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Older adults doing seated strength exercises with resistance bands, led by an instructor

Staying Strong and Mobile

Strength and mobility can be kept, and often rebuilt, at almost any age. This free guide covers the signs to watch for, what Medicare covers and what to ask a physical therapist.

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Why strength and mobility matter

Strength and mobility for seniors decide the small things: standing up from a chair, climbing the front steps, getting dressed without help. According to the U.S. Office on Women’s Health, adults lose about 3 to 5 percent of their muscle mass each decade after age 30 without enough exercise and good nutrition. By 75 or 80, that loss usually shows up in daily life before anyone calls it a medical problem.

It isn’t fixed. Strength responds to work at almost any age, and a physical therapist can build a plan around what your loved one wants to be able to do again.

What’s in the guide

  • The four types of exercise a good therapy plan covers, from the National Institute on Aging, with the everyday tasks each one helps.
  • A checklist of signs that it’s time to ask the doctor about physical therapy.
  • Medicare basics, including what to do if you’re told therapy has to stop.
  • Eight questions to ask the physical therapist at the first visit.
  • Ways to keep someone moving at home, including tips for people living with dementia.

The Medicare point many families miss

Families are sometimes told therapy has to end once a loved one stops improving. Medicare.gov says outpatient physical therapy can help maintain current function or slow decline, not only improve it. A 2013 court settlement, Jimmo v. Sebelius, confirmed that coverage doesn’t depend on someone getting better. The guide explains what to ask if you hear otherwise.

For the longer version, read our article, Physical Therapy for Seniors: Keeping the Strength for Everyday Life.

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Common questions

Will Medicare pay for physical therapy if my parent isn't improving?

It can. Medicare can cover skilled physical therapy to maintain function or slow decline, not only to improve it. If you're told therapy must stop because your loved one isn't improving, ask for the decision in writing and ask how to appeal.

How do I know if my parent needs physical therapy?

Watch for trouble getting out of a chair, shorter or shuffling steps, avoiding stairs or outings, stiffness that makes dressing harder, weakness after a hospital stay, or feeling unsteady. Bring what you notice to the doctor.

Do we need a doctor's order for physical therapy?

For Medicare to cover outpatient physical therapy, a doctor or other qualified provider must certify that it's needed. Medicare Advantage plans may also require prior approval, so call the plan first.

Can people living with dementia benefit from physical therapy?

Often, yes. The Alzheimer's Association notes that mild-to-moderate physical activity may help slow a decline in thinking skills, and therapists can adapt by demonstrating movements and giving one step at a time. Check with the doctor before starting a new routine.

More free guides for families

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Photos by Centre for Ageing Better on Unsplash.