“I don’t have time for this!”

by Nancy Alexander

Time is precious, don’t you think?   I can’t help but notice how much we pack into our days.  Our bosses keep adding more responsibilities to our jobs.  We scramble to attend as many family activities as we can.  We fill our schedules to the max.  And we wonder, “Where has the time gone?”  We move fast and demand that of others.  As a caregiver for someone with compromised physical or cognitive abilities, this can lead to significant stress and frustration.  Let me explain…

Caregivers are not bad people.  Whether they are family, friends or paid help, they act in the best interest of their loved one or client.  They wouldn’t choose to do what they are doing if they weren’t.  They are doing the best they can.  Let’s start with this understanding. 

Let’s also understand that our speed and the speed of the one we are caring for is often not the same.  In fact, it can be very different.  Take for instance an exchange I heard recently between an aide and her client.  The three of us were working in a busy nursing home and for the record, the aide is one of the best there is.  We were trying to transfer the client to the toilet in the bathroom.  The client has dementia and she found it very difficult to understand and process what we were asking her to do.  She kept asking questions.  The frustration level was rising.  The aide (under her breath) said, “I don’t have time for this!”  The client heard her.  Emphatically, the client went on to say, “I can’t move as fast as you can, I can’t process things as fast as you can.  Please give me time.”  I was amazed by how well she articulated this.  The aide felt bad and looked down to the floor.

speed limit sign

I knelt down next to the client and said, “It is true that both the aide and myself have a lot to do and we are sorry to rush you.”  “We want to help you transfer in the safest way possible and we are here to help you do that.”  The client sat and thought for a moment and responded, “What do you want me to do?”  Step by step we went through the process of completing the transfer.  The client performed this very well and the aide complimented her by saying, “You did it much better than I thought you would.  Great job.”

The client looked at us both and said, “Thank you.”  She looked at me and said, “Thank you for your patience.”

As a caregiver, meet them where they are.  Have you heard that before?  This was certainly the case here.  Realize we all work at different speeds and process things differently.  By understanding where they are, you will both me more successful and may even enjoy the process.  Taking just a little more time can be so much more meaningful.  And yes, you can even enjoy it.



Cheers to You Kris Thorsness!

Meet Kris Thorsness of Victor, NY.  If you want to be inspired, get to know Kris.  She is 57 and she’ll be the first to tell you that you have a choice to live or die… “You have a choice every day,” says Kris.  Let me tell you, she lives.

At 24, she won Olympic Gold as a rower in the 1984 Olympics.  I love looking at her medal.  If only it could talk and tell you everything she went through to achieve that goal.  She is modest.  “The training was a lot, it was very focused, but it was simple,” Kris says.  “I didn’t have time for anything else.  It’s all I did.”

Kris T2

Olympic Gold Medalist Kris Thorsness (center)

You might wonder where does one go after winning Olympic Gold, arguable the pinnacle of all sports achievement, at the age of 24.  You set a new goal, then another new goal, and then another.  “If you’re not pushing yourself, you’re stagnating,” says Kris.  “It’s all about perspective.”  Right after the Olympics she focused on getting her law degree.  She took a few years off from rowing but then got back into it.  She now serves on the Board of Directors for US Rowing.

Enter another new goal at age 50… playing ice hockey.  “I was speaking to a rowing friend in Wisconsin on the phone and asked her what she was up to.  She said she was playing hockey on a women’s team.”  “Well that’s pretty cool,” Kris thought.  “I’d like to try that.”  That day she called a local rink and inquired about any learn to skate programs.  She last skated in 6th grade and now was setting her mind on playing hockey.  This lady goes for it.  Call it luck or call it serendipity, that night this rink was starting a program to learn to play hockey.  “But I don’t have any equipment,” said Kris to the man on the phone.  He responded, “Well, we have a pro shop.”

