The Home Physical Therapist

Caregiver Resources From A Home Mobility Expert

Page 2 of 6

Why Home Physical Therapy ? Part 2

In a previous article we looked at by a doctor may refer you or a loved one to home physical therapy after being discharged from the hospital or the nursing home.

In this article we're going to look at something a little bit more specific. Why does the doctor refer you or a loved one to home physical therapy after an orthopedic surgery such as a total knee or a total hip replacement?

The answer to that last question may seem pretty obvious. But there may be more to it than meets the eye.

It's pretty common knowledge that anyone who has had hip or knee surgery will generally need and benefit from doing specific exercises. And most people understand that physical therapy is ordered after having a total hip or total knee surgery. But there's more that a physical therapist can help you with then just home exercises.

We spoke about this before, but home physical therapists frequently have to assess the living situation of a patient just returning from the hospital. Many people after a hip or knee surgery don't realize how difficult it will be for them to get around their homes. Sometimes even the simplest tasks can be impossible to do safely or pain free, such as simply getting into and out of bed.

A physical therapist can help the hip or knee patient understand what is the best way to do these simple tasks that may seem impossible at the time.

And it may seem hard to believe but many patients returning home after a surgery don't seem to understand how long the rehab process will generally take. I like to tell patients who have had a hip or knee or even back surgery to treat themselves like a million dollar athlete.

This puts things into perspective for most patients. They have their favorite teams and they have their favorite athletes. When one of those athletes gets injured and has to undergo surgery they are frequently out of the game for a considerable amount of time if not for the whole season.

Patients need to treat themselves like these million-dollar athletes and not try to get back into the game too quickly. This is what a home physical therapist can help the patient or loved one to understand.

In order for the rehab process to be successful it will take time. Generally for a orthopedic type surgery it will take anywhere from 3 to 6 months of rehabilitation for a full recovery. And depending on the severity of the injury or the surgery possibly even longer.

And last but certainly not least having a home care therapist to come in for assessment and treatment can also help the caregiver. We frequently have to teach the caregiver how to help the orthopedic patient mobilize safely as well as manage their pain and swelling.

But there is one area that family caregivers can benefit greatly from home care physical therapy after an orthopedic surgery. And that is when the home care therapist assures the caregiver that they do not have to do everything for the patient. Many times caregivers will wait hand and foot on the orthopedic patient and do even the simplest tasks for them.

Family caregivers should understand that it is important for patients to do things for them self. A therapist will look at this as a form of exercise. Any type of physical activity whether it is grooming or getting up and getting something from the refrigerator or shifting positions is good physical activity.

As long as the patient isn't going to injure themselves or is unsafe and doing it the caregiver needs to understand that it is ok for the patient to attempt to move around and do small things for themselves.

If someone you know or you yourself are contemplating or scheduled to have an orthopedic surgery don't be surprised if the physician asks for a home health referral afterwards. There are lots of things that you could learn and be benefited by by having a home care therapist come in and performance assessment on you.

In future articles we will continue to explore why a physician may refer you or a loved one to home health physical therapy services.

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Why Home Physical Therapy? Part 1

You may have heard about home physical therapy and wondered what it is. Sure everybody's heard about physical therapy, but what does a home physical therapist do?

There are any number of things that a home physical therapist can does for their patients. In this article I will only address one issue.

Most of the time when a loved one has been in the hospital or in a nursing home the physician will recommend having a home physical therapy evaluation when there discharged. This is because the doctor who has been treating the patient in the hospital or the nursing home is unfamiliar with the living situation that the patient will be returning to.

When the patient is discharged from the hospital or rehab center it's unclear what equipment may be necessary, how many caregivers will be available, or the skill level of those caregivers to help the patient continue to convalesce.

When the person returns to home from the hospital a home physical therapist is generally sent out to assess the patients home and safe mobility in that home. The physical therapist will also assess the equipment needs. Can the patient get to the bathroom safely in order to use the commode? Are there stairs leading from outside into the home or inside the home that the patient must use? Is the patient able to walk safely or will the patient best be mobilized using a wheelchair?

These questions and many like it are what a home physical therapy initially comes out to assess. And after that assessment they can make the best recommendations for equipment, living situations, or any type of modifications that may be needed may be needed in the home. Modifications such as grab bars in the bathroom or at the toilet or maybe a ramp at the front door, or possibly the need for a hospital bed to be placed on a lower level if the patient is unable to climb the stairs.

