Environmental Adaptations

It was a simple question posed by a patient last week. “What do you think about installing a railing next to the toilet?”  Why, I asked. “Well, it’s getting harder to lift myself up and I thought if I had one of those hospital bars,  I could use my arms to help pull myself up”.  Seems innocent enough, but it lead to this lengthy discussion on the environmental adaptations that we make to compensate for a loss of strength and range of motion as we become more “mature”.  For many, as long as they can figure out a way to adapt the situation, the problem’s solved.  In my opinion, changing the environment should be the last option, not the first.

Let’s play out the above scenario a bit.  So, first we install the rod to help pull ourselves up from the John because our hips and legs are weak and can no longer do a very basic function.  Time goes on, and guess what, now my arms hurt and I can no longer use them to pull up.  Problem.  Oh wait, I saw this thing in a magazine for old people. It’s this big plastic, hard, donut looking thing you can put on the toilet to sit you up higher.  Problem solved, right?…WRONG! Don’t give up function so easily.  Fight, claw, scratch, do what you need to do to keep those “doors” open.  If we can find a way around it, we think the problem’s solved.  However, we just shrunk our world a bit.

Commonly heard adaptation heard around PT clinics everywhere:

* Just moved in to a house without stairs…..what’s that going to do for your ability to climb steps out in the world….

* I can’t get on the floor, not sure if I can get back up again…..and if you ever fall?

* Had to buy a car that sat up higher, can’t get up from my old car, too low….

* I use to love playing (fill in the blank) but I had to give it up because my (blank) started hurting…….hold on to the things that bring you pure joy

* I need a chair with arm rests, or better yet, one that lifts me up with a push of a button…..

* Need to travel with my own pillow, otherwise my neck hurts…..

* I can still play basketball as long as I wear my back brace, ankle brace, elbow brace, knee brace, and I don’t have to run or jump…..

I understand some situations are unavoidable and require modifications to our environment for safety, etc, but  I feel we default to these lifestyle changes far too soon and without much of a fight.  The next thing we know, we have closed in our world, not really “living life”, rather just “existing”. 

  Aging is inevitable, but we can always improve our strength, range of motion, and flexibility regardless of our age.  Many of us just choose to use age as an excuse.  The question I have for you then is how much of your quality of life are you willing to give up?

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