The rest is history.  She bought all her gear that day including skates and she was on the ice that night learning how to play hockey.  She now plays on the Canandaigua Ladies women’s ice hockey team and is starting her 6th year.  She’s good too.  She plays defense and by the way, don’t mess with her goalie!

“I’ve heard sitting is the new smoking,” says Kris.  She believes this.  She’s had her share of injuries along the way as well as a heart attack.  She is smart and taking care of herself.  “I’m older, I get sore and I take longer to recover,” she added.  “That doesn’t mean I don’t push myself.”  “You have to keep pushing… that is how I’ve achieved my goals,” says Kris.  She added, “Sitting is the new smoking… especially after 50… especially after 50.”

Kris T

Kris Thorsness (left) of the Canandaigua Ladies Hockey Team


Welcome to AgingWell50 – the official blog of the Aging Well Academy and Achieve More Physical Therapy, PLLC. This is a forum about and for active adults who want the ability and the confidence to lead a long and healthy life. My name is Nancy Alexander and I am a physical therapist, certified strength and conditioning specialist and certified ACE senior fitness specialist. Are you ready to make these the best years of your life?

Just Like That

As we often try to do when the unthinkable happens, we try to understand and make sense out of it.  Over 50 people died at a country music festival.  More than 400 wounded.  They were singing… maybe even singing their favorite song.  They were dancing, they were happy, they were smiling.  They were thinking, “I am so incredibly happy right now… to be here with my friends and family and having the time of my life.”  I love music and I have often thought this very thought when attending shows at home and around the country.  And then it ends… just like that.  A life ends… just like that.  I don’t get it, I never will get it.  I am numb, I am mad, I am angry.  I am profoundly sad. 

Today happens to be my birthday.  I woke up to hugs from my husband, “Happy birthday, darlin’!”  Oh my life is so darn good.  Then I heard the news.  So, so sad. 

I had clients to see today and a class to teach.  “I must be focused,” I repeated to myself.  Still, between appointments, I went to my phone to see what was going on.  Soon I stopped looking.  “I just can’t right now.  The details will all come out.  I must focus on my clients and what they need and want from me.”  I did just that.  They matter to me.

I also started to feel grateful. 

I am grateful that I made it to my 56th year. 

I am grateful for my husband.

I am grateful that my niece is in my life.

I am grateful that I have so many amazing friends near and far.

I am grateful that I am a physical therapist.

I am grateful I started my own business this past year.

I am grateful that I can somehow help aging adults feel better.

I am grateful that I can help others

I am grateful for doing…

I am grateful that I did not wait one second longer to start my business and follow my passion.

Thanks be to God in Heaven that I did what I did.

Thank God I continue to do what I want every single day.

I am so thankful that I am surrounded by fun, kind, and giving friends who inspire me every single day.

I am so grateful for everything I see when I look around me. 

Because of all of this, I am having the time of my life.

Have the time of your life.  And do it now.  Don’t wait another second.  You just may not have it… just like that.

sailboat on Lake George

Welcome to our Community!

Welcome to Aging Well Now, a newsletter dedicated to you – the adult who wants to make the most out of life!  Cheers to your energy, your drive, and your passion to make the coming years the best of your life.  Why?  Because you can! You have the power to script how you feel:  physically, emotionally and spiritually.  My goal is to provide meaningful tools to help you achieve more in your life.

I will call upon the following to help you reach your goals:

  • Medical training and knowledge
  • 20+ years of experience as a physical therapist in a wide variety of settings
  • Years of experience as caregiver for my father
  • Resources and other members of our community who share your passion

This newsletter will be published quarterly and other times as appropriate by Achieve More Physical Therapy, PLLC and its education initiative, the Aging Well Academy.  Please email me at nancyalexander@achievemorept.com at any time with any questions.  I also welcome your ideas for future stories and articles.  This newsletter is about you and I want to know what matters to you.  Please feel free to share this newsletter with others too who may benefit from our message. 

