By Becky Wiese
re•store: from
the Latin restuarare to renew, rebuild, alter; to put or bring back
into existence or use; to bring back to or put back into a former or
original state. – Merriam Webster’s Collegiate Dictionary, 11th Edition
The new RESTORE program at Heritage Health’s Therapy and Senior Care
describes in a word the goal of the comprehensive therapy area now
available for seniors—restore. To bring back clients’ mobility and
ability to care for themselves as much as possible so they can feel
confident about going on with the activities of life.
The 40
facilities that make up the Heritage Health system have long been
recognized as leaders in long-term care for the elderly. However, a new
phenomenon, short-term elder care, is becoming more prevalent. As
society has changed over the past several years, the trend has been for
families to be more spread out geographically—meaning the support
network often inherent in family ties is not always nearby. And, as the
Baby Boomer generation ages and needs more medical attention, their
children may not be able to provide the necessary short-term care due to
their own family and career constraints.
Thus, when a parent or
grandparent suffers from a malady that entails more specialized care to
fully recuperate, yet the hospital isn’t quite the right environment
for that to happen and it can’t be done alone or is too much of a strain
for an elderly spouse, a short-term stay at a facility such as Heritage
Health can be the perfect answer. “The goal,” explains Susan Holifield,
Administrator of Heritage Health in Bloomington, “is to send them back
home.”
Three Main Components—
Physical, Occupational, and Speech Therapy
The RESTORE program encompasses three specific, but interrelated,
core clinical areas: Physical, Occupational, and Speech therapy.
Boasting two full-time physical therapists and two full-time physical
therapy assistants, Heritage Health offers clients the opportunity to
have the same therapist for most, if not all, of the rehab process. “The
client and therapist get to know each other in a relaxed atmosphere,”
says Holifield, “which is beneficial.”
Physical therapy
is offered seven days a week as needed and depending on the client’s
tolerance. The exact process is tailored to each individual, and is
based on the type of therapy required. Rehab will be different for a
cardiac patient than for someone who has had hip or knee replacement
surgery. Likewise, stroke or Parkinson’s patients will be likely to need
a more integrated approach, meaning a combination of physical,
occupational, and speech therapy.
Kerry Palm, Therapy Program
Manager, and her team provide therapy in a new, 2,500-square-foot
facility that features not only an inviting and attractive atmosphere,
but also boasts state-of-the-art equipment that enables the therapists
to provide evidence-based information on a patient’s progress. “One
therapist’s observation of a patient’s ability may differ from another
therapist’s assessment—many circumstances can affect a patient from day
to day. The Biodex machines we use provide objective, definitive
assessments of a patient’s ability. The measurable data the machines
provide make it easier to detect change in performance,” says Palm. In
other words, there’s no guesswork involved.
The Biodex Balance
System evaluates the patient’s balance and provides feedback through
testing the patient’s posture and stability in a controlled manner. To
do this, the patient stands on a moveable disk, watches a screen, and is
challenged to maintain his or her balance as the machine presents a
variety of scenarios by changing the stability of the base, working with
eyes open and closed and using weight shift to track a moving
object—similar to a Wii game.
Based on the feedback report
generated by the machine, the physical therapists create a therapy plan
for helping the patient improve their deficiencies. As they progress
through therapy, their balance, posture, and stability improve, giving
patients better balance control and confidence—with the ultimate goal of
becoming less prone to falling.
The Biodex Gait Trainer is
another machine that is used to evaluate a patient’s mobility. While it
looks very much like a treadmill, the Gait Trainer collects information
about a person’s walking characteristics (such as rhythm and
coordination of movement, stride length, and foot placement) which
provide insight about issues that might contribute to pain, instability,
and other mobility issues. As they progress through the prescribed
therapy, patients will typically increase their leg and ankle strength
and increase their coordination, self-confidence, as well as speed and
distance.
Currently, only Heritage Health in Bloomington offers
the type of technology and evidence-based therapy treatment that both
Biodex machines provide in Bloomington-Normal.