It is these types of questions that need to be addressed before the patient begins any exercise program or any mobility program that the physical therapist may determine that they need.

And once the patient is settled and the equipment is secured or provided it's at that time that the physical therapist may begin mobility training, balance and strengthening exercises, or caregiver training for body mechanics and patient handling.

Naturally any home physical therapy assessment is dependent upon the individual needs of each patient. Some patients who have had orthopedic surgeries such as a total knee replacement or total hip replacement will generally need a certain approach to physical therapy. Where as a patient who has had major abdominal surgery or who has had a stroke may require a different approach to physical therapy.

And in addition it depends on the caregiver's needs also. Some caregivers may have health issues themselves or maybe petite. Some caregivers may need a little more time because they are anxious or they are concerned about their abilities to provide the care. Frequently caregivers feel overwhelmed and physical therapist has to reassure them that they can meet the needs of the patient with their loved one satisfactorily.

In summary this article has given you just an overview of how a home physical therapy assessment may be beneficial to you in your situation. If the doctor has not refer to home physical therapist in your specific case, it's just a matter of calling your primary care physician or the patience primary care physician and request you know home physical therapy assessment if you think that it would be beneficial for you and in your situation.

In future articles I will address other reasons why a home physical therapist may be referred to you in your particular situation.

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Dad Needs More Care, But Mom Doesn’t Agree.

What do you do when one of your parents needs a higher level of care but the other one disagrees about it?
This happens a lot more than you would think one parent needs a higher level of care but the other one is unwilling to let them go. This probably happens for a number of reasons and it's good that family member understand what they are.
What some family members need to realize is that there was a time when going to a nursing home meant you were going to die. And that's what a lot of old timers have in mind or remember about nursing homes.
There are a number of reasons why a loved one would not want their spouse to go to a nursing home or leave the home. Some spouses believe that it's their duty to take care of their aging loved one there aging partner. They fully believe in the commitment to the marriage vow that they took to death do us part.
But in a lot of cases they don't understand how hard a job it is and how they are wearing themselves out by trying to take care of the loved one with their marriage partner. There is a guilt that they fit feel when they send a loved one away. This could be to the hospital, this could be to a nursing home, or any other type of facility where they are out of their home.
What some family members don't understand is that in the 21st century there are different levels of care that can be provided to a loved one. There are places such as board and cares, war also called adult foster care. In these facilities your family member can get more personalized care.
In general board and care facilities are located within residential homes. There may be four to six residents in each home. And generally there are two to three caregivers for  total of 6 residents. Their food, bathing, and hygiene are taken care of by staff. In addition there are also activities and outings that are provided by the care home.
Another level of care that some family members don't consider is that of adult daycare. Adult day care generally consists of a day program. The loved one will leave the house during the day and returned during the evening.
Adult day care programs are perfect for the person who it isn't limited by mobility .  They may have memory issues or dementia. But they can still get around.
Being part of an adult day care program freeze to family caregiver up during the day to take care of the home, run errands, provide for themselves, etc.
But if your loved one or family member is fairly debilitated and truly needs a lot of care, then a long term care facility is probably the best option. This is what people generally referred to as a nursing home.
There are many people who end up living in nursing homes simply because they do not have the means to care for themselves in their own house or the family does not have the means to care for them adequately.
Which one of these solutions is right for you? It's hard to tell.
One of the best things that families can do is ask their position for a referral to a home health service. Using a home health care service whenever it is nursing, physical therapy, occupational therapy, medical social worker, or what have you, these professionals can help you in making the right choice.
Home health care professionals can perform a full assessment of, not only your loved ones needs, but also your caregivers ability. In addition rehab services can assess the living situation and make recommendations for any type of equipment that may make caregiving easier. Medical social workers can also provide information and education regarding options for what is called placement in facilities.
After having home care services come in and provide a full assessment you and your family would be better informed to make educated decisions about your loved ones care.
To get that ball rolling all you need to do is talk to your loved one's primary caregiver and ask for a referral to home care services.

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As A Caregiver, How Do You See Yourself?

Warning: Opinion Alert!

On a daily basis, I help caregivers understand their roles as it relates to physically assisting their loved ones just as much as I empower my patients to move better and more efficiently.

A common point that I try to get across is that most caregivers work “too hard”. I have written before how I’ll hear a caregiver say “I didn’t know s/he could do that!”. A statement like that is essentially an admission that the care giver has been doing more than they have needed to for their patient or loved one.

