WRITING FOR GERIATRICS IN PHYSICAL THERAPY

Writing for Geriatric Patients in Physical Therapy Edward Pizzo Bouv College of Health Sciences Northeastern University

WRITING FOR GERIATRICS IN PHYSICAL THERAPY

Writing for Geriatric Patients in Physical Therapy Physical therapists are more than just glorified masseuses, as my friend jokingly calls them in a futile attempt to rattle me up. While massage therapy is one tool at a PTs disposal, the repertoire of techniques, tricks, and tools a physical therapist possesses is not so onedimensional. Physical therapists combine exercise and training to treat conditions ranging from arthritis, back pain, and balance to burns, fractures, and traumatic brain injury. The field of physical therapy is wide, with specialization possible in areas including cardiovascular and pulmonary, neurology, sports, orthopedics, geriatrics, and many others (Physical Therapist Careers Overview). It appears that instead of facing the dilemma of being too restricted, physical therapy students like myself can become overwhelmed with the number of options available. Currently, I am interested in geriatrics. Ive always understood and gotten along well with my elders. Another, more practical, reason for my interest in geriatrics is job security. The elderly population is one of the fastest growing population segments of the United States. With an increasing number of elderly, comes an increase in the number of age-related health issues. Although surgical techniques and methods continue to improve by leaps and bounds, people are less and less eager to go under the knife. They are willing to try other options namely physical therapy before committing to a major surgery. This is especially true for elders, whose age and/or condition can prevent them from being able to receive anesthesia, making non-surgical treatment more necessity than choice. However, geriatric physical therapists face issues involving their clients lack of muscle, bone, and joint strength, flexibility, and balance. Agerelated issues such as arthritis and osteoporosis place additional barriers on PTs from using their typical, effective methods. Special machines, techniques, and exercises have to be employed to

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accommodate geriatric clients; primarily, exercises that are inherently stable, have low impact, and use low weight. Physical therapists, like most healthcare professionals, share knowledge through websites. One such website is the American Physical Therapy Association, APTA.org. The American Physical Therapy Association (APTA) is an individual membership professional organization representing more than 88,000 member physical therapists (PTs), physical therapist assistants (PTAs), and students of physical therapy (About Us). It is aimed primarily at physical therapists and physical therapy students. APTA.org offers information about the various aspects of PT, including careers and education, payment, and patient care. There is even a sub-website, moveforwardpt.com, aimed directly at consumers. In this age of information, a physical therapist can expect patients to come in having researched their condition prior to their meeting. It is preferential that patients receive their information from this website rather than from a nonprofessional and/or biased website, including Yahoo Answers or any website selling a product. There is a good chance that websites written and sanctioned by the APTA will provide patients with an appropriate amount of unbiased information. Physical therapists communicate with each other using the International Classification of Functioning, Disability and Health, or ICF. It is a standardized language and framing system for physical therapists that allows for the easy and uniform classification of health conditions. Physical therapists must be aware of their clients differing perspectives, maturity, disabilities, and levels of knowledge before beginning treatment and/or education. Geriatric patients may be unlikely to have any significant medical or physiological knowledge, and will need diagnoses, exercises, and treatment explained to them in simple terms. They are also more likely to have some form of hearing or visual impairment, making effective commination all the more difficult.

