Month: <span>November 2020</span>

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COVID-19 Complications As Seen Through The Eyes of Therapists

Covid-19 complications and recovery have been at top of mind in our society today. Everyone has been taking all measures and precautions to prevent contracting this virus. While there are people that have contracted it and made full recoveries, there are still those living with Covid-19 complications and trying to overcome them.

 

Covid-19 and Its Complications
According to the CDC, the most vulnerable population are individuals over the age of 65 with comorbidities such as respiratory illnesses, cardiac conditions, diabetes, kidney, and liver diseases and immune compromised individuals. Complications from Covid-19 have been identified in many patients as shortness of breath, decreased endurance, balance, mobility, and muscle function all of which affect a person’s activities of daily living. Information about the long-lasting effects of this virus is still unknown as this is a new virus. However, current data, research and discovery are emerging on the importance of addressing these complications, issues and concerns immediately to assist these individuals in returning to the activities they love doing the most.

Covid-19 Physical Therapy & Occupational Therapy Treatment Programs
Having had experience working post COVID19 patients we have observed that the recovery process can take time as individuals may experience overexertion and exhaustion after walking 40 feet, or doing simple things as getting out of bed or standing up from a chair. Therefore, it is important to monitor their cardiac and lung function output levels and not rush the process. Therapy should be focused on improving endurance levels and strength which will ultimately improve functional abilities to perform tasks.

We understand that the recovery process can be frustrating. The physical and occupational therapists at Wedell Home Therapy are here to help. After assessing the patient with a thorough evaluation, we will develop a program that is geared towards the individual’s goals and restoring function, and strength. Unfortunately, there is still so much we do not know about this virus so it is important to understand that not every patient’s recovering process, experience and Covid-19 complication will be the same.

Wedell Home Therapy physical and occupational therapists have a great amount of experience and success working with Covid-19 patients restoring their functional ability and vastly improving their ability to perform their daily activities. We are all tested regularly for Covid-19 and follow all CDC guidelines to assure utmost safety to our patients and families.

If you or a loved one have questions about physical therapy or occupational therapy services to aid in the recovery of Covid-19, please contact us. 

Amputation Care
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How a Home Occupational Therapist (OT) Can Help a Person with a Recent Amputation

Home Occupational Therapists (OT’s) are an integral part of care for a recent amputee. Every year, numerous individuals of all ages experience amputations of their upper and lower limbs, and sometimes both. These persons may have had an amputation as a result of a trauma, vascular disease, or malignancy. The experienced therapists at Wedell Home Therapy have seen a majority of  individuals suffer an amputation as a result of vascular disease due to high blood pressure, a deep vein thrombosis, or an aneurysm, just to name a few.

amputation occupational therapy

Occupational therapists assist individuals of all ages, backgrounds, races, and socioeconomic statuses. As a result of an amputation in either the upper or lower extremity, a person will exhibit diminished strength, balance, range of motion, sensation, endurance, self-care skills, as well as participation in activities of daily living. Wedell Home Therapy occupational therapists can assist individuals in improving these areas of need. One goal is to focus on what aspects of daily life are important to a person so they can maximize their functional abilities. Depending on the age and functional potential and abilities of the person, a personalized plan will be established to reach goals.

Home occupational therapists help the person with an amputation to live their life as independent as possible. In many instances, a person is sent home from a hospital or short-term rehab facility before they receive a prosthetic in either the upper or lower extremity because of several factors. This may include additional time needed for the new amputation to heal. It is also possible decreased strength or stability has affected the limb. In some instances, a person may be awaiting insurance approval. Pre-prosthetic training focuses on said areas as described above to maximize strength, balance, endurance, and overall functional abilities prior to the acquisition of a prosthetic. Evaluation and intervention in the psychological well-being of the person with an amputation are equally as important as the physical deficits.

Occupational therapists focus on a holistic approach considering the person’s perspective and what is important to them, as well as how they want to be viewed by others. This is important for an OT to establish an appropriate plan for the person and help them achieve meaning in their life. In some cases, restorative therapy approaches for persons with amputations are not viable for a number of reasons. Compensatory strategies are more valuable in maximizing a patient’s functional potential. For example, a patient who had a recent amputation but also has a comorbidity of heart disease and is on oxygen, might benefit from the utilization of a wheelchair in the home for a majority of the time instead of a prosthetic.

