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How physical therapy can help home care patients

Diane Kaleel spent years holding three jobs at once while raising four kids. She could chop vegetables for kidney bean salad at the same time she browned meat for Syrian chicken hashweh on one burner while boiling spinach and onion on another.

“I have always been ‘go go go go,’” said Diane, now 72, of Norton, Massachusetts. “I’m the multitasker.”

That’s why the hardest words for Diane to hear are the two HopeHealth Community VNA’s Ellen O’Malley Van Haaren, PT, tells her: “Go slow.”

At the moment, Diane is doing leg lifts while lying on her back in bed. Five weeks after having open heart surgery, she is making progress rebuilding her strength thanks to home health physical therapy visits. Ellen makes sure Diane doesn’t rush through her exercises so she can get the most benefit from them.

“I’ve been told I’m a very gentle sergeant,” says Ellen, a physical therapist for 33 years, most of it in home health care.

Woman in teal scrubs help older woman lying in bed do leg lifts
Ellen O’Malley Van Haaren, PT, of HopeHealth Community VNA, left, makes sure Diane Kaleel paces herself in order to get the most benefit of her strengthening exercises for her legs, hips and buttocks during a home health visit.

Celebrating benefits of physical therapy in October

In her running shoes and teal scrubs, Ellen provides care for mostly older patients coping with serious illness such as heart failure, pulmonary disease, cancer or stroke who are trying to regain their strength and endurance. She also treats younger patients recovering from orthopedic surgery.

October is National Physical Therapy Month, which recognizes gentle sergeants like Ellen and physical therapist assistants and students looking to enter this rewarding profession. Physical therapists also work in hospitals and outpatient clinics, but Ellen has found her calling in home health care, where she enjoys spending one-on-one time with her patients. As an expert in how the human body moves, she evaluates where patients are at physically and develops treatment plans to help them achieve their goals through exercise and stretching.

For orthopedic patients recovering from a total knee or hip replacement, the goal is to get them strong enough so they can leave the house safely to continue therapy on an outpatient basis. For homebound geriatric patients, goals can be very specific to improve a person’s quality of life and prevent injuries. They can include helping someone to be able to safely get in and out of bed on their own, take a shower by themselves or prepare a meal without assistance.

Older woman seen from back going down stairs with help from phy
Ellen slowly guides Diane down a half-flight of stairs to help her work on balance and strength.

Moving to reduce pain

“When I first go in to see my patients, I try to tell them I’m not going to make it too tough on the first day,” Ellen says. “I say, ‘We’re going to work hard because we want to get you better.’”

Diane says she is feeling stronger after two weeks of physical therapy home visits. Besides guiding Diane through a series of exercises she can do while in bed, Ellen also guides her down a half flight of stairs and back up.

“It gets easier,” Diane says.

Physical therapy services for homebound patients are shown to help patients regain the ability to bathe, move in and out of bed and increase their general mobility. These small victories bring back a patient’s independence and overall happiness. It also helps with pain management. Supervised physical therapy in the home has also been shown to reduce health care costs by identifying potentially avoidable risks from falls, pressure ulcers and rehospitalization. Physical therapy at home is covered under Medicare and many insurance plans. Typically, orthopedic patients receive visits for a couple weeks until they are strong enough to leave their home to continue their therapy. Older patients may see a home care physical therapist for a month or more in order to meet their goals.

“When I first go in, I try to tell them I’m not going to make it too tough on the first day. I say, ‘We’re going to work hard because we want to get you better.’” — Ellen O’Malley Van Haaren, PT HopeHealth Community VNA

Because home care physical therapists see patients in their own homes, they get to observe them in their environments and understand the challenges they face. Ellen can identify tripping hazards like scatter rugs and have them removed. Much of her time is devoted to education as she gives instructions to patients and their caregivers on how to safely follow and incorporate their care plans into their daily routines. She also knows how to adapt her patient’s care plan to what they have in their home. You say you don’t have any 1-pound dumbbells for light arm exercises? No problem. Ellen will substitute 16-ounce soup cans from your cupboard. By using items at home, patients can easily adapt to continuing their exercises after they’ve finished physical therapy.

Physical therapy assistant walks behind older woman with walker in living room
Suzanne Levasseur, PTA, of HopeHealth Visiting Nurse, guides Noreen Loeber on a walk through her living room in Cranston, R.I. Loeber is working to rebuild her strength after a few recent falls.

Physical therapy assistants keep patients on track

The American Physical Therapy Association has recognized the multiple roles played by a physical therapist—care manager for patients and caregivers, consultant, researcher, educator, and administrator. While a physical therapist does the initial evaluation with a patient, develops their treatment plan and takes them through exercises, it’s often a physical therapy assistant (PTA) who returns to track their progress, review their exercises and make adjustments where necessary.

Suzanne Levasseur, PTA, joined HopeHealth Visiting Nurse three years ago after working in an outpatient practice. She started her career as a health educator presenting employee wellness programs. After having a baby and being a physical therapy patient herself to recover from back pain, Suzanne realized she wanted to become a PTA and went back to school.

“I just really love helping people live their best lives,” Suzanne says. “Having a background in education helps me help people improve their ability to live independently or as independently as they can. A lot of PT is education.”

Woman in gray vest in front of SUV
Suzanne had a background in health education before becoming a PTA. It sure came in handy. “A lot of PT is education,” she says.

“I just really love helping people live their best lives.” Suzanne Levasseur, PTA —HopeHealth Visiting Nurse

Sometimes, Suzanne says patients ask her why they have to do the exercises they are supposed to do. Sometimes patients think the exercises are silly.

“‘I say, ‘Well it might seem silly, but you said it’s hard for you to get up from the chair. Here’s what’s going to help you get to that goal,’” Suzanne replies. “It’s a holistic approach here in home health. I really love it.”

Ellen provides motivation for her home health physical therapy patients. (That’s Kosmo at the door.)

Learn about home rehabilitation therapy available in Massachusetts through HopeHealth Community VNA here. For Rhode Island, click here for HopeHealth Visiting Nurse.

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