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Expect It!
5
Things To Expect
From Your Home Care PT

Understanding what to expect from your home health physical therapist can be next to impossible. There’s no billboard out there telling you and you certainly didn’t learn it in school! Medicare is not telling you. So, what should you expect?

Here are 5 essentials, designed to help you understand what you should be able to reasonably expect from your home care physical therapist.

This limited guide will give you a better idea of how your PT visits should flow, what they should consist of and when to call your agency with concerns.

Due to the nature of home care, it is mostly unsupervised. This has allowed poor quality physical therapy. To eliminate this and raise the standard of home care, I have put together this list to empower and educate so your future goals can be met.

I hope you can learn, enjoy and as a result, benefit 100 fold from your home care PT experience.

Remember, if you have concerns, call your agency or your state hotline number listed on your home care folder or paperwork.

This list is not all-inclusive, but I have attempted to cover the basics. Because home care is very unpredictable, circumstances sometimes seem to lower the standard. If this is a pattern, call your agency. If it is a ‘snapshot’ talk with your PT so you can understand what happened.
Keep dancin’!

1.  Home Safety/Equipment Check. Your home care PT should do a complete home safety check, discuss potentially dangerous areas and give you recommendations for making these areas safe. Unsafe home environments can become work hazards for PT and daily living hazards for patients. PT’s are allowed to decline home visits due to hazardous environments.

Your home care PT should check all of your PT medical equipment such as walkers, canes and wheelchairs to ensure your safety and work with you and your physician to obtain safe and needed equipment. Some items may not be covered under your insurance plan. If you are unable to afford equipment, contact your local Goodwill or Senior Citizen entity for more options.

2. Complete PT Evaluation. Your home care PT should perform a full PT evaluation on you. This should include assessing range of motion, strength, balance, skin assessment for wounds or potential wound sites, functional abilities such as getting in and out of bed, in and out of the shower, up and down the steps, up and down from the commode, in and out of your car. An incomplete evaluation will only render an incomplete plan of care that is not customized to your specific needs and circumstances.

3. Completed paperwork. Your home care PT should NOT be asking you to sign paperwork that is not filled out. You are likely to be required to sign that your PT came to your home on that date. DO NOT sign a note that is incomplete or is not dated for the day of the visit. DO NOT sign more than one visit note per visit and DO NOT sign any note (or laptop) that is post dated to a date in the future.

4. Quantity time. Your home care PT should spend no less than 30 minutes at your home teaching you and instructing you with safe and effective transfers, mobility, home exercises, gait training, balance training, endurance training and pain management.

On occasion, your PT may spend most of your visit time educating and teaching you and/or your caregivers. This is part of the plan of care and perfectly acceptable. This, however, should also include hands on training and teaching where appropriate. For example – it is unacceptable for your home care PT to simply describe or show a picture of an exercise or a stretch to you or a caregiver without making sure that it is within your ability, that you are performing it correctly and that your caregiver understands how much or little to assist you etc.

All transfers and mobility training must be visually assessed. PT’s should not take your word for evaluation questions that should be observed. i.e. shower transfers, bed mobility, in and out of the car, step training etc. I always have my patients perform the given transfer and tell them that I have to check it off the list in order to eventually discharge (or graduate) them. All transfers and mobility should meet your realistic goals. Your PT should be able to help you understand what is or is not realistic in most situations.

Did you know that the quality and quantity of your PT visit time in your home could depend on how your PT is paid? No kidding!

5. Ongoing assessment. Your home care PT should be upgrading your home exercise program, balance routine, and gait training/endurance training on a regular basis based on your progress. Some PT’s end up giving you a canned program and don’t upgrade it very often. However, a gold standard PT will not only give you a home exercise program but will also do that with you at most visits and modify it visit to visit based on your daily and weekly progress. There are many times where pain or weakness gets in your way of a specific exercise and your PT should modify the exercise, change it completely or put that exercise on hold until you are stronger and have less pain.

6.-11. Yes – there are actually 6 MORE just as important things that you need to expect from your home Health Physical Therapist to ensure that you have top notch, cream of the crop care.  Your future depends on it!

  Knowledge is Power! 
Get your Power on!

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