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Why is Home Therapy better than going to a clinic for older adults?

When deciding on a setting to receive therapy services, there are a variety of factors that need to be considered, for an older adult. How is their mobility, what are their short and long term goals, how much assistance will they need, and if they have the ability to get to and from a rehab facility. When it comes to outpatient physical and occupational therapy, you may only think there is one setting you can receive these services, but that is not the case! You, or your loved one can receive outpatient therapy services in a clinic or in the home! Some reasons that outpatient therapy services would benefit older adults are: Creating a treatment plan around their own environment Creating space for a home exercise program, in their own home, may increase their participation Not needing to find a way to get to a clinic Increased privacy with one on one care A increased sense of independence, with an older adult seeing their progress incorporated into their daily routine (Schmitt, 2019) In a study conducted in 2010, fourteen traumatic brain injury patients received occupational therapy services in a hospital setting and fourteen received services in their own home, to compare the experience between the two settings. This study found that the participants and significant others found home based occupational therapy more normal, relaxing, effective, and satisfying. The participants described home therapy as “more real life” where therapy in a hospital setting was a “simulation of real life tasks”. The participants also reported in the home, the occupational therapist felt like a “friend” where at the hospital the occupational therapist felt like a “visitor”. (Doig, Fleming, Cornwell, Kuipers, 2011) Progress in a clinic setting verse how the individual’s progress presents once they discharge to their home environment, may be different. According to Katie Schmitt (PT/DPT), a patient she treated that was performing sit to stands from a standard chair at a clinic could perform that task without any difficulty. She also could walk 150 feet without any concerns. When that patient discharged home, she wanted to sit in her recliner at home, and was not able to get out of the recliner without maximum assistance. (Schmitt, 2019). Although a therapist in an outpatient clinic can ask their patient questions about their home environment and daily routine, and simulate that situation in the clinic, it is never exactly the same situation in the home. As a certified occupational therapy assistant who has worked with patients in the clinic and at home, it is beneficial to provide treatment to the patient in their own home environment. The therapist can work on transfers in and out of an older adults bed, identify what side would provide increased independence with how the room is set up, and provide tips/education on how to modify the environment or add durable medical equipment to increase their indepence. The therapist can see how the individual’s bathroom is set up and provide hands on training with mobility in their bathroom and provide education/tips on modifications to increase independence. The therapist can also see the whole layout of the home to provide hands on training and incorporate what the individual does during their daily routine, into the therapy session to assist with increasing independence with the individuals actual routine. Besides incorporating the older adults daily routine into the therapy session, the occupational therapist/physical therapist can also assess the whole home environment and provide education on modifications, durable medical equipment, or adaptive equipment to increase the individual's independence and safety in the home. An OT/PT will also be able to provide home exercise programs that revolve around items an older adult already has in their home, to help increase the participation in a home exercise program. Educating family members and caregivers on increasing independence and safety for the individual receiving treatment, with seeing and working in the set up of the individual's home, are also ways that make therapy in the home more beneficial. With each person, the needs are different and there are reasons why you may decide on a specific setting over another setting. That being said, if you don’t have a particular reason for choosing one setting over the other for an older adult, therapy in the home is a way to increase the ability for an individual to increase their independence, within their actual environment. In-home therapy provides an increased emotional connection, by inviting a therapist into the home. Reach out to Your Aging Therapist to find out how we can provide occupational and physical therapy in you, or your loved ones home, to provide a client centered intervention. Resources Utilized: Schmitt, K. (2019 Oct. 10). A Physical Therapist’s Perspective: The Benefits Of Outpatient At Home. Fox Rehab. Doig, E., Fleming, J., Cornwell, P., & Kuipers, P. (2011). Comparing the experience of outpatient therapy in home and day hospital settings after traumatic brain injury: patient, significant other and therapist perspectives. Disability and rehabilitation, 33(13-14), 1203–1214.

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