Depression in grief: how home physiotherapy rescued the will to live

By Leticia Profeta, Physiotherapist

Grief can be devastating, especially for elderly people who lose lifelong companions. Today I share one of the most touching stories of my career: how physiotherapy became much more than exercises, transforming into a bridge back to life for a grieving lady.

The scenario: when the pain of loss paralyses

I was called to attend a lady who had recently lost her husband. The picture I found was of deep depression manifested through isolation:

Initial condition:

• Total refusal to leave the house

• Isolation in bedroom - remained lying down or sitting

• Loss of motivation for basic activities

• Functional decline due to disuse

• Sarcopenia (muscle loss related to age + inactivity)

"There was no neurological loss - it was an emotional loss that was stealing her physical vitality."

The challenge: when the patient doesn't want to be helped

First Sessions - Total Resistance:

• Refused any exercise

• Didn't want to talk

• Showed irritation with my presence

• Denied need for physiotherapy

Initial Strategy: I transformed the sessions into moments of active listening.

The approach: patient-centred care physiotherapy

Phase 1: Building Trust (In Bed)

• 80% listening, 20% exercise

• Passive exercises disguised as stretching

• Gentle movements during conversation

• Respect for her pace

Phase 2: Small Achievements (In Bedroom)

• Exercises sitting on edge of bed

• Simple functional activities

• Gradual strengthening of limbs

• Improvement of sitting balance

Phase 3: Expanding Horizons (In Sitting Room)

• Exercises in sitting room using furniture as support

• Socialisation with other family members

• Increased self-confidence

Phase 4: Reconnecting with Life (Garden)

• Outdoor activities - caring for plants

• Functional exercises disguised as gardening

• Exposure to sun and fresh air

• Recovered sense of purpose

Phase 5: Return to the World (Street)

• Exercises on front steps

• First walks around the block

• Social interaction with neighbours

• Pride in showing off the neighbourhood

The transformation: from isolated to host

The magic moment:

She began waiting for me at the door, ready for our daily walk.

This simple change represented a complete revolution in her life:

Before	After
Isolated in bedroom	Waiting at the door
Refused exercises	Anxious for sessions
Avoided people	Introduced neighbours
Without purpose	Caring for plants
Sedentary	Regular walks

Lessons from patient-centred care geriatric physiotherapy

1. Listening is Therapeutic

Sometimes, listening is more important than exercising. Human connection can be the first step to recovery.

2. Emotional Progression Before Physical

Trust → Motivation → Movement → Function

3. Disguised Exercises

• Gardening = strengthening and coordination

• Climbing stairs = cardiovascular conditioning

• Walks = endurance and socialisation

4. Progressive Therapeutic Environment

Bedroom → House → Garden → Street → Community

Depression in the elderly: warning signs

Physical Indicators:

• Progressive social isolation

• Reduced physical activity

• Loss of appetite

• Sleep disturbances

• Functional decline without medical cause

Emotional Indicators:

• Persistent sadness

• Loss of interest in pleasurable activities

• Feelings of worthlessness

• Constant fatigue

• Difficulty concentrating

The role of physiotherapy in geriatric mental health

Direct Benefits:

✅ Release of endorphins through exercise

✅ Improved self-esteem with physical achievements

✅ Structure and routine in daily life

✅ Regular and meaningful social contact

Indirect Benefits:

✅ Improved sleep with physical activity

✅ Increased appetite

✅ Reduced anxiety

✅ Recovered sense of purpose

Strategies for family members

How to support a grieving elderly person:

❌ Avoid:

• Forcing activities

• Minimising grief pain

• Further isolation

• Accepting decline as "normal"

✅ Do:

• Respect grief time

• Offer company without pressure

• Seek professional help when necessary

• Maintain gentle routines

• Celebrate small achievements

Message of hope

This story teaches us that physiotherapy goes far beyond exercises - we are facilitators of reconnection with life. Even in the darkest moments of grief, it's possible to find a way back to joy and purpose.

Do you know an elderly person facing depression after a loss? Patient-centred home physiotherapy can be the first step towards recovery.