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elderly balance deficits

Overcome Balance Deficits with In-Home Therapy

Balance Deficits in Older Adults

One of the main reasons older adults seek medical attention is to address balance deficits that have contributed to falls, gait dysfunctions, feeling of unsteadiness, and overall decline in performing daily activities. As we age our balance and vestibular system slowly begins to decline. It is estimated that 6 out of 10 falls occur in the home. According to the National Council on Aging “Falls are the leading cause of both fatal and nonfatal injuries to older Americans. Every 11 seconds, an older adult goes to an emergency department to treat an injury from a fall (Georges, 2019).

Balance Deficits Causes and Affects
Balance deficits can be caused by several different conditions such as vertigo, strokes, neurologic disorders such as Parkinson’s Disease, cardiac diseases, nerve damage, post cancer treatment, neuropathy, decreased strength, hip and knee arthritis are all amongst some of the causes of balance deficits. Currently those afflicted with COVID19 are experiencing balance deficits which has been affecting their recovery process.

Cane Assistive Devices

Decreased balance can affect one’s posture, gait pattern, strength, flexibility, ability to negotiate steps, stepping into a bathtub, cooking, standing at the kitchen sink to wash dishes and even one’s attention and reaction time. This type of decline can affect an individual’s activities of daily living and in some cases stop them from doing the things they love the most.

How Can Wedell Home Therapy Help
Wedell Home Therapy can help by first performing an in-home physical therapy and occupational therapy assessment. The in-home therapists work with you to make simple modifications and identify potential fall hazards in the home.

sit to stand positioning

Trained physical therapists and occupational therapist can help reduce incidences of falls in the home. In addition, therapists work on developing a targeted rehabilitation program geared toward restoring balance, strength, flexibility, and mobility to improve your quality of life.

in-home occupational therapy

Clinical balance assessment tests are performed with you to identify areas of possible deficits. For example, a therapist will evaluate you moving from a sit to stand position, reaching into the kitchen cabinets, or stepping in and out of the shower. There is an emphasis on addressing an individuals’ specific deficits. If you or someone you know is experiencing balance deficits, contact Wedell Home Therapy to improve overall quality of life.

By Maria Li Calzi, Physical Therapy Assistant

References
Georges, C. A. (2019, December 2). Striking a Balance to Avoid Dangerous Falls. Retrieved from AARP.org

Vertigo Exercise

Physical Therapy Can Improve Vertigo

Physical Therapy can be an important modality for the treatment of vertigo. Benign paroxysmal positional Vertigo (BPPV) most referred to as vertigo is generally an inner ear problem that causes sensations of spinning, unsteadiness, nausea, headaches, and dizziness. It is a common cause of balance loss and falls.

Most people experiencing vertigo have difficulties with any type of movement including moving from sit to stand positions, sudden head movements and getting up from a lying position. Those who have experienced vertigo, like myself, have felt the sensations of constant dizziness and head spinning even while in a static position. This can be quite debilitating, frightening, and stressful.

What Causes Vertigo?

BBPV is not a life threatening disorder, but it is an uncomfortable one. BBPV is caused when small crystals in your inner ear are misaligned or become loose giving false messages to your brain when you make sudden movements. The onset can be abrupt, and, in most cases, there is no specific event which causes this to happen. There is no specific age where vertigo can strike. However, it is most common in adults over the age of 60.Maria Li Calzi P.T.A

Identifying and Treating Vertigo with Physical Therapy

Often doctors will prescribe a patient with anti-nausea, decongestants, or anti-motion sickness medications known as Meclizine. While these medications can reduce symptoms, they are not curing and will not re-align the crystals in your inner ear.

Diagnosing vertigo can be done with a maneuver called Dix-Hallpike, which a trained physical therapist can perform. This often uncomfortable maneuver is done by lying a patient on their back, moving their head, and looking for rapid eye changes while in that position. This can tell us which ear is the cause of the problem. After we identify this, a simple and effective treatment known as the Epley maneuver and other physical therapy approaches and exercise programs can re-align the crystals and dramatically reduce symptoms and improve balance to a patient.