WRITING FOR GERIATRICS IN PHYSICAL THERAPY

Geriatricspt.org is a subdivision of APTA.org specializing in geriatric physical therapy. It too is aimed at professionals but has a large section for patients and clients. The patients and clients webpage consists of two main resources: Finding a PT, and Patient Education Brochures (Resources For Our Patients). The website does a good job of making these resources accessible to the elderly, who are generally not technologically savvy. The PT search is very simple there are boxes for zip code, city, state, name of physical therapist, and categories such as geriatrics or neurological to help narrow ones search. The second resource on the page is patient education brochures. According to the webpage, These brochures were created by PT and PTA students, as a part of the annual Section on Geriatrics consumer brochure contest. Each year, brochures with outstanding content and design are selected and posted on the website (Resources For Our Patients). The webpage encourages physical therapists to print and distribute these brochures at their leisure. Although this is included in the patient/client section of geriatricspt.org, it would appear that the Patient Education Brochures are primarily for PTs themselves to print out and distribute the information to their geriatric clients. Perhaps including the links to these brochures in the members section of geriatricspt.org would allow them to be more widely distributed, as professionals may not read the patient section of geriatricspt.org. Unfortunately, since I am not a member of the APTA, I am unable to access the members section to see if these links are included there as well. There are four brochures on the page, created by physical therapists and physical therapy students. Besides a brochure archive, a link to which is included at the bottom of the page, the brochures from this year are Preparing for a Knee Replacement; Osteoporosis Awareness and Prevention; Let's Prevent Osteoporosis!; and Vision & Aging Taking Care of Your Eyes. The layout of the brochures is remarkably similar. They consist of obligatory stock photos of active,

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healthy seniors dispersed throughout the text. It is very obvious that these brochures are written for elderly people. The information is segmented in simple, bold, and often bulleted categories. Colored boxes surround and further compartmentalize the information into bite-sized pieces. There is minimal detail and almost no medical jargon about the condition just plain English that the patient will be able to understand. The first brochure deals with knee replacement and is broken up into the following categories: Things to do at home, What can a knee replacement do for you? Items to bring to the hospital, and Things to do. Many people, regardless of age, do not like feeling impaired or slowed, especially if it means they can no longer participate in hobbies. What can a knee replacement do for you? offers patients a glimpse into the world of post-op knee surgery, including moving with less pain and returning to previous activities. Things to do at home includes practical advice, such as preparing a few days worth of meals in advance and lighting the hallway from the bedroom to the bathroom. Things to do gives patients a checklist of steps from 1-2 months before surgery, such as arranging time off from work, to the day before, such as stocking the kitchen with food. Items to bring to the hospital is a handy list of commonly needed items, from ID to changes of clothes. The elderly are generally not known for their adept memory, and these lists, although simple, can be an effective way of reminding patients of things they would otherwise forget to make their operations and recovery as smooth as possible (Linderman & Windy). The brochures include references for the sources of their information. Among the sources were several scholarly articles, some official websites, and something surprising WebMD. I had expected professionals and students to use Medscape, an offshoot of WebMD aimed specifically at professionals. I was under the impression that WebMD is to health sciences what

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Wikipedia is to the academic world. Useful, but not on the appropriate level. However, considering the target audience, combining WebMD with scholarly papers was probably more than sufficient in order to get the message across. Although patients may not even notice the references, including them adds a layer of professionalism, trustworthiness, and commitment to accuracy expected from healthcare professionals. My sources, primarily geriatricspt.org and the brochures on said website, confirm my beliefs about the field of geriatric physical therapy. Geriatric physical therapy is growing enough so that a website was created to assist practitioners and patients. It seems that the APTA is aware that elderly people are less likely to come across their website, so they recommend physical therapists print and distribute the brochures to those that need them. As geriatric physical therapy continues to grow, the field will have to be modified to accommodate the shift. It is apparent that people and organizations are already working on it, but I wonder if theyre doing it quickly enough. It will be interesting to see what the future brings in terms of education, training, and distribution of physical therapists to accommodate these demographic changes.

WRITING FOR GERIATRICS IN PHYSICAL THERAPY

References About Us. Retrieved from http://www.apta.org/AboutUs/ Lindeman, B., SPT, Windy, C., SPT, Central Michigan University. Preparing for a Knee Replacement. Retrieved from http://www.geriatricspt.org/students/patient-educationbrochures/2013/1st%20-%20Preparing%20for%20a%20Knee%20Replacement.pdf Physical Therapist (PT) Careers Overview. Retrieved from http://www.apta.org/PTCareers/Overview/ Resources For Our Patients. Retrieved from http://www.geriatricspt.org/patients/resources.cfm