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I agree with the relaxation and breathing methods used to help the patient. You mentioned that the patient is wheelchair-bound and has gained weight. These can be a result of low physical activity and immobilization.  Studies have shown that treatment techniques such as relaxation, massage, and active exercises are used for nominalizing respiration and muscular control and helping the patient to become aware of how the body and mind interact ( Breitve, Hynninen & Kyale 2010).

Looking at the age of your client (65 years), as a middle-aged older adults, the stepped-care approach may be effective for her. According to Meuldijk & Wuthrich (2019), stepped-care models are effective in treating depression and anxiety with this population. The goal of stepped care is to offer the most effective but least resourceful intensive intervention for the patient. The starting step of treatment depends on the severity of the patient’s characteristics, and the patients can be stepped up and down during treatment as needed. Thus, having the right service in the right place, at the right time delivered by the right person is important in treating older adults with both depression and anxiety (Meuldijk & Wuthrich 2019).


Breitve MH, Hynninen MJ, & Kvåle A. (2010). The effect of psychomotor physical therapy on subjective health complaints and psychological symptoms. Physiotherapy Research International15(4), 212–221. https://doi-org.ezp.waldenulibrary.org/10.1002/pri.462

Meuldijk, D., & Wuthrich, V. M. (2019). Stepped‐care treatment of anxiety and depression in older adults: A narrative review. Australian Journal of Rural Health27(4), 275–280. https://doi-org.ezp.waldenulibrary.org/10.1111/ajr.12524


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