) * Older adults should aim to be active daily * At least 150 minutes a week of moderate intensity activity * Strength training should be avoided * Balance training and co-ordination should be incorporated into activities to manage risk of falls * Minimise sedentary time Task 7 Tai Chi Complete the gaps with suitable forms of the words in brackets: Tai chi is a newly emerging exercise incorporating breathing, relaxation and slow and gentle movements with ………………. (strengthen) and balance exercises. Whilst originally an ancient 13th century Chinese martial art, it has recently become more prevalent around the world as a health-…………… (promote) exercise. Whilst there is room for more rigorous research on the health benefits of tai chi, it is thought that it could help adults aged 65 and over in improving balance, reducing stress and controlling osteoarthritis pain. ………….. (Addition), in a high quality systematic review, tai chi was not only found to ……………. (significant) reduce rate of falls, but also lessen risk of falls. As tai chi is considered a low impact exercise, it is …………… (suit) for most to participate in and should be considered as a treatment option, although some may require …………….. (assist) in locating a ………….. (suit) local group for them to join. Now watch the video about the benefits of Tai Chi for older adults: https://www.youtube.com/watch?v=D-GFreeZTow Task 8 Mental health A) Complete the gaps with suitable prepositions, then complete the missing information in the table: Although it is not the prime role of a physiotherapist, in order to provide a holistic service, we must be aware ______ and understand the mental health of our patients and the impact that this may have ____ the individual. Age-related cognitive decline is inevitable, however, some conditions common amongst frail adults can have dramatic effects ________ cognition. The table below compares age-related cognitive decline ______ the early signs of dementia. Early signs of dementia Normal ageing Briefly forgetting parts of an experience, forgetting the names of people they rarely see Repeating phrases or conversations Mood changes appropriately Lack of interest in activities, difficulty making decisions B) Communication with people with dementia Dementia The word dementia describes a set of symptoms that could include memory disorders, personality changes and impaired reasoning. There are various types of dementia, the most common are Alzheimer’s disease, vascular dementia and dementia with Lewy bodies. The likelihood of developing dementia increases drastically with age and it is thought that 1 in 14 people over 65 suffer from this condition. Due to the progressive nature of the disease, communication will gradually worsen over time. What does this mean for physiotherapists? With any cognitive condition, effective communication may become challenging and prove to be a barrier to successful assessment and treatment. The table below highlights some tips to tackle this. 1. Keep commands clear and concise with one request at a time – “Stand up please” 2. Allow plenty of time for a response before repeating your question. If the patient is still struggling, try rephrasing. 3. Remove distractions – this could include talking, background noise, eye-catching pictures. 4. Use names and explanations where possible – “Your daughter, Ann” 5. Use other forms of communication: * Visual – show tasks rather than explaining instructions. * Sound – cueing can encourage normal movement. For example, counting or using music can provide a rhythm and trigger a response. It may also help provide an auditory clue when the patient cannot understand the verbal instruction – patting the chair to signify “sit down”. * Tactile – can be used to aid the movement. For example, offering a hand when walking, stroking up the spine when standing. (http://www.physio-pedia.com/Frail_Elderly:_The_Physiotherapist%27s_Role_in_Preventing_Hospital_Adm ission) C) Video Now watch this video which describes effective communication specifically for people with dementia, however, some of this could be applied to anyone with cognitive decline. Effective communication and dementia (https://www.youtube.com/watch?v=xDEYH518cKU) Watch the video and note down the tips on communication with people with dementia: Task 9 Grammar focus Verbs + - ing or infinitive. Complete the sentences: To live a long life doctors recommend… My doctor strongly advised me to stop… In many countries of the world people can´t afford… When I am old I hope… Older people hate… I told my grandmother to try… My grandfather remembers… I believe that even for seniors it is important not to give up … Extra task: Depression in ageing https://www.youtube.com/watch?v=WBZsa3diKMs Watch the video and summarise the main points.