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How older adults can get set up on a physical therapy maintenance program at home

Several people have recently described the same scenario to me and asked for advice.  The scenario goes something like this….  “My mom is 80-something and she lives alone.  She’s getting around okay, but I know that it’s important for her to stay active.  I’ve been thinking about trying to get her some home physical therapy, but how do I set that up?”  Literally, two people asked me the same question within 24 hours this weekend.  If you are in a similar situation then this article is for you.   Read on to learn how to get your elderly parent set up on a physical therapy maintenance program at home.


First a little background on home health physical therapy

Medicare pays for a physical therapist to work with a patient in their home if they are home bound and in need of skilled training for strength, balance, stamina, safety, etc.  Home bound basically means that it’s difficult to leave your home.  Typically the doctor writes a prescription for home health physical therapy when needed after a hospital stay.  Usually this happens when the patient is medically stable and safe to go home, but they aren’t getting around as well as they normally do.  Home health physical therapy sessions usually take place 2-3 times per week for a few weeks.  The goal of the physical therapy is to help the patient get back to their normal activity level.  Physical therapy is discontinued once they are back to their baseline or they are no longer home bound.

Medicare pays for home health physical therapy when it is deemed medically necessary and when the patient is showing functional improvement.


Home health physical therapy limitations

Medicare does not pay for home health physical therapy when the patient is not home bound or when they are no longer showing functional improvement.  Unfortunately they do not pay for long term maintenance programs.  If your aging parent would benefit from working with a physical therapist at home but they do not meet the Medicare guidelines then they do still have some options.


Options for setting up a home maintenance program

Physical therapy home programs can help your parent in many ways.  I’ve listed some of the most common ways below.

  1. Improved balance
  2. Fall prevention
  3. Home safety advice
  4. Cardiovascular exercise
  5. Posture training
  6. Improved strength and muscle power
  7. Improved confidence and decreased fear of falling
  8. Flexibility
  9. Management of chronic conditions like congestive heart failure, Parkinson’s, etc

 set up on a physical therapy maintenance program at home

If your parent hasn’t had a recent decline in function then they may not qualify for home health physical therapy.  I told the people that questioned me this weekend about 2 different options for working around the Medicare limitations.


Option 1

Reach out to the nearest physical therapist school (or physical therapist assistant program if you do not have a nearby PT school.)  You might be able to find a student who is capable of working with your parent without having to go through insurance.  Students are generally willing to work for a relatively low price (something like $10-20/hour would be appropriate), and they are eager to get hands-on experience.

When I was in physical therapist school, I provided this exact service for a woman named Elaine.  She had a stroke and was living in an assisted living facility.  Her daughters hired me and two of my classmates to work with Elaine 2x/week.  We helped her practice walking, worked on her sitting and standing balance, and stretched her arm which was very tightly bound due to her stroke.  The staff of the assisted living facility was better able to assist Elaine due to the guidance that we gave them.  We were still in school so we had limited knowledge, but we were able to help Elaine maintain her mobility in her last years of life.  As an added bonus, she enjoyed the company.


Option 2

Talk to your doctor about prescribing home health physical therapy for only 1-2 visits to establish a home program.  The physical therapist can teach you or another caregiver how to assist your parent with a maintenance program.  They can give you written handouts on the best exercises to perform, how to advance them, and how to safely assist your parent when they are doing the exercises.  Click here to learn more about hiring a home caregiver for your elderly parent.  


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