Mar 13, 2018

Why Are Older People With Dementia Denied Physiotherapy?

As there is a wide variety of different kinds of dementia, there are also an extensive number of possible symptoms that a person may live with.

For some, it may be challenges with their memory, for others it may be difficulties with speech and swallowing. Another common symptom that many people with dementia experience is challenges with mobility.

Physiotherapy can help people with dementia in a number of ways. They can provide assistance and support by tailoring unique routines. This can include;

  • Movement exercises to keep muscles strong and flexible and make certain motions and activities easier
  • Balance training to help reduce risk of falls and may encourage them to stand on their own or use a walker.
  • Gait re-education with or without walkers
  • Provide advice on mobility aids or equipment that a person may need to promote mobility and function

One study looked at the benefits of physiotherapy for people with advanced dementia. In a small scale study, it looked at 16 patients of a long-term care hospital ward who all had advanced dementia.

What it found was that mobility skills increased in six of these when physiotherapy – this consisted of body awareness, music and movement and functional mobility training – was introduced for the first time.

These improvements were seen within one to six weeks of treatment, and it was found therapy has the “optimal response” when done from five to nine weeks.

Unfortunately many aged care residents, hospital patients and older people with moderate to advanced dementia, find that they are denied physiotherapy for a number of reasons.

One common reason reported is that a person is not suitable because “they cannot remember the instruction or the advice given to them” or that they cannot follow the instructions given to them.

And while people with dementia may find physiotherapy challenging, the therapy can be altered and moulded to their capabilities. This may come back the health professional’s understanding of dementia and the potential benefits of keeping people as mobile as possible.

For example, instead of making them do stretches that require them to stand, do exercises that they can manage while they are sitting down, or that they can do from their beds.

Ideally, these exercises will be assisted by a physiotherapist or a carers, which lowers the risk of them falling or doing the exercise wrong.

Just because a client can be “challenging” does not give a justified reason as to why they should not access or be assisted with a particular therapy.

It’s important to encourage older people to do what they can within their limitations, and not set them up to fail with exercises that are too hard, or worse yet, give up on them entirely.

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  1. From my experience with a nursing home Craigcare, Moonee Ponds, Dimentia is a condition that most carers do not have enough understanding of. They treat the agitation as if that person is just a mean spirited person, of course not knowing what they were like before (not all carers). My mother-in-law was given the same lunch and dinners and not the food ordered for her, because she just won’t remember to complain. She has to wait a long time when she rings for assistance, because she won’t remember how long she has been waiting. My MIL goes in and out of episodes and prefers help to the toilet, however they staff never get there in time and that makes her feel bad about herself. She needs to be fed … it would be nice for her to eat a warm, nutritious meal. Dementia patients need to be treated as if they don’t have dementia. And a lot more training needs to occur for carers. The care is disappointing and even going to the Ombudsman did not help. We were told by the ombudsman that the nursing home do not need to supply the family with incident reports for falls, due to privacy. We have no health care plan. The ombudsman has just responded, they will provided. Well they haven’t. They were not mediators, they just took the word of the nursing home rather than the family. It really is a service that is a waste of tax payer money for aged care. There is no real help for families and the elderly. It is very sad that this is occurring. It is not the carers fault. It is management and their primary focus being money/profits.

  2. My husband goes to respite 3 days aweek i find they are very helpful in what they do for my husband and others that go there .I prefer respite to nurseing home . They are very caring.They have exercise my husband has to sit to do his but never the less he uses weights to lift and does afew other exercise with legs . Mostly my husband crayons pictures . They have outings but he will not go for some reason he doesnt say as he gets cofused. And he did have a fall.but not hurt . I find them very caring .and it does give me 3days respite . I have no wish to put him in nurseing home but i have been told that i should be putting his name down as its very stressful for me . He can’t take in what i say. Even if his mind is going he seems quite fit since these exercises and thats a good thing.


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