Working with the Geriatric Population

[jsmurray]

Hey there BB.com,

So I will be starting working under a new company doing personal training for home-care facilities later this week. I am still waiting for my first clients medical clearance to come back (80 years old), so I am not exactly sure what his strengths/weaknesses are. His goal is more focused towards ability to complete ADL's etc, but I was hoping if anyone had some more advice working with this population I would appreciate it. I've done about 200 hours in a physical therapy setting, so I know a bunch of creative stuff that possibly will work with the client if necessary, but any feed back would be appreciated.

Thanks,
Scott

[SFT]

A medical history is extremely important. Most people at that age are going to have at least 2-3+ risk factors. Medications can influence a variety of things from HR response to exercise, blood glucose readings, etc. These meds may also result in hypotension or hypoglycemia. This is really an interesting population to work with, but you have to know your **** and be cautious with many of them.

[WoofieNugget]

One thing you really have to be careful of with the elderly is load. While they need to achieve certain things, you have to remember that for these people being able to lift a 5 lb. bag is often a lot. Then if you increase load to 10 pounds, while a lot of people would scoff at the idea of only adding 5 more pounds, that is a 100% weight increase which is a whole lot more. Things like active range of motion is important as well.

Stick with the basics. Getting in and out of beds/chairs/the shower can be accomplished with squat and step up/down modalities. Lifting things off of the ground requires pulling and bending. Putting things on shelves requires pushing and mild spinal extension. You need to microprogress and take into account the stuff that they are going to want to do when they are 85.

[Kataz]

One thing you really have to be careful of with the elderly is load. While they need to achieve certain things, you have to remember that for these people being able to lift a 5 lb. bag is often a lot. Then if you increase load to 10 pounds, while a lot of people would scoff at the idea of only adding 5 more pounds, that is a 100% weight increase which is a whole lot more. Things like active range of motion is important as well.

Stick with the basics. Getting in and out of beds/chairs/the shower can be accomplished with squat and step up/down modalities. Lifting things off of the ground requires pulling and bending. Putting things on shelves requires pushing and mild spinal extension. You need to microprogress and take into account the stuff that they are going to want to do when they are 85.

This is key. You're working to prevent injury in daily life with people that old. Balance and simple everyday motions should be emphasized.

[SFT]

The other thing is quality of movement. For example, some people can get out of a chair just fine by rocking forward. However, if you ask them to start at the edge of the chair, with no momentum, it becomes considerably more difficult. In this way, you can often progress without using an external load initially.

[jsmurray]

Thank you for the responses. I feel quite capable of analyzing movement/weaknesses and quality of ADL's so I feel very prepared, I just havent been the one in the driver seat in terms of exercise protocol.