According to the World Health Organization (WHO), the population over the age of 60 years is the fastest growing population worldwide. This is a positive sign of increased life expectancy and improved healthcare. However, ageing comes with many challenges not only physically but also psychologically and cognitively in addition to the social and financial burdens.
Physiotherapy in general is concerned with maintenance or restoration of function and this becomes of high importance in older adults as the main problems that emerge in this population are loss of independence and decreased functional capacity. “It takes a child one year to acquire independent movement and 10 years to acquire independent mobility. An old person can lose both in a day” (Isaacs, 1992).
Due to the complexity of ageing and the diversity in physiological and functional changes seen in this population, physiotherapists working in this field need exceptional skills in terms of communication, multidisciplinary team work, creativity and patience. Working with this population can be very rewarding in terms of mutual appreciation and the experience shared.
There are some common misconceptions about the older population; some think they are lazy, passive-dependent or lack motivation to learn new things. However, when they work with an enthusiastic physiotherapist who appreciates their experience in life and wisdom, they usually are very cooperative and responsive to physiotherapy approaches. Another misconception is that physiotherapists think that, when working with older adults, they will be faced with extremely ill or dependent clients. However, the clientele from this population can be healthy older adults who just wish to maintain their independence or improve their functional performance.
Culturally, we have been very protective of our elders out of respect and recognition of their life journey. However, this does not mean that we should deprive them of their independence. Physiotherapy for older adults places special emphasis on exercise and physical activity as these are key to maintenance of function and independence.
Physiotherapy approaches used with older adults are not limited to exercise and manual approaches but they also involve cognitively challenging activities and social interaction. All physiotherapy management plans used with older adults need to be individualized and client-centered due to their diversity and uniqueness.
As physiotherapists, working with older adults, we need to always keep the famous saying of George Bernard Shaw“We don’t stop playing because we grow old; we grow old because we stop playing”.
