FAQ # 4: How Do I Know if I’m at ‘Fall Risk?’

As you know, I love to counter a question with another question, or in this case, three:

1 ) Have you fallen in the past year?

2) Do you feel unsteady with standing or walking?

3) Do you worry about falling?

If the answer to any of these is yes, research has shown that you are likely at an increased risk for falling. Now while this may seem like a short and sweet, the actual answer is a bit longer and more involved. This is where I come in. When I check to see if a patient of mine is at increased risk of falls, I’m like a detective on a trail. While I may start with these questions, their answers lead me down windy trails where I pick up clues that not only determine IF you are at fall risk, but more importantly, WHY. And it’s the WHY that allows me to help you prevent them. But that’s a story for a different post.

So, back to the question at hand. What do I look at to determine if you’re at risk for falls? 

1) I look at how you move. First and foremost, I look at your mobility, in your own home environment, sometimes when you don’t even think I’m watching (‘hey, can you give me a tour of your house?’). Without even doing another test, this would probably give me the most valuable information I can get. Do you stumble over thresholds? Reach for walls? Get distracted and lose balance with turning? Are there environmental hazards (small pets, throw rugs and more egads!) that could cause you trouble down the road? Is it dark? Is it too bright? Are you moving too fast, or too slow? Are you using assistive devices or may benefit from one? Do your movement patterns indicate an area of weakness or contracture? As therapists, this is our bread and butter. If you’re every hanging with a PT and feel like you’re being watched (or judged), you are! We can’t help ourselves, and we’re truly sorry:) 

2) I look at your balance. Obvi. Your very ability to stand upright, balanced over your base of support requires an intricate and functioning relationship between your feet, your inner ear, your eyes and your brain. This combination is lovingly referred to as your somatosensory integration. It allows you to stay upright, and then allows you to control your body as it moves both purposely outside your base of support - and unpurposely (is that a word?), as in the case of a loss of balance. By putting you in a series of different foot positions, with different degrees of challenge to each of these systems (somatosensory, vestibular, visual), I can identify which system is working and which system could work better - and then develop a plan of action to improve your balance over all. 

3) I look at aaaaallll other systems that are involved with your balance. Do you have pain that surprises you and knocks you off your feet? Limited range of motion in places that make your feet more likely to catch on the stair? Do you get tired easily or have impairments in cardiovascular function that make it more likely for you to pass out? Are you taking medicines that could make you dizzy, or confused or sleepy? Are you taking medicines that make it more likely to get injured from a fall like steroids that can make your bones more brittle or a blood thinner that could put you at risk for a head injury? Do you have other comorbidities that could play a role? Diabetes with fluctuating blood sugars? COPD with oxygen rates that drop when you move? Covid that has left you exhausted and uncertain on your feet? 

Before this FAQ becomes a book, I’ll stop there. As you can tell, there is a lot that goes into answering this seemingly simple question. Fortunately, there are Physical Therapists, like me, who train for years to become Fall Risk Detection experts and are happy to help you figure it out. If you’d like to learn more about fall risk, fall prevention and how I figure this all out, please join me Tuesday night for a Zoom webinar titled ‘So You’ve Been Told You’re UNSTEADI. Now What?’ During this one-hour seminar, I’ll dive deeper into the fall risk assessment process, explain the STEADI initiative, and how it is used by your medical team to determine fall risk and address modifiable risk factors and give you tools to make changes on your own to help you stay on your feet.

To register ahead, please click the link below and you’ll receive the zoom link from there.  

So You've Been Told You're UNSTEADI Zoom Registration

Happy New Year - and the Rule of Fives

I’ve gone back and forth what to post all day. Do I do the thing ‘I’m supposed to do’ and post a nice ‘Happy New Year you graphic? Do I write about how guilty I feel thinking about expressing gratitude to have made it through this year relatively scratch-free, when I’ve seen so many friends struggle with loss this year? Do I sit back and make Big Goals and Resolutions then share them with the world? (The possibilities are endless..)

When it comes down to it, we’ve all been changed by this year. Our children have been changed this year. The entire world we lived in has changed and I don’t know if will ever be the same.

But there can be goodness in change. There can be silver linings and lessons learned. There can be redirection and new purpose and path-righting.

I don’t have it all together, but I strive to keep most of it together, some of the time:) I took a huge leap this year snd am literally still figuring things out, as I go, every single day.

One thing I do know is I can’t thrive, and my business can’t thrive, and my family can’t thrive, if I don’t take care of myself first.

