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COTA Thoughts

My Grumpy Old Patient

Published February 28, 2014 8:46 AM by Tim Banish
If you work with patients that are in the geriatric range you know that some can be quite grouchy, mostly the result of them being unhappy due to the aging process. This is something that I always had to keep in mind as I worked with people, especially when I was younger and had an abundance of energy. As I aged it was a bit easier to remember. Now that I've reached the senior age I can attest to why some patients can be grumpy.

The first thing to remember is that old bodies move slower. Arthritis, prior injuries and balance deficits can make a person anxious about trying to keep up with a young therapist. Add the fact that about 70% of seniors do not exercise on a regular basis which impacts their energy level. I've seen some seniors that can pedal a bike for thirty minutes, but most are lucky to last ten to fifteen minutes. If you, as their therapist, ask for more than they can handle expect some resistance.

Of course their current medical diagnosis will be a factor here too. If the person has had a major illness or has been bed-ridden for an extended period their energy levels will be decreased. Yes the object of therapy is to build that energy level back up, but you also need to remember that due to their advanced age it takes more time to recover.

You also need to consider the remaining bodily functions that slow down with age. Every birthday tends to see a decrease in sight, hearing, digestion and more. One patient, a male in his 80's, once told me the worst thing he lost was his ability to make love to his wife. "And that's why I stay so grumpy!" he would joke. It's not a joking matter, but again just one more thing that leads to having a grumpy patient.

My thought here is to keep their pace in mind when working with geriatric patients. You'll sometimes find an exceptional senior who has lots of energy and it will be easy to forget their age, but for the most part this age bracket will need lots of TLC when working with them.


Until next time, hope all your "Thoughts" are Good-



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posted by Tim Banish


Thanks for your comments here Margo and Debbie.

Margo- In my eyes the aging process involves changes of the body we can't prevent due to growing older. As much as some people will sleep and eat well, stay fit and exercise, it will not stop some of the symptoms of aging. Arthritis, cancer, and other medical problems no one asks for can still affect even the healthiest person.

Tim Banish, COTA, Retired March 20, 2014 8:54 AM
Cincinnati OH

Great article, Tim.  Very insightful.

Debbie March 10, 2014 5:46 PM

Hi , I am not sure what the aging process is. We do know that several factors inhibit healthy or well aging. Lack of movement, lack of touch, loss of meaning, poor nutrition, mostly inadequate protein, fiber, probiotics and minerals such as Mg.

Other major players are poor sleep quality which results in cognitive difficulty and loss of cortical grey matter, persistent pain, resulting in the same, and loss of loved ones and a sense of belonging.

Underlying all  the above is loss of self efficacy and locus of control.

I have had a private practice for a number of years and using a program based upon positive neuroplasticity  and increasing self efficacy, have seen people improve their quality of life and take charge of their loves rather than being to resigned to "that what comes with age."

Thank-you for sharing your experience, I think that what you are seeing is the norm, all to common and it is my experience OTs are not sufficiently trained in neuroplasticity, self efficacy, therapeutic functional exercise.

What if we treated our aging clients with a rehab model?

Kind regards, Margo Traines MA OT/L LCP, Health and Wellness Coach

Margo Traines, Pain, Health - educator March 6, 2014 10:04 PM
Tualatin OR

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