I was reviewing an article earlier today from a journal I received and it hit upon something that I preach throughout the community and to anyone that will listen within the AARP boundaries.
It stated “PTs will need to emphasize prevention with older adults to keep them independent and active for as long as possible,” says Marilyn Moffett PT,DPT,GCS, and assistant clinical professor at the School of Physical Therapy and Rehabilitation Sciences, University of South Florida College of Medicine in Tampa, Florida.
There has to be a big push to keep older adults as independent as possible in their homes and for each of us in physical rehabilitation to help them keep as much dignity as we possibly can as they age and to teach them that only they can control their own destiny with a proper mindset.
This goes back to that personal responsibility issue and the willingness to learn and understand the importance what we as physical therapists are in their homes for and for us to become educators and facilitators, not just repetition counters administering ineffective exercises.
With the continual push of productivity levels in medicine, it causes many to be somewhat ineffective as time is the biggest barrier with many rehabilitation professionals going from one patient to the next creating ineffective programs and a lack of adequate teaching skills.
Time can also be an issue in the field when the rehab professional demonstrates poor follow-up skills, lack of prior preparation and poor time management skills which is not taught in schools to begin with.
You would like to think many would have developed some of these skills in school but do not be too fast to assume anything.
The rehab professional not only has to be a psychologist in a sense to find out what makes that patient tick or motivated them but also learn to determine quickly how to get through to the patient to make the patient compliant with the HEP that should be specifically tailored for that patient.
They should and must be involved when it comes to setting their own rehabilitation goals, then and only then will a patient feel that they have some input into the care and help with their compliance.
Handing out cookie cutter exercise routines will not inspire everyone nor are they effective with all. Exercise programs should be customized to a degree to fit the patient’s physical abilities and desires to reach particular goals.
Of course, each case is different when working with geriatrics and multiple diagnoses, however, placing an emphasis on more of a functional component with assorted exercises is more time efficient and practical to hopefully get patient improvement.
Physical Therapy in a sense now has a component of personal training involved as well when in the home, and each therapist should continually look for ways to challenge their patient physically and mentally if possible to keep the patient engaged and hopefully compliant.
Teaching prevention and helping the patient or client to become proactive in their own healthcare and prevent further accidents such as falls and, how to stay physically strong is a very important aspect of our role when in the home.
As the trend going into the 21st century is to care for patients in their homes rather than the more expensive route of skilled nursing facilities and other rehabilitation settings, if someone can be physically rehabilitated in their home then it is the responsibility of the rehab professional to design and implement effective programs that will add value to the patients lives and to be sure that the insurance companies are getting what they are paying for.
More agencies will be penalized for poor results in the future and that will not bode well for some.
Patient and caregiver education is a must in today’s world of physical rehabilitation, therefore, a strong teaching component is a requirement rather than handing someone a piece of paper and letting the patient do their exercise while the rehabilitation specialist is busy in the corner working on progress notes.
Unfortunately, that is more common than you think.
Multitasking is a word for the unfocused which ultimately leads to poor performance. Remaining focused on the task at hand and giving the patient and family 100% of your time and attention will reap desired results.
Less is more, keep things simple and concise this also helps breed compliance in the home and make the patient accountable for his or hers own physical rehabilitation recovery!
Richard Haynes PTA, CPT
Total Joint Fitness LLC