NEW YORK—While doing in-home rehabilitation for a home care agency, Alex Greenspan started to notice patients falling through the cracks.
“Once they were no longer homebound or [were] medically stable, we’d typically have to discharge them,” he said.
Greenspan, who has a master’s in physical therapy, started following up with his patients weeks after discharging them. He found many had not taken up his recommendation to go to a clinic for further care—often because the travel and long wait times would exhaust them.
Greenspan started seeing patients in their own homes.
“I was treating full time—six to seven days a week and … I needed help,” he said. “I just couldn’t do it all on my own, so that’s when I started to bring on other therapists.”
Now, with more than 20 therapists on his staff at Outreach Rehabilitation, Greenspan ruefully says he does more admin than therapy these days—but hopes he’ll be freed up to see clients again soon.
Besides saving a lot of wear and tear on the patients and their families with travel time, in-home therapy also helps therapists, because they can observe exactly what issues a patient is having at home.
“You can never really replicate something in a clinical setting, which you can in the home, no matter how much you try,” said Maggie McNiece, an occupational therapist at Outreach.
“If you’re trying to teach someone how to get in an out of the shower … you can have all the dimensions in the world, and you can try to set up a similar situation, but it’s never exactly the way it is when they’re in their home.”
McNiece said she is more effective in patients’ homes because she can observe how they move around—which doors and tables they grab for support or whether their mattress is too soft and is causing them to sit improperly.
Cindy Newton, another occupational therapist at Outreach, said she likes in-home therapy because it allows her to concentrate on one patient at a time in a quiet environment and do things that are important in their lives. For example, one of her patients had hip replacement and couldn’t bend down to pick up her dog, so Newton helped the patient teach the dog to jump up onto her lap.
Never Too Old to Improve
Older people often have a misconception that they are too old to really improve—but many studies in recent years, as well as the experience of the therapists, have proved otherwise.
Newton said she once had a patient who was 102 years old who could do everything her younger patients did as far as treatment.
Helping patients understand they need help, and that they can improve, can also be challenging.
If seniors find their mobility is decreasing and they become timid about going outside for fear of falling, Newton said it’s important for them to know they can get help to retain their independence.
More Than Just Exercise
Because it’s a private business and bills through Medicare part B, (which covers outpatient services) and medical equipment, Outreach is able to work with patients for longer periods than other home health care agencies that typically bill through Medicare part A, (which covers hospital stays and medically necessary services).
Outreach has physical, occupational, and speech therapists, who help seniors improve their walking, stair climbing, ability to get in and out of bed, complete their toilette, use the restroom, enunciate clearly, plan a trip on the subway, and write a check.
They also help patients access legal or social services, and set up their home with railings, bright enough lights, and accessible showers so that patients “can age where they want to age,” Greenspan said.
The therapists spend an average of one to three hours with patients each week, meaning they also serve as the eyes and ears for doctors and report if patients are having difficulty or side effects from medications.
Outreach Physical and Occupational Therapy and Speech Rehabilitation
147 West 35th St., Suite 407