Physical therapy
also involves increasing strength and flexibility, often through the use
of weights and body movement. “We have five Keiser units that allow us
to mimic what we’re training the patient to be able to do. For example,
the Functional Trainer is a machine we utilize that can be configured
to exercise in all planes of motion so we can replicate many functional
motions: reaching, pulling, twisting, squatting and combinations of all
of the above. We can adjust the resistance to a very low level, as low
as a tenth of a pound, and increase incrementally to create a smooth and
customized progression of work. All of the Keiser machines provide
resistance training using pneumatic compression, which allows for gentle
and controlled exercise of knee, hip, chest, and upper back muscles.
And these machines won’t snap or clang—they provide very smooth motion,
which is good for our client population,” explains Palm.
Occupational therapy
is often misunderstood, according to Holifield. “Sometimes people will
say, ‘Why does Dad (or Mom) need occupational therapy—he’s not going
back to work!’ But occupational therapy is not about a job so much as it
is about the daily activities required for living independently.” These
living skills include activities that may seem basic, but when disease
or injury impairs your ability to do them, they can be insurmountable
and frustrating. Things like bathing, dressing, preparing food, doing
laundry—the normal actions that we do every day—are what occupational
therapists typically work on with the elderly.
To make therapy
as realistic as possible, Heritage Health has a Living Skills Retraining
Studio that includes a fully functioning kitchen in which a patient can
practice loading and unloading a dishwasher or washing dishes in a
sink; a laundry area for practice putting items in a washing machine and
dryer; a working stove, oven, and refrigerator for baking a cake or
making other meal items; and real cabinets and drawers that provide
practice with getting items out and putting them away. Bathing and other
hygiene activities take place in the patient’s room. “The goal is to
get them back to independence,” says Palm. “That may be through therapy,
getting rid of a hardship in their home (removing throw rugs, for
example), or providing adaptive equipment.”
Prior to discharge, a
therapist can conduct a home assessment during which necessary
adjustments can be highlighted. Adjustments may include a ramp to get
inside and outside, grab bars in the shower/bath, rearranging furniture,
or re-organizing the kitchen cabinets so commonly used items are easily
accessible.
Speech therapy for the elderly
involves both physical and cognitive goals. For patients who suffer from
dysphagia (difficult or painful swallowing), eating becomes difficult
and health deteriorates due to poor nutrition. Other speech therapy
cases involve working on cognition—exercising their brain. The therapist
may perform an evaluative test such as the Montreal Cognitive
Assessment to determine the deficit and then develop a therapy program
that may involve cognitive exercises to enhance short-term memory. This
is especially beneficial for remembering safety issues such as taking
medication on a regular basis, locking the wheelchair before trying to
stand, or turning off the stove.
Just as important is a concept
called “carryover”—meaning what was learned today should be remembered
tomorrow. A patient’s short-term cognitive ability may be an important
consideration in determining whether the person could or should go home.
A special speech therapy program, the Lee Silverman Voice Training
LOUD program, is especially for Parkinson’s patients who have difficulty
speaking clearly as well as maintaining a consistent volume. “Heritage
Health is the only facility that offers this service in our community,”
says Palm. This intensive four times a week for four weeks program helps
patients in their everyday living by helping them sustain a
conversation, which increases their independence and overall confidence.
This program also has a corresponding physical therapy portion (BIG)
that works on gait training, postural stability, and strengthening.
Heritage Health is one of the only facilities in Bloomington-Normal that
offers this program.
Progress toward the goal of going home
The length of a short-term stay at Heritage Health in Bloomington
varies depending on the patient’s needs. Patients on Medicare require a
skilled need, such as physical, occupational, and/or speech therapy, to
be admitted. Medicare will pay for up to 100 days, but the patient must
make progress to continue to qualify. The therapists and staff work
together to help the patient continue to improve.
“We meet every day as a team: nurses, therapists, dietitian, social worker—health is a multidisciplinary issue,” explains
Holifield.
“We discuss whether someone seems upset or depressed or doesn’t seem to
be eating as well or making progress in their therapy, and we try to
figure out what’s going on.” The emotional and mental state of the
patient is just as important in restoring their health as the physical
goals. “Getting someone home is a team effort,” says Holifield. The
ultimate goal is to restore their independence and increase their
quality of life to the best level possible.
If you have any questions or would like additional information about
RESTORE: Heritage Health Therapy, or therapy services in general,
please use Heritage as your resource. Call Heritage Health in
Bloomington at 309-827-8004 or visit www.HeritageOfCare.com/restore.