Considerations for working with aging patients

According to the most recent numbers from the U.S. Census Bureau, the number of older citizens aged 65 and older is expected to undergo almost exponential growth.¹

By 2050, the number of American adults over the age of 65 will be almost 84 million, which is nearly double that population for 2012. This is due to the more than 125 million Americans born between about 1945 and 1980 form the baby boomer generation and generation X. ^2-3

With over 14 percent of chiropractic patients over the age of 65, you can expect to see a significant increase in the number of patients you treat.^4-5 However, before treating this growing demographic, there are some considerations when treating older patients.

Instrument-assisted adjustments

There has been any number of studies comparing the effectiveness and safety of manual high-velocity low-amplitude (HVLA) spinal adjustments to instrument-assisted adjustments. For some patients, an instrument-assisted adjustment is safer than a manual adjustment, as the former will distribute the same amount of thrust with less force.

An article published in the March 2012 issue of the Journal of the Canadian Chiropractic Association pooled together the findings from eight articles examining the effectiveness of instrument adjusting in treating common musculoskeletal disorders. Instrument adjustments were found to be particularly effective for patients with fragile bones due to osteoporosis, which is common among older patients.

Best practices for treating older patients

Doughterty, et al. suggest adjustments for patients who are frail should use less biomechanical force, and patients with bone degeneration or cancer should be treated with low-force manipulations. Additionally, patients taking anticoagulant or corticosteroid medications should not be given any treatment that compresses the tissue.⁴ This team provides a concise list of ways in which standard chiropractic treatments can be modified for the older patient, depending on various patient characteristics.

Effectiveness in treating common geriatric conditions

Dougherty et al. also discussed various smaller studies that have addressed chiropractic treatment for a number of medical issues to which the elderly are prone. These include constipation, post-stroke symptoms, Parkinson’s disease, and chronic obstructive pulmonary disease.⁴ Although the sizes of these studies are small, the results look promising for the role of chiropractic in safely treating the geriatric population.

Looking ahead

As Ortman et al state, “This changing age structure of the population will affect both families and society.” Prepare now for population growth and the continued increase in older patients seeking chiropractic care. DCs must understand the unique needs of older patients to provide the best possible treatments for aging patients.

Additional resource

Hawk C, Schneider M, Dougherty P, et al. Best practices recommendations for chiropractic care for older adults: results of a consensus process. J Manipulative Physiol Ther. 2010;33:464-73.

References

¹ Ortman JM, Velkoff VA, Hogan H. An Aging Nation: The Older Population in the United States. U.S. Census Bureau. Published May 2014. Accessed July 2015.

² Pollard K, Scommegna P. “Just how many baby boomers are there?” http://www.prb.org/Publications/Articles/2002/JustHowManyBabyBoomersAreThere.aspx. Population Reference Bureau. Published April 2014. Accessed July 2015.

³ MetLife Mature Market Institute. Demographic profile: America’s Gen X. Metlife Insurance. Published 2013. Accessed July 2015.

⁴ Dougherty PE, et al. The role of chiropractic care in older adults. Chiropr Man Therap. 2012;20:3.

⁵ Weigel P, et al. A longitudinal study of chiropractic use among older adults in the United States. Chiropr Osteopat. 2010;18:34.

⁶ Huggins T, Boras AL, Gleberzon BJ, Popescu M, Bahry LA. Clinical effectiveness of the activator adjusting instrument in the management of musculoskeletal disorders: A systematic review of the literature. J Can Chiropr Assoc. 2012;56(1):49-57.