To your health,

Nancy Alexander, PT, CSCS, ACE Certified Senior Fitness Specialist, Licensed Buff Bones® Instructor

NancyAlexander-012 (1)



Beware the Injury You Cannot See

Just a few days ago we celebrated the first day of fall here in the Finger Lakes region of NY…  with summer-like temperatures.  While we can’t prevent fall from coming (eventually), we can take action to help prevent falls.  You know, the serious kind.  Fall prevention is a very broad topic.  I want to focus your thoughts today on one very important aspect of fall prevention:  the injury you cannot see.

Are falls preventable?  Yes!

Falls can have a profound impact on you, your family and society.  Every 13 seconds an adult over age 65 is rushed to the emergency room due to a fall.  If by discussing fall prevention here leads to one less fall, we have done a great thing.

fall prevention pic

Photo courtesy of National Council on Aging


A fall is defined as landing on the ground or some other lower surface when you didn’t intend to be there.  This may include slips, trips, etc.  Have you had a fall in the past year? Past 6 months, past 3 months?  Were you hurt?  Do you feel unsteady when standing or walking?  Do you worry about falling?  Do you limit your activity because you fear falling?  Fear of Falling is a lasting concern that may cause someone to stop doing activities that they remain able to do.

Fact:  The fear of falling is in itself a risk factor for falls.

Here’s why:  Legs weaken with inactivity. When we sit, we lose muscle strength that we need to use to stand and walk and move. Inactivity leads to falls due to the change in strength, balance and coordination.  Also, it may make someone feel alone.  Over time, if they avoid activities with others, this can lead to depression or anxiety.

}  Fear of falling is the injury you cannot see.

}  You may not even see it yourself, but your loved ones might.  I usually hear from someone’s daughter that their mother needs help.  And I will add that the one who fears falling is almost always receptive to information and help.

}  Falling, and the subsequent fear of falling, shakes your confidence.

}  There is an evidenced-based questionnaire called the ABC Scale that I often use to help assess someone’s confidence and fall risk when it comes to their mobility.  Please let me know if you would like a copy of it by emailing me at nancyalexander@achievemorept.com.


Here is a list of factors that are also known to help predict fall risk.  A score of 4 or more implies someone is at risk for falls.

◦      Age 65 or older

◦      Three or more documented medical diagnoses

◦      Prior history of falls within 3 months.

◦      Incontinence

◦      Visual impairment

◦      Impaired functional mobility (eg fear of falling)

◦      Environmental hazards

◦      Poly-pharmacy (4 or more prescription meds)

◦      Pain affecting level of function

◦      Cognitive impairment

How did you score?

(Source:  MAHC-10 – Fall risk assessment tool)



What can I do about it?


}  Fall prevention sometimes requires a multi-dimensional approach.  That is, consulting with your physician and other allied health professionals can put you on a path to a healthier lifestyle.

}  Take control of your fitness level.  By becoming stronger, we are better able to handle the varied environments and surprises that come our way.

}  According to WJ Evans, chief of physiology lab at Tufts University said, “Most falls are due to profound muscle weakness from not doing anything.”  Great news!!  We can change this!

}  Think positively… believe you can make a change

}  Exercise

}  Eat right

}  See your physician regularly


}  Your mindset is critical.  If you believe you can improve your health and fitness, you can!

}  If you believe you can’t, you most definitely won’t.



ALWAYS talk with your doctor or healthcare practitioner before starting an exercise program.

Begin with physical therapy or fall prevention classes. Be sure the classes you sign up for are designed for your age group or ability level and have an experienced instructor. Let the instructor know you are new to the class when you first arrive.  Observe a class if you’re not sure.

When you find something that works for you, stick with it.

Some types of exercise known to be effective to reduce falls include:

}  Fall prevention classes

}  Core training

}  Pilates – Buff Bones® (visit http://www.Buff-Bones.com for more information)

}  Tai Chi

}  Walking program

}  Aquatic exercise (good for fall prevention – limited effectiveness to help with bone strengthening)


In summary:

}  Fall risk increases as we age.  Falls have a profound effect on our lives.