Have I been perfect this year? Nope. Have I tried my best to eat healthy and stay active despite all this chaos? Yes, for sure. Could I do better. Absolutely.

As a physical therapist, and a human, I can attest that the first step in achieving any of your goals, is caring for your body. Putting good things in, keeping bad things out. Keeping it moving snd active.

Should I make business goals and other more concrete resolutions? Probably. (It’s on my to-do list. Don’t judge:) ) But, I have decided, that all that ‘stuff’ needs to comes after this: my rule of FIVES - five things I think i can commit to that will make me a healthier person. This stuff isn’t earth shattering, and it isn’t even that hard. But it’s the stuff that matters and the things that WORK.

I, for one, am looking forward to 2021. This year turned our lives upside down, tossed our kids out of their schools and little kid worlds. It tossed everything into a giant socially-isolated quarantine bowl and spun it around. We, like all of you, have found a new way to live, to get through, to change and persevere in a new, very bizarre pandemic-world. I’ll use these five rules to center myself, keep focused on my health first and seek consistency in a totally-inconsistent world.

I wish for all of you a year of health, happiness and growth. I hope we can celebrate, instead of seclude, this time next year. And I hope we can take all the lessons and silver linings from this year and hold them close even after Covid is a thought far in the rear view.

Happy 2021, Katie

Deep Thoughts at the Dentist

Guys I have a confession to make…

I haven’t been to the dentist in over a year. Between Covid-related closures and life, it just didn’t happen. But I went this morning, and am so glad I did. And it got me thinking about a few things.

Leading up to my appointment, I found myself having apprehensive thoughts, like dreading the visit in fear I’d be told I have seventeen cavities and need a root canal because I missed my regular visit. I considered cancelling and waiting till the Covid-risk is lower. But, fortunately, I had the insight to realize that when it comes to your health, Ignorance ISN’T bliss and I made it to my 9am at the Future of Dentistry - Wakefield (shout out for a super-clean, comfortable experience this morning!

When we avoid facing a reality out of fear, it doesn’t make that reality magically disappear. And when it comes to caring for your body and your health (and in this case, my teeth!), what may seem innocent enough, like postponing regular healthcare prevention visits, can actually make the problem worse!

So back to my teeth. Did you know that good oral hygiene is about more than pearly whites and avoiding the pain and nuisance of a filling? Oral health not only affects your mouth, but can cause other, bigger, health problems. Bacteria living in your mouth can travel, impacting other systems, like your heart and lungs. Poor oral hygiene can increase your risk of endocarditis (an infection in the lining of your heart), cardiovascular disease and pneumonia.

As a Physical Therapist, I’d 100% rather see a patient BEFORE they have a problem, than work with them to fix it after. Unfortunately, our healthcare system historically promotes rehabilitation and medical management over prevention. While there has been some within the physician treatment model to do better in this area, this hasn’t trickled down as much as I’d like to see within the practice of Physical Therapy. We, as a profession, have so much to offer in the realm of PREVENTION and it is my hope, that in 2021, payers like Medicare and other Managed Plans begin to see this, and offer better reimbursement for visits designed to address issues before they arise.

In the meantime, you have a choice. You can CHOOSE prevention. You can CHOOSE to put healthy things in your body, keep unhealthy things out, and to make exercise a regular part of your health maintenance (just like taking vitamins or seeing your primary care physician regularly). You can even CHOOSE to see a Physical Therapist before problems arise. PT’s like HAE offer Annual Physicals, just like your physician, and can help you take a clear and comprehensive look at your current health, your health behaviors and help you construct a plan that will set you on a path towards Healthy Aging.

“When you have to make a choice and don’t make it, that is in itself a choice.” -William James

So, as we turn the corner to 2021 (Good riddance, 2020…), let’s do some thinking. How could we treat our bodies better this year? 2020 has not been easy on any of us, and our collective health has suffered as a result. What problems could we choose to face, head on, instead of ignore, as we enter the new year?

If you like the idea of a Physical Therapy Annual Check-Up, and think it could help you start 2021 on the right track, call me:) I’m more than happy to help.

#haept #stronger #fitter #functional #physicaltherapist #physiotherapist #physicaltherapy #physiotherapy #exercise #health #wellness #aging #healthyaging #optimalaging #successfulaging #exerciseismedicine #insurance #medicare #momboss #annualcheckup #prevention #rehabilitation

FAQ #3: What DO You Actually Do ???

FAQ: What do you actually do?

