Maintaining Independence:How the Family Can Help

Andrea Burns, Physiotherapist and Brain Injury Case Manager

Helping to maintain Independence

"Independent" was defined as remaining active and contributing to the community, while living either in a private residence or retirement village, alone or with others, and with or without support services.

What Losses Might You Experience?Physical and Mental LossesYou may become aware of changes in your physical and mental abilities,such as not remembering appointments or having difficulty climbing stairs,opening jars, or walking long distances. Other changes may include:

• Vision problems• Less control over emotions• Less physical energy• Less flexibility• Hearing problems• Less ability to move easily• Memory problems• Less stamina

Social Loss

Physical losses can gradually limit the ability to participate in socialactivities – sports, cultural outings, parties, and even dining out. Forexample:

• A person with a significant hearing loss, even with a hearing aid,might begin to avoid social situations for fear of missing conversationor having to ask others to repeat themselves.

• A person with heart disease suffering from shortness of breath maybe unable to continue daily walks with buddies. Over time, lesscontact with others may lead to fading friendships.

What Losses Might You Experience?

What Losses Might You Experience?Emotional LossLoss of independence can create tremendous frustration, feelings of uselessness, and sadness, due to a sense of loss of control in one’s life.

For example:• Some people might have a vision problem that prevents them from driving at

night. This might cause them minor inconveniences, but usually does not prevent them from pursuing their usual activities. If the vision impairment worsens and daytime driving becomes dangerous, their independence becomes more threatened. People often feel a loss of control when they are unable to get where they want to go when they want to get there.

• Necessary activities like grocery shopping and medical appointmentsmight seem impossible to accomplish. Being unable to do what usedto be ordinary activities can be extremely frustrating.

What Are Some Reactions to Loss of Independence?

When thinking about or beginning to experience loss of independence dueto aging, it is common for people to experience complicated feelings suchas:

• Fear: Some people become frightened by their new vulnerability, wondering how they will manage on their own. Overwhelmed, they may begin to expect close friends and family to be always available for them.

• Anger: Others, feeling angry that they can no longer manage on their own, may take their anger out on their loved ones.

• Guilt: Still others may feel guilty and refuse needed help from family and friends because they think they will be considered a burden.

• Confusion: It is not uncommon for people to feel confused about needing help and long for “what was.”

Important Factors in Maintaining Independence

• Positive attitudes to ageing; • Having adequate income; • Support with personal health needs and needs arising from

disability and degenerative conditions; • Having appropriate housing and security; • Access to transport; • Opportunities for recreation, education and use of public amenities;

and • Work.

Role of Physiotherapy

• Physiotherapy can involve a number of different treatment and preventative approaches, depending on the specific problems you're experiencing.

• As your first appointment, you will have an assessment to help determine what help you might need.

• Three of the main approaches a physiotherapist may use are:1. education and advice 2. movement and exercise 3. manual therapy

Role of Physiotherapy cont.Education and advice• One of the main aspects of physiotherapy involves looking at the body

as a whole, rather than focusing on the individual factors of an injury.• Therefore, giving general advice about ways to improve your wellbeing

– for example, by taking regular exercise and maintaining a healthy weight for your height and build – is an important part of treatment.

• A physiotherapist can also give you specific advice that you can apply to everyday activities to look after yourself and reduce your risk of pain or injury.

• For example, if you have back pain, you may be given advice about good posture, correct lifting or carrying techniques, and avoiding awkward twisting, over-stretching or prolonged standing.

Role of Physiotherapy cont.Movement and exercisePhysiotherapists usually recommend movement and exercise to help improve your mobility and function. This may include:

•Exercises designed to improve movement and strength in a specific part of the body – these usually need to be repeated regularly for a set length of time •Activities that involve moving your whole body, such as walking or swimming – these can help if you're recovering from an operation or injury that affects your mobility •Exercises carried out in warm, shallow water (hydrotherapy or aquatic therapy) – the water can help relax and support the muscles and joints, while providing resistance to help you gradually strengthen•Advice and exercises to help you increase or maintain your physical activity – advice will be given on the importance of keeping active, and how to do this in a safe, effective way •Providing mobility aids – such as crutches or a walking stick to help you move around •Your physiotherapist may also recommend exercises that you can continue doing to help you manage pain in the long term or reduce your risk of injuring yourself again.

Role of Physiotherapy cont.Manual therapy

Manual therapy is a technique where a physiotherapist uses their hands to manipulate, mobilise and massage the body tissues. This can help:

•Relieve pain and stiffness •Improve blood circulation •Help fluid drain more efficiently from parts of the body •Improve the movement of different parts of the body •Promote relaxation