Continuing Education Module
Who Assumes Care? Taking Steps to Prepare for the Next Phase by Alisa Curry, PT, DPT
Physical Therapists specialize in assessment, establishing a plan of care and the provision of treatment. We are reminded daily of our own morbidity, mortality, and the fragility of health. We promote wellness with our patients but how well do we focus on our own health? As a clinician and educator, I repeat the phrase “you can’t take care of other people if you don’t take care of yourself” when I train on body mechanics, patient safety, and staff education. Articles and research highlight the mental and physical health risks for health care providers.1,2 I am starting to look at the next phase of my career after working as a provider for over 25 years. Retirement is not an immediate goal. However, I am also closer to the end than to the beginning of my career. This generates thoughts about my own aging, long term planning, and what I want the future to hold. There is an expectation for family responsibility, particularly for those who are married with children, that your family will assume your care. Therapists and other providers do this regularly in the acute care setting when patients are ready to leave the hospital. If we encounter patients who say they have no one, we may assume that they are estranged from family, will get assist from friends, or hire outside help. The lesbian, gay, bisexual, transgender (LGBT) community is a growing subset of older adults. Societal GeriNotes • November 2020 • Vol. 27 No. 5
acceptance and acknowledgement of same-sex couples is variable across the country, with potential for discrimination in both urban and rural areas. According to Services and Advocacy for GLBT Elders (SAGE), “there are three million adults over the age of 65 who identify as lesbian, gay or bisexual. By 2030 those estimates are expected to double.”3 LGBT older adults are similar to their straight counterparts in risk factors for and detrimental effects from disablement. They are also more likely to rate their health as poor, have higher prevalence, and earlier onset of disabilities.4 The country has moved in a positive direction with the implementation of several Federal changes: the passage of the ACA in 2010, the Supreme Court’s ruling overturning DOMA in 2013, and subsequent ruling in Obergefell in 2015 (guaranteeing the right to same-sex marriage nationally), have significantly affected access to care and coverage for LGBT individuals and their families, expanded nondiscrimination protections, increased data collection requirements, and supported family caregiving.5 There is a current effort to eliminate the Affordable Care Act, which could remove some of the protections given in the coverage. This will affect any persons that may not have been previously covered by insurance, likely those with lower income positions, blue collar and/or part time roles. Making a plan for my “golden” years has now taken 17
