As a seasoned hospice nurse, I have witnessed the advantages of physical therapy for patients grappling with diverse medical conditions. Nevertheless, when it concerns geriatric patients with dementia in the terminal stage, physical therapy can, at times, yield adverse effects. In this discussion, we'll explore five reasons physical therapy might not be optimal in such cases.
Suppose you are on the fence as to whether you should have your loved one with dementia receive physical therapy. May I suggest you contact a local rehabilitation center where you know they provide rehab for dementia patients (where would your own loved one go?) to find out what days and times their physical therapists are giving therapy? Then do surprise visits where you either don't tell anyone why you are there or state you are just visiting a friend. Then, spy and try your best not to get upset over what you see and hear. In my experience as a hospice nurse, while I never see abuse by the therapy personnel, I do see confused dementia patients who are crying, hurting, or otherwise confused as to what is being done to them. I want you to focus on the last three words, “done to them!“
Agitation and Confusion
Physical therapy and dementia-induced agitation: Geriatric patients with dementia often grapple with bouts of agitation and confusion. Engaging in physical therapy can exacerbate these symptoms. The concentration and focus required during therapy sessions can overwhelm patients, particularly those with advanced Alzheimer's disease, intensifying their agitation and distress.
Elevated Fall Risks
Physical therapy and fall hazards: Physical therapy commonly involves exercises and movements that can be challenging for geriatric patients with dementia. These activities heighten the risk of falls, which can be perilous for individuals already in a fragile state of health.
Increased Pain and Discomfort
Physical therapy and heightened discomfort: Physical therapy can also amplify pain and discomfort for geriatric patients with Alzheimer's in the terminal stage, especially if they have underlying conditions like arthritis or osteoporosis. Sometimes, it might even result in muscle strains or tears, further intensifying their pain and discomfort.
Fatigue and Exhaustion
Physical therapy's taxing nature: Physical therapy can be demanding even for younger, healthier individuals. However, for geriatric patients with dementia, the physical demands can be overwhelming and exhausting. This exhaustion can exacerbate their overall fatigue, which in turn can negatively impact their well-being.
Diminished Quality of Life
Physical therapy's impact on quality of life: Physical therapy might reduce the quality of life for patients with dementia due to cognitive and physical limitations that hinder their participation. Additionally, physical therapy's time-consuming and strenuous nature can lead to a decline in the patient's overall quality of life.
Conclusion
While physical therapy holds undeniable benefits for many patients, it's essential to acknowledge that it may not always be the ideal choice for geriatric patients with dementia in the terminal stage. If you're contemplating physical therapy for a loved one in hospice care, it's crucial to consult their healthcare provider and hospice team to determine its suitability. Hospice care's primary aim is to provide comfort and enhance the quality of life for patients, and any consideration of physical therapy should align with this overarching objective.