}  Falls are largely preventable.

}  There are many causes of falls and thus many solutions.

}  Our fitness level has a major bearing on fall risk.

}  We can decrease our fall risk by getting stronger… at any age!

}  Beware the fear of falling… the injury you cannot see.

}  Contact your physician and fall prevention expert like a physical therapist or experienced trainer to discuss options that are safe for you.



I’m sitting and I can’t get up!

Have you ever been out to dinner with family and friends and struggle to stand when it’s time to leave? Just last week, two women at different times came to me and asked for help.  “It’s so embarrassing when I try to stand,” they both said.  “I’m stiff and it hurts to try to stand up straight.  I’m too young for this.  What can I do?”

Ladies, you are not alone.  Joints tend to get stiff when you’re in one position too long.  This is especially true if you’re not very active and you are older with degenerative changes at your joints.  And, you’re right:  for someone in your 60’s and 70’s, you are too young for this.

Now the good news!  There is something you can do about it.  Read on for three steps you can take to live better now.

You have the power!

1) First and most importantly, exercise regularly to improve your strength and flexibility

That’s right, get moving and keep moving.  It doesn’t matter what your activity level is now, this is your starting point.  If you sit most of the day, start by doing gentle exercises in your chair.  If you can walk throughout your home, start with this.  Try to slowly increase how far you can walk over time.  This will help build your strength and endurance.  If you are more active than that, consider buddying up with a friend and walk outside on a regular basis.  The weather is beautiful outside now.  Enjoy it!  Beyond that, join a class at your nearby YMCA or community center.  No matter your starting point, you have options.  Just start…

2)  Improve your posture

Good posture is maintaining the natural curves of your spine.  A lumbar roll can help support your low back.  Another way to improve your posture has to do with the seat you are on.  Try to use a pad or a strategically folded towel to raise your hips above your knees.  This will decrease the tendency of the spine to flex at the lower level.  Make sure feet are flat on the ground.  This provides proper support from the ground up.

3) Try this maneuver just before you stand

Have you heard of a pelvic tilt?  Just before you stand, perform a few pelvic tilts while seated – start with a small range of motion and make it bigger as you feel able.  Others will not even know you’re doing it.  This gets the lower spine ready for extension which is required for standing.  Remember, the longer you sit the more difficult it will be to rise.  If you know you will be sitting a long time, excuse yourself when you start to squirm and go to the bathroom – if you have to go or not.  Just getting up and moving will help you loosen up.


These three ideas have helped many of my clients feel better now and allowed them to keep up with their friends and family.  Try them out! I’d love to hear how it’s going.


What if…

Facebook pic with Dad

What if you always tried to do what was right…

What if you got thrown into a whirlwind of unknowns and the responsibility to handle all those unknowns by yourself…

What if some days you just slid by the seat of your pants…

What if some days nothing went right…

What if some days everything went right…

What if you loved unconditionally and did the best you could…

What if I told you I lived all of the above?  What if I told you I came out of it better than I could have ever imagined…

Sometimes we don’t choose our journeys, they choose us.  I had the honor of taking care of my father for the last 18 years of his life which included a long road with dementia.  He handled it like he did most everything else… with enduring grace.  I will be sharing our journey together in a new book I am writing.

Happy birthday in heaven Dad.  You inspired me beyond belief and you are about to inspire many, many more.

Welcome to my world everyone… and welcome to my story.   I am drafting my story as we speak and plan to have it written by Thanksgiving  (yes, I thought that was appropriate, too).  I know writing it is helping me.  I really hope it helps many of you who read it to help you understand you have the power to script your life, even when all appears to be out of control.  We all have choices.  Choose wisely.  And do your best to enjoy the journey.  Stay tuned…

Welcome to AgingWell50 – the official blog of the Aging Well Academy and Achieve More Physical Therapy, PLLC. This is a forum about and for active adults who want the ability and the confidence to lead a long and healthy life. My name is Nancy Alexander and I am a physical therapist, certified strength and conditioning specialist and certified ACE senior fitness specialist. Are you ready to make these the best years of your life?



