Aging in Physical Therapy with Dr. Rory English


I interviewed my friend Dr. Rory English, who I’ve known since physical therapy school, as he works with the geriatric population. He is a physical therapist who specializes in such and I talked to him so he can shine a light on the aging process. There was a demand for this topic because I have a lot of clients who have misconceptions about it. 

 

This blog will help you understand more about the aging process and how physical therapy can help with that. 

 

What Got Dr. Rory English Into Geriatrics 

 

Dr. Rory English wanted to be a Physical Therapist in sports. He wanted to assist athletes and take care of them as they get back to the field. As he finished his degree in physical therapy, he got involved in being a physical therapy aide at an out-patient clinic and there was one particular case that he handled, which struck him. 

 

He talked about this patient who is an older adult and is very active and participatory in the lives of his family. That patient would undergo a physical fitness and wellness program in the out-patient clinic Dr. Rory English worked at and he was aging well. Unfortunately, that man had a freak accident one winter. He slipped on the ice and fractured his neck. The man had to undergo rehabilitation and Dr. Rory English was part of that process. The man’s goal was to walk again at the end of the summer so he can walk his granddaughter down the aisle. 

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This resonated with Dr. Rory English emotionally and saw how that patient worked so hard to reach his goal. The patient was able to walk his granddaughter down the aisle and seeing him able to do that made Dr. Rory English want to switch to getting into the geriatric population. 

 

Dr. Rory English On The Challenges Of Geriatric 

 

Dr. Rory English’s story about his patient who made him want to get into geriatric isn’t always the case. He shared that there are so many challenges in this area because there is a lot of extra emotional things that come with working with older adults. 

 

Also, the society is uncomfortable with the aging process so we do not talk about it a lot. There are also misconceptions about aging like the older you get, the worse it gets. The society has put out this notion that the more you age, the lesser you can do, the lesser you can move. Older adults are expected to just sit around all day and not contribute to the society, but that should not be the case. 

 

Dr. Rory English On Breaking The Misconceptions of the Aging Process

 

Dr. Rory English pointed out that not all older adults get the worst versions of themselves while they age. He said that many older adults are in control of their life as they steer the ship of how they age. Just like my parents, who are in their late 60s, I feel like they remain ageless because they still get to do the things they like doing when they were younger. For example, my dad would still race with me and my brother up the hill. 

 

Dr. Rory English pointed out that so many people focus so much on adding years to life but they do not focus on adding quality to those years. Physical therapists make it possible to add quality to one’s years. 

 

Dr. Rory English On Being Proactive During One’s Earlier Years And How It Helps As They Age 

 

Dr. Rory English also talked about how being productive during your younger years would help you when you are already an older adult. He said that this will set people up to age well so they can be functionally well and healthy and be medically healthy, too. 

 

Dr. Rory English On What He Focuses On As He Works With The Geriatric Population

 

Dr. Rory English said that the core principles in working with people through physical therapy remain the same with the geriatric population. He pointed out that the muscular system, the balance system, and the pain systems all function the same way. However, there are changes as to how the body operates when one ages so he makes sure that they adopt to these changes. 

 

He said that he focuses on loading the muscles and strengthening them for the patients under geriatric care. The most important aspect is to come up with functional activities that will help with the changes. Dr. Rory English may not let them undergo power lifting moves, but we can break down the complex movements so it would be easier to perform. 

 

Overall, he does not treat them differently and he is not afraid to overwork them because they can be challenged. As long as he knows that they are safely monitoring their vital signs and making good differential diagnosis on what is going on, they can challenge them like anyone else. 

 

He also said that they have to let the geriatric population understand why they need to do certain activities and relate it to what matters to them. For example, if you ask these older adults to do exercises to strengthen their glutes, they might question it. That is why they should be told that it would help them safely get out of their chair or so that they can be more secure in watching their grandchild. It is best to let them know the reason behind the activities that they do in relation to what is meaningful to them. 

 

Dr. Rory English On Motivating Patients 

There are times when older adults get frustrated with the activities they are doing because they perform at a lower level than they did before because of certain circumstances. Dr. Rory English talked about how motivating them is just as important as explaining to them why the activities are important in relation to something meaningful to them. 

 

He said that keeping them engaged is very important especially when things change in a blink of an eye for them and they lose their will to function. It is a tough thing to navigate, but it is a very important aspect. 

 

Dr. Rory English On Reflecting And Learning From His Patients 

 

Because these older adults lived in a different time, Dr. Rory English said that he also learns a lot from them. They tell him stories from yesteryear and it’s good to be reminded of it time and again because people lose sight of that often. 

 

Dr. Rory English On The Geriatric Population’s Mental Health 

 

Dr. Rory English said that listening to their stories make him understand their value and the implications of the society on their mental health. Especially because when they age, they kind of lose their voice and are not expected to contribute as much to the society. Listening to what they are feeling will let us understand what the impact of this situation to their well-being is. 

 

Many older adults suffer from depression and anxiety but it doesn’t get recognized. That is why physical therapists can help with these issues by helping them overcome different barriers in relation to this. One way to make this possible is through having one-on-one sessions with the patients under his care. 

 

Dr. Rory English On What He Wants People Caring For Their Parents, Grandparents Understand About The Geriatric Population 

 

Dr. Rory English said that one of the most common mistakes that people do when taking care of older adults is that they assert themselves on what these older adults can and cannot do. For example, when an older adult makes lunch, younger people tend to do it for them because the former is taking too long to do it. Dr. Rory English said that this would not help older adults at all because they would lose the ability to actually make lunch for themselves. 

 

It is important to allow older adults to do things that they can still do and let them feel supported instead. This is important because there is a therapeutic aspect taken from actually doing the activity and not just looking at the end result. 

 

If people aren’t sure if the older adult can or cannot do something safely, it is best to consult physical therapists. Consulting with an expert does not mean that something bad needs to happen first. The earlier you work with a physical therapist, the earlier you understand how to take care of older adults in a better manner. 

 

Dr. Rory English On Being Worried About Your Family 

 

Dr. Rory English understands that there remains to be a worry among the younger people towards the older adults in their family. However, if they worry all the time, older adults will not be able to have their independence. 

 

It is best to reach out for help from local support groups who have the same worries. Another way is to find a really good establishment that will take care of older adults. If these steps are not taken, it will only make things worse and no one will be moving forward. 

 

Dr. Rory English On Working With Medicare 

 

There are a lot of benefits through Medicare. However, there are things that make it challenging. For instance, there is a lot of fraud in the Medicare space and it has negatively affected patients and providers alike. Providers even make rules and regulations to protect people but it also has a negative effect of disincentivize providers that they end up not giving great care to their patients. 

 

Dr. Rory English believes that providers should be paid based on how they deliver the outcome and how much time they spend with their clients and I think things are moving now in the proper direction. 

 

He also talked about reimbursement being another issue. This is why he firmly believes that value-based care will be the best way to solve the issues surrounding Medicare. 

 

Dr. Rory English also shared how patients can help with advocating for the services that clinicians provide. He noted that they actually have third party data that is objective and talks about the benefits of physical therapy. Such data will definitely help them with their struggles in relation to Medicare and helping older adults with quality care.  

 

Dr. Rory English On What He Wants To Change In Health Care 

 

On the topic of aging, Dr. Rory English said that he wants to help patients understand the importance of preventative wellness and have access to it. He noted that he hopes there is a more robust infrastructure around education and incentivizing on choosing healthier lifestyle. Shining the light in this aspect is important and should really be changed so that people can be more proactive than reactive. 

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