(Aka when your PT doesn’t ‘look’ like a normal PT..)

I get it - Physical Therapists who don’t always look and act like ‘normal’ physical therapists can throw you for a loop. Us Geriatric Mobile PT’s don’t have a clinic. We don’t work with aides. Heck, we don’t even own an ultrasound or estim unit (usually!). So what is that we actually do?

To answer this question, I’ll start with a few things we aren’t:

We aren’t nurses - but we do take your vitals, check your meds and help you manage your chronic diseases. 

We aren’t massage therapists - but we do perform soft tissue work, manual therapy and other hands-on techniques to help reduce your pain and improve your movement. 

We aren’t occupational therapists - but we do work with you in areas where OTs usually hang out, like to work on transfers in the bathroom, teach you how to move around safely in the kitchen and how to keep your balance while you get dressed. 

We aren’t your doctor - but we have ‘direct access’ that allows us to see you first, before you see your doctor, because we have the advanced education, skills and know-how to identify when it is safe to see us - and when you need to see another clinician first. 

We aren’t social workers - but we are great resources for how to access support within your community. We have great connections to senior centers, home health agencies and other health professionals and can steer you in the right direction.

We aren’t your therapist - but we are great listeners. We understand that the key to helping you benefit from physical therapy is to find ways to motivate you and get you more confident in your abilities. This requires getting to know you, your life, your goals, the ‘what makes you tick’ stuff. We can’t be effective without understanding this first.

So, back to the original question. What the heck do you do?

Geriatric Mobile Physical Therapists are experts in healthy aging. We understand that Exercise is Medicine and we are masters at finding ways to help you move, despite your limitations, despite your medical conditions, despite the fact that you are getting older and despite the fact that you may be scared, physically limited or simply don’t know where to start. 

We are movement and mobility masters. EVERYTHING we do as humans requires movement. Taking care of yourself, your loved ones and your home (getting dressed, taking a shower, cooking, going to the grocery) all requires mobility. Doing all the things you LOVE and ENJOY requires mobility. Golfing, playing tennis, socializing with friends and family, picking up those grandkids and getting to the floor to play with them. These aren’t always easy tasks as we age - but they are the very most important ones. Physical therapists are THE people to help you find ways to keep doing these, without less pain, with less risk of injury and with less risk of falling. 

We are illness and injury rehabilitation professionals. It is nearly impossible to grow old without experiencing some bumps in the road. These bumps may be hospital stays, broken bones, strokes or progressive illnesses like Parkinson’s. We are the people to help you find your way back. Back to health, back to moving, back to living, back to being you.

None of this stuff is easy. Growing old ain’t for sissies (direct quote from more than one of my past patients!). Mobile Geriatric Physical Therapists (like me!) make it easier. We help you stay healthy as you age. We help you recover from bumps in the road. We even help you stay comfortable as you progress towards the end of life and help your family learn to care for you if they need to. So, will you get modalities and massages and be given a home exercise program and sent on your way? Nope. Not by a long shot. Will you learn to better care for yourself, care for your loved ones and age more successfully? You bet. Want to know more? Ask us:) #ChoosePTfirst

#haept #stronger #fitter #functional #physicaltherapist #physiotherapist #physicaltherapy #physiotherapy #exercise #health #wellness #aging #healthyaging #optimalaging #successfulaging #exerciseismedicine #insurance #medicare #momboss

FAQ #2: How ‘Old’ Do I Have to be to See You?

FAQ: How ‘Old’ Do I Have To Be to See You

(Hint: It’s a trick question)

I’ll answer this question with another question. Are you older than you were yesterday? Then you’re ‘old enough’ to see me.

As a geriatric physical therapist, I specialize in healthy aging. This means that while I’m a great person to see if you are having age-related issues like pain or limitation from arthritis, or trouble walking or difficulty with your balance, I’m also a great person to see if you want to PREVENT some of this stuff down the road.

There are so many diseases and disorders associated with aging (Congestive Heart Disease, Diabetes, Heart Disease, Osteoporosis and Cancer to name a few), but the key to prevention is making healthy choices, and developing healthy lifestyle habits BEFORE you get older. I’m 38 - and everyday I consciously make choices that will make me a healthier older person when I get there.

So, the answer to this question is you have to be exactly as old as you currently are:)

#haept #stronger #fitter #functional #physicaltherapist #physiotherapist #physicaltherapy #physiotherapy #exercise #health #wellness #aging #healthyaging #optimalaging #successfulaging #exerciseismedicine #insurance #medicare #momboss