Once a patient is well enough to be discharged from the hospital, the last
thing they want is to be readmitted anytime soon. However, people are
readmitted to the hospital with such frequency that part of health care
reform is to find ways to reduce readmissions.
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Adhering to physical therapy regimens, often when supported by family
or professional in home caregivers, is one way that people can reduce
the risk of a fall in the home and steer clear of being readmitted to
“Physical therapists (PTs) serve an important role in patient safety
and patient care transitions,” states the American Physical Therapy
Association. “PTs should advocate and communicate their expertise
and critical decision making in providing recommendations for the most
appropriate level of care post-acute care discharge within the health
care team prior to and during care transitions to help in reducing hospital
October is National Physical Therapy Month and Bone and when Joint Health
National Awareness Week occurs.
Be Part of the Team
When someone comes home from the hospital they are likely to have new
medications, need additional assistance to perform activities of daily
living such as toileting and preparing meals, or experience changes in
mobility. Anyone of these factors can increase the likelihood of a fall
or other complication that could, in turn, lead to a trip back to the hospital.
“Physical therapists look at where the person is functional,”
said Patrice Winter, PT, DPT, MHA, FAAOMPT, and spokesperson for the American
Physical Therapy Association. “This might include evaluating the
home situation and how they are in their home. We want to evaluate their
balance, their stair climbing, how they get articles out of washer and
dryer, and more.”
Once this evaluation is complete, a physical therapist will make recommendations
and this might include specific exercises to do regularly to regain strength,
endurance, and balance. Ms. Winter is aware that many people avoid doing
their physical therapy though.
“They think it will hurt,” she said. “Or it hurts their
pride to use a cane or other assistive device.”
This avoidance—whether from a fear of pain or wounded pride—means
people remain at risk for falls in the home and possibly a return to the
hospital while they are recuperating.
Caregivers can help to reinforce the recommendations of the physical therapist.
“A physical therapist will work with a caregiver by showing them
how to do the exercises the correct way, or how to use a cane, the correct
way to transfer in or out of a car safely,” said Ms. Winter, who
also coordinates George Mason University’s Life Planning/Eldercare program.
Get Back in the Game
Ms. Winter suggested that people think of their physical therapist as
a coach who is there to assess the strengths and weaknesses and get you
back in the game.
“When we look at the rehabilitation of anyone it’s like a
group activity,” she said. “If somebody has a stroke, we’re
going to evaluate where a person’s skills are post-stroke and what
their potential will be. As physical therapists, we want to get somebody
to their highest level of possible functioning. As the coach, we look
at how many people we can involve to get this client or patient to their
Ms. Winter said that physical therapists are limited in what they can
do given that they might spend one hour a day with a patient, whereas
a caregiver might be there 24 hours a day.
“I want to rally the team to make sure the patient or client has
as many people helping as possible,” she said. “This might
mean that when grandkids come over they can massage grandma’s sore
hand, so everyone can contribute.”
The ultimate goal is a return to as much independence as possible in a
“We want people to have a quality of life,” said Ms. Winter.
“We want them to achieve their highest functionality after an illness
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