There are many areas in which physical therapy intervention can be applied to benefit the client who is old. Indirect services from caregivers supplement direct treatments to help ensure success. Assistive devices such as canes and walkers can be utilized to help maintain independent ambulation. Increased staff-to-client ratios ease the burden that clients who are old and frail can place on staff resources because of their need for assistance.
Very little has been written on how to assess the client who is mentally retarded and old from the perspective of psychology. The task is not simple and requires a thorough understanding of this particular population.
Usually, if any previous cognitive assessment is available it reflects the cognitive abilities of the client at an early age. In the majority of the cases that we saw at the Kennedy Aging Project, past cognitive and even performance data were sketchy or nonexistent. Therefore whenever staff reports a recent decrease in the client's functional abilities, it is difficult to determine, without any prior data or previously-available record, at just what level the client functioned before the lamented "decrease in ability."
Further, the lack of previous cognitive assessments makes testing burdensome. At times it is necessary to adjust the testing materials to the same modality in which the client "functions best" in his actual environment. For example, for one client who was evaluated, the entire test had to be presented in written form. This particular client could not retain verbally-presented material because of her own interfering verbal