Wedell Home Therapy can make recommendations regarding the set up of the home, limiting obstacles for a wheelchair and other adaptive devices for the patient as well as, continuing to improve strength of the patient. This would provide the patient the continued ability to propel the wheelchair in home. In addition, they could access items in the kitchen and bathroom from a seated level. In this case it is a “personal” care plan for the patient tailored to their needs to maximize functional abilities to achieve the highest level of independence.

Below are some specific areas of focus and intervention the therapist can establish based on a person’s functional needs and abilities.

  1. Strength of the upper body including hands to aid a person’s ability to perform activities such as self-care, transfers in an out of bed, toilet and shower as well as putting on and taking off potential prosthetic
  2. Sensory integration of amputated limb due to patient’s potential numbness and phantom sensations post amputation
  3. Potential home modification for person to perform functional mobility more easily with safety in mind throughout household
  4. Hygiene management of amputated limb, skin monitoring at incision site, and cleaning of potential prosthetic
  5. Education of medical equipment to be utilized in the home, use of them safely, as well as functional use (i.e., wheelchair, sliding boards, transfer benches, dressing equipment, hospital beds, commodes)

Contact one of the home occupational therapists at Wedell Home Therapy for more information. In-home physical therapy services are also provided to amputees by appointment. Visit the Amputee Coalition™ website for additional resources.

Written by:  Joseph Chirco, MS, OTR/L, CSRS

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Tele-rehabilitation: Navigating the global pandemic

Tele-rehabilitation is a term you may hear about more often. With the current global pandemic, it has become more difficult than ever to simply walk outside. The simple things such as going to the grocery store and spending time with others have now become a challenge. With the pandemic encouraging people to “socially distance”, technology has brought people together and provided a feasible option for therapy. While New York State was “sheltering in place”, many people still required occupational, physical and speech therapy. Tele-rehabilitation was identified as the sole platform for providing therapy.

Reason for Home Tele-rehabilitation

Tele-rehabilitation has emerged as an integral tool by providing skilled services over a web-based platform. While tele-rehabilitation is not appropriate for everyone, it can be beneficial for people who have difficulty with the following daily activities:

• Dressing
• Feeding
• Bathing
• Grooming
• Play Tasks

Tele-rehabilitation also assists with the progression of developmental milestones. Tele-rehabilitation has allowed therapists to be present with clients in their home environment while encouraging the client or caretaker to serve as the facilitator of the therapy under the therapist’s supervision. In a time when the field of occupational therapy is confined to four walls, it is also a time when therapists are able to teach a parent how to:

  1.  Help their child ride a bike
  2.  Help with handwriting difficulties
  3.  Assist with a cooking task
  4.  Provide adaptive recommendations for preparing a meal

Tele-rehabilitation allows the therapist to observe the actual tasks an individual wishes to work on and allows the task to be practiced in a natural environment. This can lead to increased engagement therefore, increasing the likelihood of success and promoting carryover (Maciver et al., 2019). This does not discount the need to continue to address underlying components related to task-specific performance. Tele-rehabilitation can assist with the transition from an inpatient stay to home for an adult/child. It’s an option for an adult/child who is unable to attend in person sessions. Tele-rehabilitation also serves as a home follow up service when a client has been discharged from in person outpatient services. The benefits of tele-rehabilitation include increased access for clients and families, convenient appointments that do not require travel, and use of their own environments.

How The Process Works

The process for tele-rehabilitation begins with access to a smartphone, tablet or a computer to use a secure web-based platform. Initially, a modified evaluation is performed to determine deficits and identify client-centered goals. Next, a discussion of materials and toys to use during therapeutic interventions is addressed. Then, a recommendation of frequency of services is discussed.

Possible Tele-rehabilitation Outcomes

Ultimately, tele-rehabilitation can be a sustainable tool in providing patient education. It helps people with challenging day-to-day tasks and providing continuity of care, thereby improving participation in age-appropriate tasks and functional independence. Interested in learning more? Call Michelle at Wedell Home Therapy. 516-582-6374

References:
Maciver, D., Rutherford, M., Arakelyan, S., Kramer, J. M., Richmond, J., Todorova, L., Romero-Ayuso, D., Nakamura-Thomas, H., Ten Velden,M., Finlayson, I., O’Hare, A., & Forsyth, K. (2019). Participation of children with disabilities in school: A realist systematic review of psychosocial and environmental factors. PloS one, 14(1), e0210511. https://doi.org/10.1371/journal.pone.0210511