Physical Therapy Assistant Exercises

Physical Therapy Help Manages Vertigo Symptoms

I have experienced vertigo firsthand and have worked with many patients to restore balance into their lives. Physical therapy can help. We can show home exercises to manage your symptoms and teach patients self-maneuvers should a reoccurrence happen. Please contact Wedell Home Therapy to learn more.

By Maria Li Calzi, Physical Therapy Assistant

References
Benign Paroxysmal Positional Vertigo (BPPV). (n.d.). Retrieved from John’s Hopkins Medicine: 

wheelchair fitting

How To Select The Right Wheelchair

Which wheelchair is best to select? Selecting the right wheelchair comes with thoughtful considerations. Measurements, skill limitation assessment, and compensatory planning are just a few factors to consider when choosing a wheelchair. The goal is to match the wheelchair support and features needed to enable independent mobility based on your needs. Many aspects are involved in selecting a wheelchair.

Occupational Therapists (OT’s) have a unique understanding and in-depth knowledge in selecting the right wheelchair. OT’s are familiar with many disabilities and how someone can better facilitate function. Occupational Therapists are experts in how to help individuals facilitate compensation when it comes to certain disabilities.

Assisted Shower Device

It’s part of an (OT’s) job to know the ins and outs of the wheelchair market. Wedell Home Therapy has extensive knowledge about wheelchairs and the specific features available. Occupational Therapists at Wedell Home Therapy are in a unique position to find the best match for individual mobility support.

The wheelchair market consists of many different wheelchairs and a multitude of features that can be applied to ones needs. It’s important to compensate or adapt to a limitation/disability. Hence, it can be difficult to select the right wheelchair without help.

Choosing a wheelchair can be even more complex than making an automobile purchase. It can be intimidating when selecting a car due to all their new features. However, a wheelchair not only requires the basic features of power, ease of operation, warranties, cost etc. It requires the perfect match to the individual’s physical proportions. Size, length, height, width and all other bodily proportions are taken into consideration when choosing a wheelchair. Wedell Home Therapy guides people in selecting wheelchair features vital for just the right fit.

The insurance reimbursement process requires in-depth justification to obtain a wheelchair. Occupational therapists have the skill, knowledge and experience to facilitate this insurance justification process. Insurance companies can be the biggest barrier in obtaining the best wheelchair for your situation.

Occupational therapists are accepted by the state as a wheelchair provider. Wheelchair providers like (OT’s) provide wheelchair assessment services. They are qualified to identify the best wheelchair fit considering the most reasonable approach. For example, if an individual is unable to shift his or her weight or has minimal extremity movement, they may have different wheelchair needs. A wheelchair can be custom built to meet those basic needs in addition to color and comfort selection.

Specialized wheelchair

A person with paralysis has completely different needs for a custom fit wheelchair and mobility over another individual with other limitations. There are many options to consider including:

  1. Seat depth
  2. Head support
  3. Control options for hands, of a sip and puff control for those lacking coordination in their hands
  4. A simple change in the joystick for optimal control

The possibilities are endless. A mid wheel drive wheelchair versus a rear wheel drive power wheelchair reach has its advantages and disadvantages.

Mark Wedell, Owner of Wedell Home Therapy attends the Abilities Expo held in New Jersey at the NJ Convention and Expo Center every year. It helps keep him abreast of the current advances in the wheelchair market. Mark can see what’s new with wheelchair capabilities and share it with clients, family members and friends. The Ability Expo is an annual convention for the adaptation market highlighting the latest in the market and new technology and life enriching products.

Mark Wedell watches demonstrations provided by the presenters, users and manufactures at the Ability Expo. Seeing the demos in person provides him with good insight. Mark learns about the all the possibilities. He figures out how best practices can be applied to the individuals he works with in his occupational therapy practice.

