The number of older people is increasing daily and OTs need to be ready to treat them. Geriatric rehab patients/clients require a different approach than the younger set. First of all, these people usually do not see the need for occupational therapy because they are retired. They see an occupation as a livelihood””NOT an activity. Therefore, your first step will be to clarify what OT is all about.
Next, you must get the senior to understand why occupational therapy is necessary and how it will benefit him/her. You are “selling” the senior on doing therapy; so act like a salesperson. Customers want to know the WIIFM factor. That is…what’s in it for me?
You’ll need to stress the positive outcomes as well as the negative of what will happen if they don’t do the therapy. “Your life will be a lot harder than it needs to be, if you choose not to do therapy,” always worked for me.
Make it seem as if they are making the choice. It’s similar to dealing with children by saying, “Do you want to wear your blue coat or your red coat?” The bottom line is…the child will be wearing a coat. Offering controlled choices can lead your elderly patient/client into occupational therapy.
As a rehab nurse, it was my job to get patients to do their range of motion exercises each evening. The stretching hurt, so people didn’t want to comply. When I explained it was their choice if they wanted a normal looking limb or not-- they always did their ROMs.
Sometimes geriatric patients/clients think that occupational therapy is a waste of time. I often heard the complaint, “They tried to make me to do things a kindergartner would do!” That was followed by, “I wouldn’t do it.”
If that senior citizen understood that putting pegs into holes on a board would ultimately help him regain the function in his weak arm, he probably would have done it.
Show and Tell
Show the geriatric person the goal and explain how you plan to help them reach it. Some forgetfulness is a natural part of aging. So, writing it down helps to provide a visual reminder of how and when to do the activity, as well as why the person should put in the effort.
Focus on your goal--to get the senior to do what you need him/her to do. Meeting that goal will lead the patient/client to improve as much and as fast as possible. Avoid focusing only on the issue you are there to treat. Look at the whole picture.
Normal aging with decreased visual acuity, decreased stamina, forgetfulness, and decreased motor function all need to be taken into account.
Most geriatric people have more than one problem. The senior might have general deterioration from aging as well as some chronic health issues. And now, that senior has another problem that requires OT.
Say the senior already had arthritis and now has a stroke…that could double the amount of pain that person usually tolerates. Monitor each person carefully to be sure there is adequate pain control. A person in pain is NOT going to do much therapy. Determine the pain source and treat it accordingly. Try ice, heat, massage, manipulation, topical treatments, oral pain medication, or whatever you think will help make your session most effective.
Most patients I treated did not want to take oral pain medicine regularly. They worried about “getting the habit.” It took time and effort to educate them before they understood that taking pain medicine before therapy would help them to function better and get home faster. After they finally understood…they took it because they knew it was in their best interest.
Motivation is not a strong skill in the elderly. They complain, “I’m tired and retired. “ Convince the patient/client that it will benefit him or her to do OT.
The geriatric mind set is different from that of younger people. Older people usually worked hard all their lives. They typically want to “follow the rules’ and don’t want to be seen as a “troublemaker.” Use that to your advantage. Explain what you need them to do. Then tell how and why they should do it.
Motivate seniors with constant praise. Also, remind them of the benefits they will earn by working hard. That way you will both be doing your best!