Monday, 22 April 2013

Can I help you? – How to assist older people to do more, with less help

For many years I worked as a physiotherapist in nursing homes, mainly with patients in their 80s and 90s. Over time I became obsessed with making my patients move more and become more independent. For example, if the main difficulty of one of my patients was to stand up from a chair on his own, then the treatment was focused on strengthening the necessary muscles, learning the correct technique and practicing a lot until the person was capable of doing it with the least help possible.

Of course, many people asked me “ isn't it easier to help the older person get up from the chair?”, and I always answered: NO! I’m not saying this because I’m a bad person, but because, while it may look easier in the short term, this would only make things worse in the long term. Think about it: the more help I give, the less opportunity the person has to complete the activity on his/her own. The less the person practices, the quicker he/she loses the ability to complete that activity independently, requiring increasingly more help, and so on.

I believe that often we are the ones to blame for older people losing the ability to complete certain daily activities independently. I don’t think we do this because we are bad people, don’t get me wrong. I think we do this because since childhood we were taught it is polite to help older people. Of course there is no problem with being polite or helpful. The big problem here is that, in most cases, to help means to do something for the older person. Nobody taught us that when doing this we may be taking away their opportunity to do it themselves, what, over time, might mean them losing the ability to do that activity altogether.

So the question is: how can we help older people to complete their daily activities as independently as possible? My first tip is, before assuming that the person is incapable of doing something on their own, just OBSERVE. Pay attention to what aspects of the task are more difficult. Chances are that they are able to do a good part of it alone, needing help only in certain moments. Or maybe the person only needs clear verbal instructions. Many of my patients are capable of standing up on their own if I remind them step by step what to do. Also observe if it is possible to modify the task in any way to make it achievable. Often, simply changing the type of chair may enable an older person to get up independently or with minimal help.

My second tip is BE PATIENT. Older people may take longer than what you judge acceptable to complete a task, but that doesn't mean they can’t complete the task. Don’t let your impatience or anxiety dictate what the person can or can’t do. After all, your impatience is your problem, not theirs! Allow the older person to take their time, giving verbal instructions only when necessary and in a gentle manner. There is nothing more off-putting than someone constantly telling you what to do, especially if this is done with an impatient tone of voice.

My last tip is REPETITION. We all know that practice leads to perfection. This is no different with older people. Encourage the person to repeat the task daily. Praise them when they manage to complete it on their own. Recognize their effort and encourage them not to give up.

I’m not saying that following these tips is easy, but I can assure you that by doing this, in the long term, you are being truly helpful to the older person.

Brenda Reginatto

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