There’s are unconscious and unspoken beliefs that many caregivers have. These beliefs directly affect the level of stress on both caregiver and patient. They have the greatest effect on family members. But, paid caregivers are not immune either. To better deal with these beliefs it would be helpful to have a better understanding of the role that the caregiver plays.

Somewhere near the top of the list are a couple that I address on a very frequent basis.

1) their loved one can’t and shouldn’t be expected to do anything for themselves. And, if they do, they will either get hurt or, it means the caregiver has not done all that they could.

And, 2) I am not a good caregiver if I can’t “do it all”.

The following is an article that will help caregivers/family members sort out their roles.

The way you view your role makes a big difference

For some of us, middle age brings new opportunities – career reinvention, an empty nest, and time to pursue new interests. For millions of others, it brings the daunting and awkward responsibility of caring for an ailing parent.

Nearly 10 million adults over age 50 give full-time or part-time care to their parents in the United States, and their numbers are growing.

As a recent paper in the academic journal The Geronotlogist put it, “the longevity of the relationships that baby boomers have with their parents and siblings is unprecedented,” and the generation “will witness unprecedented numbers of people who both provide care to the generation that preceded them and require care from the generation that will follow.”

Why Your Identification Matters

“Caregiving means caring for both your loved one and yourself, so the health and well-being of two people are at stake when caregivers do not self-identify,” says Next Avenue columnist Sherri Snelling, chief executive of the Caregiving Club.

When you don’t think of yourself as a caregiver, you may fail to take advantage of a range of support services available to help you manage the role. “

________________

For the rest of the article

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Home physical therapy part of joint replacement

I stumbled across this article telling what to expect with joint replacements and the rehab process that follows.

A good percentage of home care physical therapy cases are either total hip or total knee replacements. There are some total shoulder patients also but these usually are seen in outpatient clinic as the doctors want to keep them immobile for the first several weeks.

Some of my readers have already had a major joint replacement. Others may need them down the road. You may find that even as a caregiver, the person you’re caring for may need to have a joint replacement. You never know.

As I read this article, I thought that it was very pretty much on point and had some very good information in it and I wanted to share it with you. Make sure that you read the entire article. It’s pretty good.

Physical therapy part of joint replacement

knowing what to expect can ease process
By Mary Proffitt

Driven to lead more active and pain-free lives, more Americans are turning to total joint replacement surgery. The knee and hip are the most frequently replaced joints with over 600,000 knee and 285,000 hip replacements performed each year.

Upon leaving the hospital, you will likely begin outpatient or home health physical therapy. As your range of motion and strength improve, your physical therapist will guide you in gait and balance activities designed to promote a more normal and stable walking pattern.

Once you are able to walk without pain or a limp, your rehabilitation program will focus on functional task training such as stair climbing, lifting, and any other activities specific to your job demands or recreational/sport demands. Outpatient recovery generally lasts from 1-3 months.

The following suggestions will ensure that you are getting the most out of your physical therapy program:

Rehabilitation following joint replacement surgery might seem overwhelming, but with proper guidance from your surgeon and physical therapist you can expect to regain mobility and to return to a full and active lifestyle.

Mary Proffitt is a Physical Therapist/Graduate Research Assistant in the Department of Rehabilitation Sciences at the University of Kentucky, College of Health Sciences.”

Well worth reading the short article

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Building Muscle: Essential For Use As We Age

Everyone loses muscle mass as they age. But, one of the more significant contributors to caregiver stress levels is the amount of physically demanding work it calls for. I am talking about, not only the amount of “busy work” like chores and running errands, but also the physical work of assisting your caree get out of bed and from the toilet or even getting them bathed and dressed.

You may not realize it, but, general weakness on your part and on the part of your loved one may be the reason why cargiving may feel as draining as it does. A regular exercise routine can help alleviate this.

Dr. Deborah addresses the benefits of maintaining good muscle mass as we age in this article.

“As individuals we can ask ourselves: how’s my balance, the strength of my gait? Can I walk rapidly across a parking lot? Are my muscles maintaining their size and strength? And for physicians – often sitting long days at a desk ourselves – we tend to forget the importance of examination and counseling regarding the strength of the muscles of the body. We would serve our patients better if we remembered that the identification, reversal and prevention of muscle weakness is part of a good physical exam.”

Read More

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