Home health care physical therapy

Deborah C. Escalante

Home health physical therapy encompasses a wide range of services that PTs and PTAs provide in the home.

If you practice physical therapy in a home setting, we have resources to support you.

The APTA Home Health Section is specifically dedicated to those who share a common interest in the delivery of physical therapy in the home and other alternative settings within the community.

Home health care can be cost-efficient, convenient, and as effective as the care patients get in a hospital or skilled nursing facility. Home health PTs and PTAs work one-on-one with patients in their own environment, making services completely relevant to the patient’s needs and goals.

Medicare Part A (Hospital Insurance)

 and/or 

Medicare Part B (Medical Insurance)

 cover eligible home health services like these:

Usually, a home health care agency coordinates the services your doctor orders for you. The home health agency caring for you must be Medicare-certified.

Medicare doesn’t pay for:

  • 24-hour-a-day care at your home
  • Meals delivered to your home
  • Homemaker services (like shopping, cleaning, and laundry) 

    that aren’t related to your care plan

  • Custodial or personal care 

    that helps you wi

    th daily living activities (like bathing, dressing, or using the bathroom), when this is the only care you need

Who’s eligible?

All people with Part A and/or Part B who meet all of these conditions are covered:

  • You must be under the care of a doctor, and you must be getting services under a plan of care created and reviewed regularly by a doctor.
  • You must need, and a doctor must certify that you need, one or more of these:
    • Intermittent skilled nursing care (other than drawing blood).
    • Physical therapy, speech-language pathology, or continued occupational therapy services. These services are covered only when the services are specific, safe and an effective treatment for your condition. The amount, frequency and time period of the services needs to be reasonable, and they need to be complex or only qualified therapists can do them safely and effectively. To be eligible, either: 1) your condition must be expected to improve in a reasonable and generally predictable period of time, or 2) you need a skilled therapist to safely and effectively make a maintenance program for your condition, or 3) you need a skilled therapist to safely and effectively do maintenance therapy for your condition.
  • You must be homebound, and a doctor must certify that you’re homebound.

You’re not eligible for the home health benefit if you need more than part-time or “intermittent” skilled nursing care. You may leave home for medical treatment or short, infrequent absences for non-medical reasons, like attending religious services. You can still get home health care if you attend adult day care.

 

Content

We work with your doctor to develop an individualized plan of care to allow you to remain comfortably at home and maintain your independence while we attend to your medical needs.

Skilled Nursing
Skilled nursing care can be provided by a registered nurse or licensed practical nurse. Skilled nursing can include, but is not limited to:

  • Wound care (changing dressings, monitoring infection, teaching care techniques)
  • Assessing blood pressure, heart failure, and respiratory disease
  • Catheter insertion and assessment
  • Medication and disease education
  • Infusion therapy
  • Telehealth visits

Physical Therapy
A licensed physical therapist evaluates your level of functionality and establishes a plan of care for your specific needs. Physical therapists and licensed physical therapy assistants help improve your mobility, strength, balance, endurance, and coordination and teach you and your caregivers how to reduce your risk of falls.

Speech Therapy
Our licensed speech-language pathologists can help you with difficulties related to speech, eating and swallowing, communication, memory, and cognition.

Occupational Therapy
A licensed occupational therapist or a licensed occupational therapy assistant can help you improve your ability to care for yourself, perform activities of daily living, and use adaptive equipment to make tasks easier.

Medical Social Work Services
If you receive nursing or therapy services, our social work services can refer you to community resources and assist with living arrangements, finances, long-term planning, and more.

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Home Health Aide
Nursing assistants provide help with personal care while you receive nursing or therapy services.

 

Home health physical therapy may be part of your care plan if you are having difficulty moving around your home or have had falls due to pain, illness, injury or surgery. For example, in-home physical therapy may be prescribed for you by your doctor if you qualify for home health and you have the following:

  • Surgery like a knee or hip replacement
  • Recent heart attack
  • Acute-onset medical condition
  • Exacerbation of a chronic medical condition like heart failure, COPD or diabetes
  • Trouble with balance or falls
  • Difficulty walking or moving around
  • Pain after an injury, surgery or illness
  • Functional decline related to a progressive neurological condition such as Parkinson’s, Multiple Sclerosis or ALS
  • Suffered from a stroke and have loss of use of one or more extremities

Our at-home physical therapists and physical therapy assistants help you move with greater ease in the comfort of your home. Your plan of care is based on your needs and your doctor’s orders. Physical therapy for seniors is designed to restore normal mobility or maintain the highest level of functioning possible, so you can do daily tasks and activities you enjoy.

WHAT IS PHYSICAL THERAPY?

Physical therapy is a type of care designed to relieve pain and improve people’s ability to move and function easier.

A doctor may order in-home physical therapy for seniors who have had an injury, surgery or illness that makes it hard to do daily tasks.

If you need home health care physical therapy, you’ll work with a physical therapist – an educated, licensed professional with specialized training. These specialists understand how the body works and what it needs so you can do the things you care about most. Our physical therapists create personalized plans using a variety of treatment techniques such as balance retraining, stretching and strengthening exercises, gait training, teaching fall reduction strategies, physical agent modalities such as ultrasound, electrical stimulation and hot and cold therapy, and patient and caregiver education.

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WHERE IS HOME HEALTH PHYSICAL THERAPY PROVIDED?

With home health care physical therapy for the elderly, a physical therapist comes to your home. This can be your private residence, a family member’s home, a group home or a senior living community.