Mark Wedell works with local assistive technology specialists or direct manufacturers. As a result, these valuable relationships allow Mark to implement the latest and greatest advances of today’s mobility products. A custom approach for a wheelchair can be identified and worked out based on any individual’s need.

Mark of Wedell Home Therapy has been providing wheelchair assessments for over 20 years. His experience ranges from working in skilled nursing homes and hospitals to offering in-home occupational therapy services. Mark and his team have a body of knowledge that has grown significantly over the years. Wedell Home Therapy has become a reliable source in the home therapy services industry. The staff ensures the best wheelchair fit for each and every client based on their independent mobility.

The wheelchair purchase, initial seating and positioning assessment are great places to start. There is a need for continued wheelchair maintenance and updates. Upon the warranty expiration, it’s important to keep the chair in optimal functioning condition with annual or biannual assessments, adjustments, upkeep and support. Support is necessary to stay mobile and maintain skin integrity.

The wheelchair controls may require an update or maintenance. Technology changes with wheelchairs too, just as it does with computers and phones. You may also purchase pressure relieving cushions. Sometimes patients wear out the wheelchair cushions. The Wedell Home Therapy team makes recommends for any physical changes that require new or adjusted wheelchair accommodations.

Other considerations are wheelchair transport and ramps into and out of your living quarters. Would a portable ramp be sufficient? Maybe you a considering a permanent ramp? Local permits and variances may apply. Safety features and grading the inclines should both be a consideration. This ensures you or a loved one a whole new level of freedom and mobility independence.

At Wedell Home Therapy we are ready to work in conjunction with the consumer at the highest level of professional support. Experienced staff provides guidance with wheelchair selection and adjustment process. An in-home occupational therapy company like Wedell Home Therapy can help you make challenging decisions. The goal is to ensure that ones mobility needs are met beyond expectation.

Contact Mark Wedell to discuss your home wheelchair assessment needs.

Surgery preparation

How To Prepare For Surgery And Improve Recovery

Are you wondering how to prepare for surgery and improve your recovery? If you are considering surgery, this is a great blog to read. It’s not good enough to hope for the best prior to considering a surgery or having one scheduled already.

Of course, we all want the best possible outcome. Maybe you are hoping for the best during the surgical event. It’s just not enough, if you want to have a better overall recovery. If you are seeking out a program to inform, empower, and support you through this process Wedell Home Therapy has the solution.

Pre-surgical health

Wedell Home Therapy offers pre-surgical conditioning or prehabilitation. Occupational therapists provide direction and help clients reach the best possible outcomes prior to surgery.  As a result, recovery after surgery is most often easier and faster for the patient.

Considerations for Pre-surgical Conditioning 

First, education with instruction and case management with the MD are provided as an empowering and motivational approach. Second, general conditioning training, lifestyle modifications, immune support, and dietary modifications are recommended based on the individual.

Third, stress reduction, improved rest schedules, spiritual enhancement, family/care giver education and support, and medical equipment planning for the recovery stage are all part of a total healthcare approach.

Preparing for Surgery – Think Like An Athlete

Prehabilitation

Many people do not think about prehabilitation before surgery but athletes do. For example, many athletes seek pre-surgical conditioning for sports injuries so they can perform at the same level or even better after surgery. Their daily conditioning and level of health prior to the surgery place them in an advantage to shorten hospitalizations. Low infection occurrences are often noted with athletes. Athletes shorten recovery and rehab program times when participating in pre-surgical conditioning. 

Despite modern medical advancements and improved surgical out comes preparing for surgical intervention requires information. Sound decisions are made best with guidance and support. By seeking out a pre-surgical evaluation your concerns are addressed through experienced and insightful healers. Occupational Therapists and healers of the rehabilitation industry are experienced in supporting recovery, healing, and rehabilitation. Goals are set with clients to maximize their individual needs. Rehabilitation programs at home support optimal biological, physiological and functional outcomes.

