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4 Questions to Ask Yourself to Stay out of the Nursing Home

Updated: May 10, 2022

I’ll admit it, the title of this blog post probably, no definitely, sounds a bit dramatic. But as a PT of almost 14 years now, and as someone who has treated patients from babies to those over the age of 100 in multiple medical settings, I’ve been able to see the bigger picture. I also spent several years of my PT career working in a Short-term rehab and Nursing Home, where I treated patients who end up needing 24/7 care. I feel a moral obligation to share the following information.

From what I’ve been able to observe and see first-hand, there are a few key simple but extremely important lifestyle and health factors that make the difference between you living independently and actively at home well into your older years vs. ending up in Nursing care prematurely. (Of course there are always special exceptions to all these rules in the case of major physical accidents, certain medical diagnoses, etc.). Here are questions to ask yourself and seriously consider if you want to grow old and active, not old and sick:

1. Can I get on and off the floor??

A lot of patients we see in the clinic at some point realize that they are no longer able to get on and off the floor. This ability is a good indicator of overall mobility, strength, flexibility, and balance. Those who practice yoga regularly or who like to scrub the floor on their hands and knees take this ability for granted. Somewhere along the line, many of us come to the realization that we don’t even know where to begin when it comes to getting ourselves onto and off from the floor or ground. Think about it, if you slip, trip, or fall, it’s pretty important that you can get yourself back up if you want to keep your independence. But many of us in our older years cannot do this! So, if you can easily get on and off the floor, make sure to do this a few times per week to keep up the ability. And if you can’t, you should get yourself to a Physical Therapist to work on this, as well as your overall strength, flexibility, and balance.

2. Can I stand on 1 foot for more than a few seconds?

Similar to the above, many of us don’t realize that we can’t do this until someone asks it of us. Then we try to stand on 1 leg and fail and say, “Oh my gosh, when did I lose the ability to stand on one leg?” It could have been months, years, or decades ago! But as it goes for getting on and off from the floor, standing on one foot safely and comfortably is a simple indicator of your overall balance. And if your balance is poor, you are more likely to fall and end up in nursing care, or injure yourself and end up hospitalized with injuries. Again, not trying to be dramatic, but the importance of maintaining and improving your balance as you age cannot be understated! So if you fail at the stand on one foot for a few seconds test, again, get yourself to a Physical Therapist for a balance screen. Believe it or not, no matter how poor your balance is now, it can improve dramatically with a Physical Therapy program

3. Polypharmacy: Does this apply to me?

Poly-what? The definition of polypharmacy is the simultaneous use of multiple drugs by a single patient, for one or more conditions. If your medication list is longer than your favorite movie’s ending credits, you are on too many medications. Nowadays with patients having multiple specialists, doctors, etc., it is easy to end up on a laundry list of medications. THIS IS ONE OF THE MOST COMMON DENOMINATORS I WAS ABLE TO RECOGNIZE IN PATIENTS WHO ENDED UP NEEDING 24/7 CARE. It’s the chicken and the egg. Did multiple medical diagnoses lead to the need for all the medications, which led to the need for more care, or was it the medications that led to more issues, that led to more diagnoses, that led to the need for more care and more medications? Do you follow?

There is a huge problem with patients ending up on TONS of medications and Physicians not taking the time to weed out which medication is for an actual medical condition vs. which medication is just to treat a side-effect of another medication, which then causes another side-effect, which then gets prescribed another medicine. If you have a long medication list, it’s definitely worth having a serious conversation with your PCP about why you’re on the medications you’re on, if you absolutely have to be on all of them, and if there are some you may be able to eliminate or slowly wean off from over time through diet and exercise. Do YOU even know why you're on each medication that you take? You'd be surprised at how may people take medications each day and have no idea what they're even for. DO NOT STOP OR REDUCE YOUR MEDICATIONS WITHOUT TALKING TO YOUR DOCTOR FIRST. I’m just saying that if you’re on a ton of meds and you don’t know exactly why, you need to have that conversation with your doctor. And if they won’t or can’t take the time to have this conversation with you, it’s time to get another Doctor.

I have to do the Mom thing now and get preachy and state the obvious:

4. Do I live a healthy lifestyle?

All things in moderation. A lot of patients who I treated in the Nursing home had a history of smoking and/or heavy drinking. This is pretty self-explanatory as to why it’s bad for your health, but not everyone thinks of these things as lifestyle factors that can land you in a nursing home prematurely. But these lifestyle choices do wreak havoc on your body and mind not only now, but prematurely age you later in life. All things in moderation, so casual drinking is fine and a cigar here and there’s great, just don’t go overboard on a consistent basis if you want to hedge your bets to be healthy in your later years.

Also, try to maintain a healthy diet, think 80% healthy items, 20% indulgences if you must. Incorporating more plants (fruits and veggies) into your diet can add life to your years and years to your life. Oh, and don’t forget to hydrate! Aim for ½-1 oz of fluid per pound of body weight per day (75-150 oz/day if you’re 150 pounds).

Oh, and exercise! Standard recommendations state that for substantial health benefits, most older adults should participate in at least 150 minutes of moderate-intensity aerobic activity, 75 minutes of vigorous-intensity aerobic activity, or an equivalent combination of each per week.

So there you have it! Some people claim that they would rather live life now and don’t care what happens later on. But you might think differently when you’re 70 and physically failing. And staying healthy and active into your later years doesn’t mean you have to live in a prison of health, exercise, and kale smoothies. Little changes and habits each day make all the difference. If you would like to schedule a free consultation with one of our Doctors of Physical Therapy by phone or in-person, you can sign up here

In good health,

Dr. Ashley Bertorelli, PT, DPT, Founder/Owner of The Green Room Physical Therapy

Ph: 518-326-3771

Clifton Park & Troy

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