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Monday, 21 October 2013 12:36

Who can qualify for Home Physical Therapy?

iStock 000020827295XSmallI recently received a call from a gentleman asking about the criteria to qualify for home physical therapy. He was inquiring on behalf of his 79 year old mother. She was living independently in her own home, but has had 3 falls in the past year. She now uses a walker most of the time and he was worried that she the next time she falls she may break a bone. As we talked, he shared that his mother has always been very active and goes out 4-5 times per week for appointments and social events, but is no longer able to drive.

I told her son that it sounds as if she would definitely benefit from physical therapy to improve her balance and strength. She is at a high risk for having continued falls without therapy intervention. However, I recommended she ask her doctor for a referral to an outpatient physical therapy clinic. Because she goes out several times a week, Medicare will not cover Home Physical Therapy. Medicare and several other insurance companies only cover home therapy if it is difficult and taxing for a person to go out, and he/she requires assistance to leave the home. A typical person receiving Home Physical Therapy may go out for doctor appointments, religious services and occasional family events, but he/she would need someone to help them safely get in and out of the house.

Do you know someone who isn't quite as steady on their feet as they used to be? Do you know someone who struggles to do his/her daily activities, or gets easily winded? A few visits of Physical Therapy may be the answer.

Published in Blog
Tuesday, 17 September 2013 00:00

How do I know if I need a walker or cane?

caneAs a Physical Therapist, I am often asked this question by the older people I work with, as well as their family members. Physical Therapists truly are the experts in "gait training", or analyzing how you walk. We receive extensive education in gait training while we are in school, and many of us continue to seek out additional learning opportunities after we complete our education. As a result, a Physical Therapist can tell you if you need a walker or a cane after doing a few simple balance tests with you and watching you walk.

The primary things a Physical Therapist will examine are:

  1. The way you walk, noting how steady you are and if you need to hold on to anything when you walk
  2. The speed that you walk
  3. The strength in your legs
  4. Your balance- this is assessed by doing simple activities such as asking you to stand with your feet close together, stand with your eyes closed, and stand on one foot.

In addition, a Physical Therapist should ask you for your medical history as there are some illnesses and medications that increase your fall risk. Determining if you need a walker or cane is only one part of a comprehensive Physical Therapy evaluation, but it's very important. As a Physical Therapist I tell all of my clients that safety comes first and there are a lot of little things you can do to reduce your fall risk.

Sometimes people don't want to use a walker or cane because they worry it will make them look "old" or "weak". But the truth is that using a walker or cane can often increase your independence, rather than decrease it.

If you are finding yourself leaning on furniture to get around your house, feel unsteady when you walk, or have fallen in the past, I highly recommend asking your doctor for a referral to a Physical Therapist, who can determine what you need to stay safe and independent. Most insurance companies, including Medicare, cover Physical Therapy with an order from your doctor.

Are you experiencing any of the issues stated above and need someone with you when you leave the home to help you get out for appointments? If so, you may qualify for a Physical Therapist to come to your home.

Published in Blog

iStock 000019872183XSmallAs a physical therapist (PT) I appreciate that it can be very difficult for the average person to know what to expect from their physical therapist. Some people have the benefit of comparing their experience with friends or family who have also had physical therapy but it's still difficult to know what you can expect of a physical therapist.

Physical therapists are required to go to school 6-7 years after high school and currently most physical therapy programs graduate students with a DPT (Doctorate in Physical Therapy). Physical Therapists are found in several different settings in healthcare. They are in the hospitals, nursing homes, rehab facilities, outpatient clinics and they even come to your home when you meet the qualifications under your insurance. Physical therapists have a wide range of specialties and while some choose to specialize in certain areas such as orthopedics or neurology, many others have experience seeing people with a wide range of health issues.

Here a few things you should expect the physical therapist to do, regardless of which setting you see him/her in:

  1. A Physical Therapist should listen to you: The best physical therapists pride themselves on being good listeners. On your first visit the PT should ask you questions about your medical history, your pain and what your goal for therapy is. Your goal should be incorporated into the treatment plan by the PT.
  2. Perform a thorough evaluation: A PT goes through several years of training to learn how do accurate and thorough evaluations. At a minimum, the first time you see a PT he/she should check your range of motion (how far your arms and legs bend and straighten), your strength, your mobility (walking or using a wheelchair) as well as your sitting and standing balance. The PT will likely check other things as well depending on what setting you are in and what you are seeing him/her for.
  3. Give you a Written Home Exercise Program: This should include pictures and written instructions of exercises the PT gave you during your PT session. The PT may or may not do this on the first evaluation visit, but he/she should definitely do this on follow up visits. This instruction should also include signs and symptoms to be aware of that may indicate you are overdoing it.
  4. Explain the purpose of the treatment/Home Exercise Program: A good PT will always explain to you why they are doing what they are doing during your time with him/her. If they don't- ask!
    The explanation should be easy for you to understand without a lot of technical terms. The PT should also explain how the treatment/exercises are going to improve your quality of life and help you reach your goal.
  5. Communicate with your doctor: Knowing that doctors are very busy, a good PT will still make a strong effort to communicate with your doctor, by phone or fax. This should involve telling the doctor what the PT has found in his/her evaluation of you. The PT should also communicate with your doctor if you are having any issues or aren't progressing with therapy.

As a PT, I feel extremely fortunate to have the opportunity to help people feel better and be more independent. It is an extremely rewarding profession and one I would encourage others to consider. I do feel that all PT's are obligated to do the absolute best they can to help each and every person they come in contact with.

Are you unsteady on your feet or have weakness in your legs? If so and you need someone with you when you leave the home to help you get out for appointments, you may qualify for a Physical Therapist to come to your home. 

Published in Blog