You can’t always judge a book by its cover… or a person for that matter

Another real life encounter…

by Nancy Alexander


There is this woman at a local nursing home who pretty much keeps to herself.  I don’t think I’ve ever seen her smile.  Most often, she looks at you as if you’ve done something she doesn’t like and she is about to call you on it.  She has dementia, like many of the other residents.

Today I was asked to see her for physical therapy.  I didn’t recognize the name on my list.  As soon as I walked to her room I realized who I was to see.  Hmmm, this might be interesting.

When I entered her room, she was sitting in her wheelchair holding a soft-cover book.  “Good morning,” I said as I looked her in the eye and smiled.  “How are you today?”  “I’m fine.  Who are you?” she responded.  I scanned around her small half of the room to see books piled high on two small tables and at the end of her bed.  She literally was surrounded by books.  “My name is Nancy and I would like to do some exercises with you,” I responded.

“Oh no, not today.  Can’t you see I’m busy?!”  “I can see that,” I said.  She clutched the book in her hand a little harder.

“What book are you reading?”

“Oh… this?”

young girl

It was a small book with a young girl on the cover.  There was a bookmark about mid-way through it that looked to be hand-stitched.  As I looked more closely at the cover of the book, I saw something remarkable.  Her name was at the bottom.  I looked again and sure enough, she was the author.

“You wrote this book?”  I asked.

“Why yes I did,” she remarked.  “It’s just a book.  It’s not like one of those big ones over there.  This one’s small.”

“But it’s a book!  You wrote a book.”  The expression on her face was priceless.  Her mouth gaped opened slightly and her eyes widened as if to say, “I did… I did write this book.”

“When did you write it?” I asked.  She didn’t answer me but quickly thumbed through the first few pages.  Above the ISBN number was her copyright under her own name dated 2010.  It was published seven years ago.

She then told me some of her family history which she described in amazing detail.  “How can I remember these things?” she asked me.  Because it comes from the heart, I thought to myself.  That’s true.  But in addition, her book contains adventures of her family when they were young.  She is reminded of her family history every day she reads her book.

“What would you like me to do with you?”  she asked.  She proceeded to do everything I asked and she worked very hard at it.  “You need to keep moving,” I said to her.  “If you don’t move, you won’t move.”

“You’re right,” she said.

She took my hand at the end of our session, smiled and said, “Thank you.”

Oh no, I thought.  “Thank YOU,” I said.  Thank you for making this a most interesting and wonderful day.

Mr. Resourceful

I have had the honor and privilege of meeting some of the most amazing and interesting people in my life – whether it be at work or at play.  Here are some of my observations that I will share from time to time.  Don’t worry…names are changed to protect the shy, innocent and everyone else too.  This is just about real people surviving, growing and often inspiring others. Their challenges are significant.  How they respond is often amusing, sometimes even amazing.

Meet Mr. Resourceful…  He is 86 years old, a widower of many years and lives alone in a home he has known for over 55 years.  By the looks of things, it hasn’t been updated since he moved in.  It is small and always clean.  He has someone come in a couple days a week to help out with that. 

When I look at Mr. Resourceful he reminds me of Santa Claus.  His white hair and white beard certainly give this away. His stature does too.  He is tall and has a round belly that moves when he laughs.


Not Mr. Resourceful


He walks about 10-20 feet with his walker before having to sit and his standing tolerance is 7 seconds.  How do I know?  He counts this regularly.  When rising from his chair, he takes a bit of time to stand up though he never gets all the way straight.  Years of wear and tear on his knees, hips and spine have led to arthritis and other degenerative changes.  He is no longer a surgical candidate due to other medical issues.  He wants to stay in his home.

