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NCHPAD - Building Healthy Inclusive Communities

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Physicians Need to Refer Their Patients to NCHPAD


James H. Rimmer, Ph.D., Director
James H. Rimmer, Ph.D., Director
A few months ago I was having a phone conversation with my mother about the growing pain in her knees. She had been commenting for some time that they were bothering her, but this was the first time she had mentioned quitting her volunteer work as a teacher's aide at a local nursery school because she was having difficulty walking. This alarmed me because there was the imminent danger that that she would have to quit the one thing that she dearly loved and that kept her connected to the community. What concerned me more than anything was the social deprivation she was about to experience, going from a 3-day a week, 5-hr per day volunteer job, to spending the majority of her time in a small dark apartment wedged between rows of apartment buildings in New York City. For a woman who loves to be around people, especially children, this could be a difficult stage in her life. Having no family members close by and living within the confines of a large, metropolitan city that often moves at a much faster pace than many older New Yorkers can tolerate, pain and functional limitations often drive people with disabilities deeper into their homes, rendering them to a life of boredom, social isolation, and often depression.

Painful joints, fear of falling, and difficulty ambulating, are common reasons why many older adults with disabilities rarely leave their home. Having lived most of her life in this fast-paced, never-sleep city, my mother was approaching a critical turning point: tolerate the pain and continue to work, or quit the one thing that she looked forward to - working with children and being around people. I decided that it was time to do something about it and made an appointment with a rheumatologist at a time when I would be available to drive my mother to the doctor while attending a conference in New York City. During a brief consult that I was privileged to sit in on, the rheumatologist told my mother that she needed to start taking pain medication and attend physical therapy two days a week for six or seven sessions. The doctor also mentioned that my mother needed to continue exercising to avoid other health problems. These recommendations were nothing out of the ordinary, and I'm sure millions of other people with arthritis have heard similar recommendations from their own doctor.

Unfortunately, what was lacking in the doctor's comments was the substance to make it happen. Advising an 80-year old woman that she should "continue exercising" will do little good if there is no support mechanism in place. What my mother needed to hear was how and where to exercise. Examples could have included joining a chair aerobics or Tai chi class at her local senior center, finding a warm water pool in her neighborhood (most YMCAs offer warm water exercise classes for seniors with arthritis), or purchasing a stationary bike and some elastic tubing to strengthen her leg muscles in her own home.

Had the doctor known about the National Center on Health, Physical Activity, and Disability, she could have downloaded a NCHPAD fact sheet on exercises for arthritis and then searched the NCHPAD database for exercise programs in my mother's neighborhood that offer classes for seniors or people with arthritis. My mother is an outgoing person who would benefit greatly from a community exercise program, where she could interact with others, make new friends, and enjoy performing a variety of new and enjoyable physical activities.

Professionals in medicine and rehabilitation must begin connecting their patients to community exercise programs. No matter how small the community, there is usually some type of exercise program offered within a few miles of the person's home. NCPAD's growing database on accessible programs would be very helpful to doctor's needing to make referrals to patients in need of exercise.

In a few days my mother will see a physical therapist who will prescribe some home exercises that she'll try a few times before she becomes bored and stops. This is precisely where NCHPAD could reach its greatest potential, picking up where therapist and doctor leave off. NCHPAD is only beginning its fourth year of operation, and the vision for this exciting Center is to bridge the medical community with the growing world of exercise and fitness. Doctors and rehabilitation specialists must begin to use some of the precious minutes they spend with their patients connecting them to the National Center on Health, Physical Activity, and Disability. They won't be disappointed.

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