By Joe Fleming

In a perfect world, older patients would terminate physical therapy only after they have fully recovered from their injuries and have regained 100 percent mobility. But, in the immortal words of Huey Lewis, there ain’t no livin’ in a perfect world. Sometimes, a patient’s health insurance company cuts off payments. Other times, for various reasons, the patient is no longer willing or able to continue sessions.

In these situations, all the progress made over several weeks or month can dissipate very quickly. So, it’s imperative to give soon-to-be-former patients the tools they need to retain what they have worked so hard to build.

Changes to a Dwelling

Most health professionals have a conversation about changes to a dwelling/lifestyle early in their relationship. But now that the sessions are coming to an end, it’s time for a checkup. Sometimes, patients do not understand the urgency of the situation, and they need to understand that without these changes, there is a very good chance they will have another accident and require additional therapy. For example, about half of senior citizen fall victims are repeat fallers.

Now is also a good time to have a reassessment conversation, because the therapist knows, based on the patient’s condition, which items are must-haves and which ones are optional.

  • Eliminate the Clutter: Clutter happens. The grandchildren come over and they make a mess, or friends come over to watch the game and do likewise. Ensuring that pathways are entirely clear is the best way to get around in one’s own house. On a related note, minimize the throw rugs and area rugs.

  • Additional Light: AMD (Age-Related Macular Degeneration) is extremely common in adults over 50. Older retinas simply let in less light, which makes it harder to see. Have your patients compensate by adding lots of night lights in hallways and installing specialized full-spectrum bulbs in overhead lights to reduce glare.

  • Wheelchair Ramp: Even if your patients are not in wheelchairs, it is a lot easier to go up and down a ramp than climb two or three steps over and over and over. They should be sure that the ramp has a slip-proof top and is not at all steep.

  • Doors: Some hinges allow doors to open all the way to the frame, and the extra inch or two often makes a big difference. Lever doorknobs are a good idea as well, because they are easier to manipulate than round ones.

Stress to your patients that just because they incorporate these changes does not mean they are feeble. Changes like grab bars for toilets are kind of like fire insurance. They are thoughtful preparation for what will most likely never happen.

Personal Changes

Small changes to one’s personal habit are probably even more important than changes to a dwelling. For the most part, they are also easier to incorporate.

  • If the doctor prescribes a medical device, like oxygen or a walking cane, they should always use it. If the patient is stubborn, compromise and state that going without the device must be the rare exception, e.g. for every day you don’t use oxygen, you must use it for five consecutive days.

  • Move around. Even a walk around the block a few times a day makes a tremendous difference. Joining a fitness activity for seniors, like a yoga class, is even better because lonely people also get social interaction in these groups.

  • Watch your diet. As we get older, metabolism slows down, so we must eat fewer calories to maintain a healthy weight. Therefore, make the calories count by eating as many fruits, vegetables, and whole grains as possible.

Saying goodbye to a patient is never easy, but if you reinforce these tips, your work will not have been in vain.


Joe Fleming is the President at ViveHealth.com. Interested in all things related to living a healthy lifestyle, he enjoys sharing and expressing his passion through writing. Working to motivate others and defeat aging stereotypes, Joe uses his writing to help all people overcome the obstacles of life. Covering topics that range from physical health, wellness, and aging all the way to social, news, and inspirational pieces…the goal is help others “rebel against age”.

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