However, this does not always occur. In my summer research, I conducted a qualitative study into the older patient’s perspective of what constitutes success in rehabilitation from strokes and fractures. We conducted interviews in Te Whatu Ora Wāitemata. This article sets out to explore some of the challenges and successes of older adults undergoing rehab.

It is important to set the scene for some of the challenges older adults face. The event of either a fracture or stroke can be debilitating [2]. It can be a life-altering event that potentially takes people out of their past life and into an institutionalised setting with their routines, tasks, and lives decided for them [2]. Older adults and the desire to lead a meaningful and good life in later years have gone through a renaissance in popularity recently. This is firstly due to the expanding older adult group percentile of our population, but also due to the New York Times best-seller “Being Mortal” by Atul Gawande. This has thrust discussions of quality of life and mortality into the mainstream. However, there is still a significant stigma around older adults and their role in shared decision-making in clinical settings [3].

We found from our results that there was a huge unmet need for the psychological aspects of rehab. Overall, individuals were pleased with the physical rehab aspect for their health, albeit with a fair amount of pragmatic acceptance, but found a huge lack of mental support to deal with their lifestyle change. There should not be an understatement to just how big of a shock a debilitating event can be to some people. Their lives are often flipped overnight. A lack of mental health support can cause their quality of life to suffer.

One interviewee said, “I’ve gone through a death, but where is the rehab to deal with those feelings?’’. This demonstrates the enormous complexity of emotions these people are going through. And sadly, many feel like a burden. This feeling of being an onus was a common theme throughout our interviews, which was heartbreaking to hear. These people have lived long, fulfilling, and generously contributive lives and they deserve to feel worthy of therapeutic treatment and, most importantly, to be valued in society. Many do consider older adults as an afterthought; as the parabole goes, “the measure of a society is how we treat our most vulnerable”, and older adults are worthy and deserving of the utmost care, respect, and admiration.

I personally had great admiration for how resilient these older adults were. Some confided truly horrific stories of illness, loss, and grief. But what struck me was how in many of their words, “they just got on with it”. There were people who had lost their husbands of sixtyplus years months earlier to having a stroke, and people with all their family and support systems overseas, out of reach. Despite having their lives turned upside down with a lot of reasons to shut down and reclude, they decided to proceed with determination. It was incredible to see the mismatch of wider society’s views of older adults slowing down when what I saw was some of the strongest willpower to continue on regardless.

Another surprising theme that arose was the language used in the rehab setting and the effect that it could have on the mindset of older adults. One lady described the use of rehab itself with connotations of drug rehabilitation. Which she was certainly not in for. Another 82-year-old lady described how the language used by the medical team of being either uplifting or pessimistic greatly altered her belief of what could be done. These semantics were not just superficial; they had a tangible impact on what people believed could, should, and would change and therefore ended up impacting the results of rehab [4]. This demonstrates that in a clinical setting, the words that are chosen play a huge role in impacting care. It is a sad reality that every interaction health care professionals have with patients will ultimately be more memorable for the patient and that patients hang off every word said in consultations, rounds, and appointments [5]. Therefore, the utmost care and thought should be placed into framing not only what information is delivered, but by what choice of language, and who is present. This taps into an interesting issue, as there is not one communication style or use of language that will be beneficial to everyone [5]. The variety in people’s beliefs is something that I found fascinating. Thus, weaving a tapestry of knowledge of what makes someone who they are and what will help them and their whānau the most will be a question that should be answered every time a person enters the clinic.

Another major theme that came up was goal setting. In rehab, a lot of the goals were identified by people as being conventional goals (i.e. everyday aspects of living) rather than functional goals, or goals that were related to what they found important in life. This appeared to lead to a larger dissatisfaction with their rehab. Some people did not see the point of rehab if it wasn’t designed for them reaching their functional goals. This led to a view that rehab was a series of red tape obstacles to get over rather than something that carries the purpose of improving their lives.

This presents an opportunity to alter some goals to further increase older adult buy-in to the rehab service. As it is exceedingly difficult to motivate someone when they do not see the point of it. This motivation can extend to life as well, certain older adults (not all it needs to be pointed out) see life as not having much left to give. However there is value, and meaning to life in the twilight years. It may look different from years gone by but it can still be found.

I hope that you take away some of the challenges, resilience, and inspiration that older adults demonstrate. The care and kindness shown towards older adults I saw during my time on the wards was heartwarming. The healthcare team showed dedication to their craft, and compassion day in and day out which is something that is not always recognised and valued in society. However, the value of rehab to the older adults’ lives could not be understated. I want to pay thanks, especially to Dr Katherine Bloomfield who supervised me on this project. It was an eye-opening experience that I hope this piece does justice to.