Better Surgical Outcomes with Prehabilitation

One can optimize their surgical outcomes by applying the practices noted above. However, pre-surgical conditioning can be as simple as daily walks with incremental advancements in duration and distances supporting:

  1. Weight Loss
  2. Strengthening Cardio
  3. Strengthening Pulmonary Function
  4. Vascular Dilation To Improve Blood Flow
weight training

A more aggressive approach can include weight resistance training for selected muscle groups in addition to the basic exercises. Lifestyle modification coaching can support weight loss, sufficient rest, dietary modifications, immune support, stress reduction and phycological support.

Immune support can focus on removing allergens. In addition, supplements and dietary changes to support or enhance your immune system can help normalize your lab values. Dietary changes can point the obvious don’ts and reinforce more positive selection. Based on your health and blood labs, there may be must haves for your particular concern such as cholesterol and triglyceride reduction. Dietary modifications and immune support can reduce infection rates and speed up the healing process. These important changes can help you avoid more serious or secondary infections.

Stress reduction directly effects ones homeostasis. Reducing stress allows the body to seek its optimal state. Less stress can mean deeper sleep, normalization of hormones and a more balance mind. Spiritual enhancement is encouraged to fulfill ones sense of being and calm the inner sole. Each component of the process supports the final goal of optimizing the surgical outcomes.  The end goal is from better survival and low infection rates to quicker hospital discharges and faster return to independent function in your daily tasks.

Contact the Occupational Therapists at Wedell Home Therapy for more information.

Written by Mark Wedell, BS OTR/L

References:

-International Anesthesiol Clinical 2017 fall 55(1;12-20) preparing the patient for enhanced recovery after surgery, Christopher Jankowski, MD

-The effectiveness of prehabilitation or preoperative exercise for surgical patients: a systematic review. JBI Database System Rev Implement Rep. 2015 Jan;13(1):146-87. doi: 10.11124/jbisrir-2015-1885. Cabilan CJ1, Hines S, Munday J.

-A Guide to Implementing Enhanced Recovery After Surgery Protocols: Creating, Scaling, and Managing a Perioperative Consult Service.

Cummings JJ1, Ehrenfeld JM, McEvoy MD.Int Anesthesiol Clin. 2017 Fall;55(4):101-115. doi: 10.1097/AIA.0000000000000163.

Home Occupational Therapy Improves Quality of Life

Each year millions of people of all ages are discharged home from hospitals or rehabilitation facilities. The journey of gaining back their independence begins once they are home. 

People may have experienced a musculoskeletal, cardiac, neurological or medically complex injury.  They may ask themselves several questions. For example, How am I going to get myself into my bathtub when one of my arms is paralyzed? How am I going to cook for myself when I can only stand for less than a minute? Home occupational therapy services can address many answers to these questions and more. 

Common questions may also include, How am I going to get myself dressed after my hip fracture? These are common questions patients ask themselves upon home arrival. If these questions are not addressed, a person can experience diminished performance in areas of self-care, activities of daily living and overall enjoyment in life. Home occupational therapy services provide solutions to worrisome questions asked by patients. 

Buttoning Shirt

Occupational Therapists (OT’s) can assist you in achieving the ability to perform your activities of daily living through strengthening, balance activities, neuromuscular re-education and self-care training, just to name a few. Occupational therapists who provide home care like Wedell Home Therapy can address the environment you live in for potential modifications. An OT can improve overall mobility and everyday tasks by breaking things down easily through practice. This may reduce your fall risk and reduce your chances of going back to the hospital. 

