The Impact Of Physical Therapy From The Comfort Of Home

By Jacqueline Lewis Keefauver, PT, DPT
FOX Regional Quality Assurance Liaison Team Lead

You’ve been practicing for a few years but never considered geriatric care.

Perhaps, you’re hesitant about geriatrics because it wasn’t a focus during school or you fear there may not be enough support as you treat in homes.

I, too, had a similar experience, as geriatrics was the only setting I had not explored during my clinical rotations. Yet, here I am with five years of geriatric experience on my resume​.

I was intrigued by FOX Rehabilitation’s Emerging Professionals Mentor Program and the bounds of opportunities that FOX presented. I decided I would take the plunge and learn everything I could for a year.

I found out about FOX through a family friend. I spent a lot of time speaking to the recruitment team and asking them questions.

FOX also allowed me the opportunity to shadow physical therapists in the home care and senior living communities so I was able to see many perspectives and a clinician’s day to day. I told myself that I would gain as much as I could from the experience and I’d explore other options and any new opportunities.

Fast forward five years – it’s 2017 and I can confidently say I am still with FOX, and I love my career.

As a FOX PT, I have the privilege of being welcomed into people’s homes.

When I signed on, I was skeptical of how I would apply the evidence-based practice that was engraved in my academic career while stepping into someone’s home.

I recognize now that my skepticism was unwarranted.

As a clinician making house calls, I am able to see not just someone’s physical impairments, but also their social, psychological, and environmental challenges that they face every day. I am able to appreciate the dynamics of their home life, frustrations, successes, and motivational level.

Over the last few years, I have challenged my creativity by finding innovative ways to apply my treatments based on their home setup and personal goals.

Sometimes, that means I have to challenge 60 percent of their one-rep max by using a soup can or milk jug. Other times, the patient only has a broom to assist with Active Assisted Range of Motion, or AAROM, activities. There could also be a retired apple farmer will only work on leg strength with me if it means I can get him on or off his tractor.

This was new to me from my clinical experiences.

Often times, I think PTs tend to get used to the same repetitive exercises or treat people by a diagnosis.  For me, it was really looking at the specifics with their individual impairments, personalities, and struggles. I have always had an interest in finding multiple ways to complete a task and allowing my patient to become successful.

However, people with dementia were a different story. I leaned on co-workers, executive directors in my buildings, and family members to really learn about each patient’s individual stories.

In addition, I searched out different resources, books, and articles to keep the patients engaged. It was a challenge for me. Finding this connection with patients continues to be a huge factor in keeping me engaged as a clinician.

The autonomy has not always been easy for me. Initially, scheduling was a challenge. Finding times that were suitable for my patients seemed difficult. As I grew, I learned how to properly communicate with my patients and families on adjusting their schedules and working with them to find the best availability.

In times of struggle, I speak up and utilize the resources that FOX provides. I always feel that I will be given the tools I need to be successful. There are countless clinicians and individuals from the leadership teams who are tirelessly working to guide and encourage clinicians on performing the best clinical care.

That was shared with me at orientation, and the message still stands true today.

Older adults may not be the easiest population to treat as you are often treating patients who have a multitude of comorbidities and variety of family dynamics. For me, it has given me the opportunity to have a new and different day every day.

Individuals and families are motivated because it is a matter of having a loved one for one more day, hearing one more story, participating in one more event, enjoying one more holiday, witnessing one more grandchild’s birth, hearing one more laugh.

That’s incredible. I am the clinician that gets to be a part of all of that.

The people featured in the photo are real FOX clinicians and patients. Though, these are not the people mentioned in this article.