Physical therapy processes-interactions between a physical therapist and an older client with dementia

In Japan, the population aging rate highlights the need to examine various care provisions for older adults with dementia, including physical therapy. However, despite its positive effects, there are also many challenges associated with providing physical therapy for older adults with dementia.

This qualitative case study examined the interactions between a physical therapist and a patient with dementia and the process by which physical therapy was provided to her.

This study utilized a modified grounded theory approach to analyze the interview of one physical therapist, a woman with four years of clinical experience who specializes in physical therapy for older adults who provided a 20-minute physical therapy session to her client, a woman in her 80s with dementia who sought to maintain her ability to perform activities of daily living and preserve her independence. Data were collected in January 2017.

Fifteen concepts that represent aspects of the services that the therapist provided to her client were identified. Five distinct categories were derived: 1) foundations of the relationship; 2) understanding individual factors; 3) supporting execution of functional activities; 4) assessing cognitive function; and 5) support to ensure safety in daily living.

Physical therapists help older adults with dementia execute functional activities, which helps ensure their safety and independence, and fosters strong therapist-client relationships. Future studies should interview multiple physical therapists to generate additional concepts. Further, quantifying these concepts and developing tools to assess clients will improve care provision and inform physical therapists with limited experience in treating patients with dementia.