[Reversing the effects of a sedentary way of life.]

W hen Laura, age 81, arrived at the nursing home, she was used to walking one half hour a day for exercise. The home allowed one certified nursing assistant (CNA) to take care of ten patients… a light assignment. Laura was the only patient who liked to walk every day assigned to CNA Joan. The other nine patients were in wheelchairs, so Joan knew exactly where they were at all times.

Joan’s job was to stay with her patients and take care of them. She reported Laura many times to the head nurse for wandering away from her group. Finally, Laura’s daughter and legal guardian, Elaine, was contacted. Explaining to Elaine that Laura could not be properly attended to if she kept walking away from her CNA, the head nurse suggested that Laura be given a wheelchair and have light restraints applied for safety.

Elaine thought about this and decided it made sense to sign the consent form for the restraints, as long as Laura would have a supervised one-half hour walk each day. But because one certified nursing assistant had to be with ten patients each shift, this supervised walk never happened. The nursing home’s physical therapist only worked with rehab patients and a supervised walk was not considered “rehabilitation.” So a “Catch-22” situation developed around Laura and her daily exercise, with rather devastating results.

The “light restraint” that was applied to Laura while in her wheelchair was, in effect, a modified straightjacket called a “posey.” Laura had to place her arms in its sleeves and strong strings tied her to the back of the wheelchair. The fact that the strings were tied with bows instead of knots rendered it a legal “light restraint.” Essentially, Laura couldn’t leave her wheelchair on her own, or even shift into a more comfortable position easily. Being strapped in meant Laura no longer had the use of her legs for transportation, and had to rely on the wheelchair to get from place to place.

For several months, Laura complained of pains in her legs and spasms in her foot muscles. She also experienced burning pain in her knee joints. As her circulation diminished, there were occasions of numbness alternating with stabs of pain in both legs and feet. While her circulation was valiantly trying to save her muscles, her lack of exercise was diminishing her muscle strength. Her knee and ankle joints swelled, her skin became discolored and she ultimately lost her ability to walk at all. Eventually, Laura needed to be lifted from her bed to the wheelchair, from the wheelchair to the commode, and back into the bed again.

Then one day, Laura’s daughter Elaine received a doctor’s legal evaluation on her mother. The report stated that Laura was now legally “paralyzed” from her hips to her feet and indicated that Laura would never walk again. Elaine was furious! In less than a year, her mother had deteriorated from being an active senior, walking a half hour a day, to a wheelchair-bound patient who no longer had the use of her legs.

“Laura” and “Elaine” are real people, though I changed their names so I could tell their story in print. Elaine knew that I was a licensed massage therapist and told me what had happened to her mother during her stay in the nursing home. She wondered if Laura’s condition could really be permanent… and whether massage therapy could help her walk again.

I knew that massage was the next best thing to doing your own exercise, so Elaine and I obtained written approval from the doctor, the nursing home and the head nurse for me to come to the home to give Laura daily massage therapy sessions.

Every day for thirty minutes, I gently massaged Laura’s feet, lower legs, knees and upper legs toward her heart. Sometimes she was massaged in her hospital bed and other times in her wheelchair. After just one month, her skin color started looking healthier. I continued the therapy for half an hour a day for another month. Then I took little walks with her. She used a walker at first, and her first walk was only a minute long, but to Laura, being able to stand erect and balance herself on her own two feet felt like a great achievement after being stuck in a wheelchair for so long.

Within another month, she had graduated from the walker to a cane and eventually to walking on her own. Shortly afterward, Elaine was able to bring Laura home.

Needless to say, the doctor who had reported that Laura would never walk again, apologized.

This story has a lesson for all of us… not just for elderly patients convalescing in nursing homes. If we don’t move around and exercise our muscles and joints, we could eventually lose our ability to move at all. In Laura’s case, she wanted to exercise but was prohibited from doing so for the convenience of others. The rest of us may not have such a handy excuse for being sedentary. It took less than a year of immobility for Laura to be diagnosed as “paralyzed” – and only thirty minutes a day of walking to stay actively mobile. Something to think about…

Jeff Bohrer, M.S., LMT, is a licensed massage therapist, traditional Usui reiki master and EMF Balancing Technique advanced practitioner, who makes home and office visits in the Tampa Bay area. (727) 455-1407.