Physical therapists (PTs) who specialize in geriatric care are at the forefront of keeping the country's aging population healthy and mobile. Since the American Physical Therapy Association (APTA) launched the Geriatric Certified Specialist (GCS) designation in 1992, more than 600 PTs have obtained this advanced voluntary certification for working with elderly patients. With this additional training and credibility, geriatric PT specialists find their expertise valued and welcomed by a variety of employers.
Treating and Teaching
"Being a GCS made me a better therapist and has really opened some doors," says Bill Staples, PT, MS, GCS. For starters, it helped him land his job as director of the physical therapist assistant program at the University of Indianapolis after selling his share in a rehab center in West Lafayette, Indiana.
The certification has also led to opportunities to make presentations, speak at seminars, consult with nursing homes and write a chapter on geriatrics for a PT textbook. Inspired by the boost in his self-confidence and skills, Staples is now earning his doctorate in physical therapy (DPT), which he feels will better equip him for his day job -- providing home healthcare for Home Services Unlimited in Indianapolis.
The GCS certification is especially valuable given the breadth of geriatric care, Staples says. Geriatrics covers issues ranging from wound management, frailty and osteoporosis to orthopedics and neurology. "Therapists also need to know a lot about Medicare reimbursement and regulations, and they must be able to work in a variety of settings -- acute care, nursing homes and outpatient," he explains.
Reaching Out and Raising Awareness
As clinical coordinator of education at Mary Greeley Medical Center in Ames, Iowa, Jill Heitzman, DPT, GCS, touches the lives of therapists, outpatients, physicians, therapy students and community members alike through educational programs.
"We need more people to understand that we don't have to accept what we have in the past in terms of our assumptions regarding aging," says Heitzman, who plans continuing-education programs for staff therapists and community-education programs for residents older than 55.
Heitzman's geriatrics certification, completed in 1999, has raised colleagues' awareness of aging issues, increased her confidence in working with patients and unquestionably boosted her credibility. "I get looked at differently," she says. "People know that I know what I'm talking about." What's more, the certification stimulated her thirst for more knowledge; Heitzman earned a DPT in 2002.
Advising and Consulting
Serving as president of the APTA's Section on Geriatrics gives Jennifer Bottomley, PT, PhD, unprecedented visibility and access as she promotes the cause of healthy aging.
On the local level, Bottomley, an independent consultant, sets up rehab services in nursing homes, as well as outpatient, home and community settings in the Northeast and Pacific Northwest. Across the country, Bottomley teaches geriatrics at universities lacking a specific geriatric track for PTs.
As a consultant with the Office of the Surgeon General and the Office on Women's Health in the Department of Health and Human Services, Bottomley advises agencies on how PTs can contribute to falls-prevention and similar programs. She reviews materials, leads seminars and represents the profession in initiatives such as the National Blueprint, a broad-based coalition to increase physical activity among people 50 and older.
Exercise promotion is also part of the Section on Geriatrics's mission. The section, formed to meet the needs of PTs working with aging patients, serves as a resource for local and national agencies on aging regarding issues related to exercise prescription and staying fit.
"I really enjoy the direct elder interaction in nursing-home settings when I'm setting up programs," Bottomley says. "I also enjoy knowing that the initiatives I'm involved in are being used to provide the highest level of care for the elderly and making a difference in the way that Medicare laws are drafted."
Beyond Nursing Homes
While many PTs serve older patients in nursing homes, other opportunities are starting to pop up in fitness centers, assisted-living facilities and work sites. Many adults returning to active employment after age 65 are evaluated and treated by PTs in industrial rehabilitation centers. "Our role is going to expand as the elderly population grows," Bottomley predicts. "Our goal as physical therapists working with aging adults is to obtain a maximal level of independence."