Physical Therapy Services At Home

By Dana Pavelock, Dir., Home Care Operations

In today’s ever changing world, combined with significant aging trends, shorter hospital and skilled nursing facility stays, the demand for physical therapy is ever increasing. In fact, state and national averages along with Saint Francis Hospital Certified Home Health Services statistics reflect that 68 percent to 73 percent of all patients receive in-home care physical therapy services. In-home physical therapy is ideal for many patients and has been an option available in the health care field for many years. I’ll attempt to provide some education as to what types of services at home Physical Therapists perform, determining what patients may qualify for In-Home Therapy and how to access services and choose the right provider.

The starting point with most home care services, including Physical Therapy, generally begins with obtaining an order from your treating physician or contacting a home care agency and presenting your circumstances to an intake worker that will help you navigate the system. Those recovering from any type of musculoskeletal problems, suffering from neurological conditions like Cerebral Vascular disease (stroke), Multiple Sclerosis (MS), Parkinson’s disease or recovering from orthopedic surgery like knee or hip replacement, are very commonly served by arranging physical therapy at home.
Most agencies will consult with the physician and obtain a script for an assessment to be completed. One of the primary criteria to receive in-home rehabilitative therapy is the patient must be considered “homebound,” requiring assistance to get in or out of the house due to some muscle weakness, decreased balance or endurance, and difficulty walking due to some musculoskeletal or neurological deficits. Patient evaluation may include measurement of range of motion, strength, balance, safety awareness, and level of assistance required in determining intervention outcomes.

A home safety evaluation will review various safety hazards such as loose rugs/carpeting, evaluate the home environment for needed modifications to make living space more accessible with assistive devices and durable medical equipment such as raised toilet seats, tub/shower chairs, transfer and lift devices, walkers or wheelchairs, grab bars and personal emergency response systems. The evaluation will incorporate procedures and techniques in determining one’s ability to perform at his or her optimal level: Based on one’s prior, versus current, level of functioning, physical therapy intervention is valuable in achieving improvement in future quality of life.

Once an assessment is completed a physical therapist will create a comprehensive plan of care in collaboration with your treating physician and other caregivers with the end goal helping achieve your highest functional mobility if not to bring you back to your prior level of functioning before your illness. Physical therapy services focus on therapeutic exercise programs, activity training like transfers and bed mobility, neuromuscular re-education to work on balance and muscle strengthening, gait training and pain management. Safety training is of primary concern to make sure that during your recovery period secondary complications from falling will be avoided. Generally, Medicare long term or private insurance will also authorize a Home Health Aide, oriented by the treating therapist, to assist the patient with their therapeutic exercise program.

Special thanks to Phil Ricafort, Physical Therapy Supervisor with Saint Francis Hospital Certified Home Health Services, (845-483-5550), an expert in the field, who contributed to this information. According to Ricafort, one of the most important actions one should take in choosing an agency is to review credentialing, insuring the agency is certified by the state Department of Health and Joint Commission accredited. Another important factor is to review quality outcome measures of the agency you are considering to obtain services from that can be accessed by visiting http://www.medicare.gov/.