He uses a wheelchair for appointments and other outings.  He relies on others to pick him up at his home and drive him to where he needs to go.  There is always someone to help him get to where he needs to go.  You get what you give don’t you think?

He is sharp.  When asked when it was that he last took his medicine, he looks it up in his log he keeps on a daily basis.  “Why that was 6:30 this morning.  I took one.”  “When do you go to the doctor again?”  Out comes the log, “Next Friday, 1:00pm.  So-and-so is taking me.”  Impressive.

I call him Mr. Resourceful because nearly every piece of furniture in his home is placed for a reason.  His kitchen chair is on wheels so he can roll around in the kitchen and make a meal and transport items to different parts of the room.  His cabinets are stocked within reach with what he needs on a daily basis.  His chair is mostly parked at the kitchen table (the table is not on wheels thankfully) and is strategically located between the table and kitchen sink/counter.  You see, he pushes himself up to stand with a lot of arm support on these stable surfaces. 

He has an ottoman in his living room.  It is an old stool with a wrapped-up sleeping bag strapped to it.  It is just the right height and positioned just far enough from his chair so that he can stand between it and the chair and also rest his legs on it when seated.  How do I know this?  I started to move it one day.  “Don’t move that!  It’s right where I want it.”  I should have known, Mr. Resourceful.  “My apologies.”

I asked him if he was an engineer when he worked.  “I was an expediter.  Do you know what that is?”  I responded, “You did things fast?”  He replied, “I had to be efficient, too.”  Efficient he is.  This is how he is still in his home.

Mr. Resourceful is kind and giving.  He told me of overhearing a family at breakfast the other day in a local diner.  He enjoyed hearing the laughter of the children behind him and how they talked to each other during their meal.  He left before they did and anonymously paid the check. 

“I’ll keep living this way until I can’t,” he told me.  “I’m not done yet.”  I believe you Santa.  I believe in you.

To your health,

Nancy Alexander

Hey You!

Hey you!  … yes you!  You don’t have to feel this way.  You know what I’m talking about… thinking that you’re alone with the challenge you’re facing.  Chances are very good you’re not.  In fact, I’d be willing to bet there are many others who are or have been just where you are.  It’s not a great place to be.  I know, I’ve been there.  OK, I’ve been there a few times.  OK, I should get frequent flyer miles for all the times I’ve gone there.  You’ll get through it… and you’ll grow along the way, too.

Truth is, when we are challenged by someone, some situation or even ourselves, we have options.  We may not see them, but we do.  We get so wrapped up in how we should react that we forget to look outside of ourselves.  We just see what we know and what we know how to do… and we keep seeing it over and over again.

For example, when I was caring for my father with dementia I took pride in handling the challenge myself.  “I got this”, “ I can do it… I don’t need any help.”  I adored my father and it was my turn to take care of him.  This was how I could and should honor him.  If I couldn’t do it, it meant failure.  Oh, how the mind can play with us.

I did it until I couldn’t.  You know it when it hits you.  I was exhausted, sad, mad, and desperate.  Poor choices come from this mindset.

I reached out.  I reached out to physicians, nurses, aides, social workers, local organizations, support groups, friends.  It was then that the cavalry arrived.  With the help of others, we found a way to keep my dad happy, engaged, safe and otherwise healthy as long as possible.  The same went for me.  It was a win-win and a valuable learning experience.

Dad with his favorite nurses

I am in another challenge now and my very first thought was, “I got this”, “I know what to do.”  I quickly recognized the error in my reaction and righted the ship.  You can’t know everything.  You only know what you know.  So simple…  So I’m reaching out.  This blog is actually part of it.  It is enormously helpful.

So, do you get the point?  You are not alone.  Challenges will come and go.  You will have challenges come at you your whole life.  Look at them as not an obstacle, but an opportunity.  Nothing is a failure if it is a building block of your growth.  Your perspective means everything.  What do you see?

To your health,

Nancy Alexander