Transcript 2. Adjusting the Boomers

Even Old Surfers Need
Chiropractic Care!
Adjusting the “Boomers”
Lisa Z. Killinger, DC
Palmer College of Chiropractic
The Facts...
• * 33% of chiropractic patients are
50+ (Job Analysis of Chiro; 2000)
• 16-17% of chiro. patients are 65+
(Goertz, 1996, Hawk, 2000)
• 6.5% of people aged 65+ used
chiropractic in 1994 (Paramore,
1994)
The “Boomers” are Coming!
• Centenarians now around 100,000, in
2050 will = over 1 million.
• Now, 6,000 people/day turn 65
• By the year 2010, over 10,000
people/day will turn 65 !!
(Alliance for Aging Research, 2002)
They Really Are!
• By 2020 there will be 50 million older
Americans
• By 2030 there will be 70 million!!
• ***The US has a HUGE shortage of health
professionals trained in geriatric care;
Chiropractors can help fill that gap!
The trends…as hippies turn 60
• The ‘turned on’ generation’s use of
complementary/alternative care
(including chiropractic) is rapidly
increasing.
(Eisenberg)
• Collaboration between health care
providers is increasing (“ID” care)
• Health care teams are including more
‘non-traditional’ providers, like
chiropractors (Integrative care)
Our Roles as Chiropractors...
• Healers: Help facilitate the body’s
natural healing process
• Teachers: Educate our patients to
participate in & achieve optimal
health
• Professionals: Utilize our professional
ethic & abilities for the good of the
patient
Goals of an Aging ‘Boomer’
– To remain independent !!!
– To remain active (Do what we like)
– To have less pain
– To take fewer meds
– To stay tuned in, turned on, and as
far out as possible!
Goals of the Chiropractor:
Condition Based Care
– To  or eliminate pain and compress
morbidity
– To  patients’ reliance on medications
Health Care
– To  patient health and
– To  patient’s control over health (HPP)
Wellness/Development Care
– To educate/empower patient to achieve
optimal wellness over the life span (HPP)
“Health” Care (Re)-Defined:
•Health is a state of physical,
mental, and spiritual wellbeing and not merely the
absence of disease.
After all…
these are the children of the 60’s!
Encourage the “boomers” (and all
patients) to make real “health”
their goal.
☺☺☺☺
Chiropractic care
can help aging persons
(all of us!)
achieve that goal.
(Health Promotion & Prevention is key!)
“Normal” Aging* (It impacts
how we adjust the Boomers !)
• * muscle mass
• * bone density
• * ligament/tendon elasticity
• * capillary/skin/bone fragility
• * vascular plaque/atherosclerosis
(Souza, Soliman; Normal Aging.TICC;
1996)
“And above all, do no harm”
Common chiropractic
malpractice claims (older pts)
– Failure to diagnose
– Rib fracture (post-menopause
females)
– Hip fracture/dislocation/injury
– Rotator cuff/shoulder injuries
– Falls off of tables
– Burns from ice/heat/modalities
(NCMIC)
Ger. Care Considerations:
• Orthostatic hypotension (often
caused by medications or
atherosclerosis)
• Adjust with  muscle mass/bone
density, lig. elasticity in mind
• Consider pathology odds
• Evaluate pt’s overall clinical picture
• *Then, develop your care plan
accordingly!
Caring for Frail Patients:
• Lighter palpation and adjustment
• Choose your fulcrums wisely...
• Use rotatory adjustments
sparingly/cautiously
• Handle ribs and hips with care
• Avoid “re-thrusting”
• Caution with heat/ice/modalities!
Caring For “Boomers”
Responsibly….
• Take x-rays !! Use caution with the
osteoporotic or osteophytic spines
• Alter your technique choices in pts.
w/ heavily plaqued vessels.
• Use lower-force techniques, or
modify techniques appropriately
(demos later)
Even More Specifically...
• Emphasize mobilization
• Decrease thrust magnitude
• Broaden contact points
• Protect patient from falls in your
office!
(Cooperstein/Killinger; Book chapter on
technique in “Chiropractic Care of the
Older Patient”; )
Sound clinical judgement
should prevent:
• Post-adjustment stroke (very rare!)
• Post-adjustment discomfort (Pt & Dr)
• Rib or other fractures (easily
preventable)
• Soft tissue strains, pains, and
bruising (common, preventable)
Summary of General
Thoughts...
• Many technique and management
options for chiro. ger. care
• We should design a care plan only
after considering the entire clinical
picture
• We need to listen to, look at, and then
touch our patients
• Your patient’s aging spine is changing;
‘adjust’ your care strategies too!
Demonstration:
☺☺☺
Chiropractic Techniques
With Aging in Mind….
Is geriatric practice
worthwhile?
YES!!!!
Most Older Patients:
• Have more disposable income than
any in other times of their lives
• Are willing to pay out of pocket for
healthcare
• Are a great source of referrals
• Are great at keeping appointments
• Have the greatest need for care
“Boomers” Are Great
Resources and Need Some
Resources Too!
• Handouts available on ger resources
• What do you offer your older pts?
• What do your older patients have to
offer? (To other pts, to you, and to
the community)
Some Advantages of Aging:
Hey, This Is Not So Bad!
• Boomers have more time,
• Less responsibility,
• More security, stability
• Soon, Boomers will be the MAJORITY
• (Man, how our society will change!)
More advantages….
We can swear like sailors
and people just think we’re
being cute!
We can finally tell those stories
of our ‘wild and wooly’ days
(without people trying to punch
us or chase us)!
We are more motivated to to
develop a relationship with a
Higher Power.
(Given the content of some
of our ‘stories’, we had better
start praying!)
•
And….
“If you’re gonna get old, you
gotta dig it!”
Fred Van Dyke; Surfer, Age 70k
Peace!!!