Improves Quality of Life with Home Occupational Therapy Services

Installing grab bars and re-configuring furniture are a few simple recommendations that can be made. Occupational Therapy helps people who suffer from chronic disorders manage in the long term. Chronic disorders such as diabetes, heart failure, hypertension, Chronic obstructive Pulmonary disease (COPD) are common among the adult and elderly population. Occupational Therapy is key to the management of diseases to prevent further deterioration, and potential permanent damage. In addition, Occupational Therapists improve the overall quality of life for individuals with disease or injuries. 

Better Health

Activities of Daily Living Made Easy By Home Occupational Therapists

Everyday activities and simple tasks can be improved with the help of Occupational Therapists. Many family members think about hiring home rehabilitation services for major medical problems. However, Occupation Therapy includes managing your hygiene, inspecting your skin on a daily basis, as well as simply planning a healthier meal. 

Wedell Home Therapy looks at the whole person in regards to their internal physical factors as well as the external factors that affect your ability to function more independently. 

An Occupational Therapist can address the physical dysfunctions of a person but they can also assist with people who exhibit memory, visual or perceptual deficits. If a person suffers from a stroke or neurological impairment, it may hinder their ability to perform not only their physical abilities but mental, hearing and visual acuity. Sometimes deficiencies can’t be seen easily from the outside. 

Occupational Therapists assess and train a patient in cooking a meal, cleaning a bathroom or simply remembering to take a medication. Such tasks may be difficult for certain people to complete after a disabling impairment. 

A good Occupational Therapy service focuses on a patient from either a restorative or compensatory approach. Decisions are based on the severity of a person’s impairments. The goal is to come up with the best and safest solution for long term success. Many patients discharged home require home health aides and home Occupation Therapy services like Wedell Home Therapy. 

Wedell Home Therapy trains family members, caregivers and friends to assist patients in achieving appropriate and safe functional mobility and activity performance in the household. This can be anywhere from providing safer and consistent pressure relief techniques, safer transfer techniques, hygiene management and home exercise programs. A person is more likely to recover with assistance and surrounded by loved ones in their home setting. 

If you want to learn more about how a home Occupational Therapy company examines the whole person with regard to what is important to them and their support system contact Mark and Joe at Wedell Home Therapy. 

Home Occupational Therapist

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

Why Hire An Occupational Therapist or Health Counselor Privately?

There are so many reasons and benefits to hiring an Occupational Therapist or Health Counselor privately. Obtaining care outside of a facility can improve your chances of recovery and overall health. Even if you are thinking of supplementing care with an Occupational Therapist or Health Counselor, you can’t go wrong.

Dealing directly with a licensed Occupational Therapist or Health Counselor takes the middle man out of the equation. Oftentimes, healthcare facilities are at the mercy of health insurance companies, not too mention your overall health and eating habits may not be a focus at all.

Many times a patient or client is treated for a specific injury or disease and they only receive treatment a few times a week. The limitations on insurance coverage make it more challenging for a complete and full recovery. An Occupational Therapist with a background in Health Counseling can provide you with overall wellness guidance without worrying about insurance caps or restrictions based on insurance types. Your health and condition is treated one-on-one without insurance restrictions and healthcare facility guidelines that may impact your ability to recover fully.

When working with a Registered, Licensed Occupational Therapist, the client knows who he or she is dealing with and the buck stops there. The therapy is custom to meet individual needs. It is outcome directed without question. The therapies are chosen by the client and facilitated by the therapist. The therapy is prescribed by your Medical Doctor. There are no limiting factors set by the third party payers/insurance.

Whether it is hand writing training for school age children, splinting or bracing for a busy working parent or task skill training for lost skills needed for life by a disease process, the proper therapies are identified. These therapies would be unfettered by third party interests and only influenced by your needs.

Therapies are offered on a daily basis weekly, bi-weekly or on a monthly basis. The choice is yours. It is possible to meet your needs prior to having your deductible met facilitation of healing and skill acquisition is affordable. Be your own advocate or an advocate of your loved one by seeking out a Registered, Licensed Occupation Therapist or Health Counselor that has your best interest at heart.

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