When women turn 50 in Ontario, we get a happy birthday message from the provincial government that lets you know it’s time for a mammogram, a pap smear and a colorectal cancer screening. Yay, happy birthday, you are officially old.
Recently, in my consulting life, I’ve been working with several professions that fall into the rehabilitation/ mobility realm, and I’ve developed my own little pet project that I would undertake if I were the minister of health: a comprehensive mobility assessment at the age of 50, and the development of a personal plan for strengthening and sustaining mobility.
I have been thinking about this a lot as I’ve entered my 50s, and started experiencing the weird stiffnesses and aches and changes in metabolism that come along with this decade. I’ve noticed an increasing number of my peers who can’t comfortably walk up or down two or three flights of stairs. I’m not talking about people with the kind of injury or deficit where they might already be seeing a physiotherapist or other mobility professional — I’m talking about the “move it or lose it” kind of agility and strength.
I’ve been thinking a lot about the need to sustain mobility as we age. There is a lot of evidence that physical activity in older people is a critical part of preventing disease and sustaining wellness, maintaining independence and creating a good quality of life. If we can’t move our bodies in some ways, we’re at greater risk for diabetes, high blood pressure, heart disease and depression. If we don’t feel comfortable walking a few blocks, there are fewer and fewer activities available to us. Mobility is critical to aging well — which is one of the main points of this blog’s existence.
And, there is almost nothing in our current primary healthcare framework that focuses on fostering agile aging. We are screened for the biggest problems inside our bodies — cancer, heart disease, diabetes, and there is an increasing focus on health promotion (participaction and the carrot app, anyone?) that encourage individuals to take action. But my suspicion — supported by anecdotal evidence by my colleagues in cardiac rehab and mobility professions — is that most of those programs are going to sweep in people who already see themselves as physically active in some way, or if their health providers have told them to become more active.
I think there would be huge benefit in providing a safe, supportive framework for an assessment by a healthcare provider focused on mobility (physiotherapist, athletic therapist, occupational therapist) at the age of 50 or so, and the development of a personalized plan for each person, focused on aging with the greatest mobility. We don’t all need to climb mountains or do endurance runs or ride our bikes across Estonia. But I do think that aging with the greatest agility, strength and ease available to each of us is more accessible than some people think.
Right now, for the most part, access to the services of physiotherapy and these kinds of professions fall into the 30% of healthcare in Ontario that are privately funded, not publicly supported. If you have a benefits plan that covers physiotherapy, a comprehensive assessment in your early 50s and goal-setting personal plan is accessible. But most people are only referred to physios when they are already injured, and for those of us without this kind of funding, it’s never on our radar. I think making planning for long-term mobility a normal part of aging should be something we all do — and it should be an integral part of our health system.
What do you think?