AMEDISYS IN-HOME PHYSICAL THERAPY SERVICES

An Amedisys physical therapist will work with you, your doctor, caregiver and other members of the home health care team to understand your needs. The services you receive will be tailored to your goals and needs. Your in home physical therapy services could include:

  • Balance training to help prevent falls
  • Vestibular rehabilitation to improve balance and reduce dizziness
  • Manual therapy to isolate specific tissues or joints causing pain or other symptoms
  • Strength training
  • Ultrasound to reduce inflammation and promote blood flow
  • Electrical stimulation to reduce pain and improve function
  • Heat and cold therapy
  • Light therapy
  • Training to help you walk or stand independently, or transfer from one place to another
  • Education for patients and their caregivers about the patient’s condition, needs and home exercises
  • Personalized exercise program
  • Practicing using an assistive device like a cane or walker, if needed
  • Suggestions to make your home safe such as grab bars or moving rugs

Often, physical therapists for the elderly teach at-home exercises that patients can do between visits to help their progress. As your needs change, your physical therapist will update you and your healthcare team and work to adjust your treatment as needed.

Types of Conditions Treated in At-Home Physical Therapy

In home physical therapy for seniors can be used to help with a wide variety of conditions. With home care physical therapy, we often care for home health patients with:

  • COPD

  • Heart Attack

  • Cancer

  • Cystic Fibrosis

  • Arthritis

  • Osteoporosis

  • Alzheimer’s Disease

  • Stroke

  • Parkinson’s Disease

  • Cerebral Palsy

  • Multiple Sclerosis

  • Fibromyalgia

  • Spinal Cord or Brain Injury

  • Hip, Knee, Shoulder or Joint Replacement

  • Back or Elbow Surgery

  • Amyotrophic Lateral Sclerosis (ALS)

  • Incontinence

  • Amputation

  • Balance Disorders

  • Wounds or Burns

  • Diabetes

 

PHYSICAL THERAPY MAY HELP IN SITUATIONS LIKE THESE

 

Diane’s Story

Diane had several health issues – hypertension, diabetes and heart disease – that were limiting her ability to move around the house and keep up with basic tasks like getting dressed. In home health physical therapy, she worked on balance and strength, which allowed her to walk longer distances and get back to things she loved like church and visiting her family.

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Dan’s Story

Dan had a recent stroke and struggled to get around his house without a walker. Physical therapy helped minimize his need for a walker, so he could stay as active as possible.

Malcolm’s Story

A car accident resulted in multiple fractures to Malcolm’s legs and back and a prolonged hospital stay. To support his recovery while he was wheelchair-bound at home, his doctor ordered physical therapy. Within a couple months, Malcolm learned to transfer from his wheelchair to use the restroom and stand with a walker, eventually progressing toward walking independently.

WHAT TO EXPECT FROM PHYSICAL THERAPY HOME VISITS

With home health care physical therapy, your therapist comes to your home. At your first physical therapy home visit, they will evaluate your needs. You might be asked:

  • Are you having pain or other symptoms? What level is your pain?
  • Do you have difficulty doing daily tasks like getting out of bed, getting dressed or bathing?
  • How are you sleeping?
  • Do you have a medical history of illness or other health problems?
  • What types of things would you like to be able to do?

Your Amedisys physical therapist might ask you to walk, bend, grasp, climb steps or do other motions to better understand your needs. They will also look at your balance, strength, flexibility, range of motion and posture. At this initial physical therapy home visit, you’ll learn about your treatment plan and how often your physical therapist will visit. You’ll also set up a schedule.

At subsequent physical therapy home visits, you’ll discuss how you’re feeling and any changes since your last visit. You’ll practice exercises and do activities to help you reach your personalized goals. Your physical therapist can teach you how to move safely and help identify environmental hazards at home. They can provide education for your caregiver as well.

At the end of each visit, your Amedisys physical therapist will share updates and progress with the rest of your home health team. This way, all team members who visit you will understand how you’re doing.

HOW LONG IS PHYSICAL THERAPY?

The number of home health physical therapy visits you receive depends on your needs and doctor’s orders. Some patients receive physical therapy for six to eight weeks. If you have a serious or progressive condition, you might require more visits. Alternatively, if your condition improves quickly, you may have only a few home health physical therapy visits along with a home exercise program.

How long is each physical therapy visit? A typical visit is 45 minutes to an hour but the length of physical therapy depends on your needs. Some physical therapists see patients once or twice a week initially, and then once a week once they’re stabilized.

HOME HEALTH PHYSICAL THERAPY GOALS

You’ll work with your doctor and home health team to set up a treatment plan and goals. Your specific focus areas will depend on your condition and needs. Some common home health physical therapy goals include:

  • Reduce pain and swelling
  • Improve your ability to move around
  • Educate patients and caregivers
  • Regain muscle control
  • Prevent disability or further deterioration
  • Return to prior levels of function after a stroke, injury, surgery or accident
  • Improve your balance and flexibility
  • Increase physical fitness and stamina
  • Manage a chronic illness at home
  • Improve circulation
  • Avoid unnecessary trips to the hospital
  • Breathing activities to conserve energy
  • Prevent falls and increase home safety
  • Teach you safe ways to stand, sit, lie down, and walk up and down stairs
  • Learn to use an assistive device like a cane or walker
  • Resume normal routines and regain independence

Physical therapists help patients prevent falls by improving strength and core muscle stability.

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Amedisys physical therapists take the time to review your needs and address issues that you may not have worked on in the past. With us, physical therapy is more than exercises and tasks. It’s about assessing your health and your environment and making changes that improve your day-to-day function.

The benefits of physical therapy for seniors can be significant, especially if patients are willing to learn and try new things. We recognize that change can be hard, so we focus on building a strong patient-therapist relationship first. Then we explore ways to do tasks safely and offer tips at the right pace for you.

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Many of our patients have lost hope that they can do tasks they used to be able to do, such as showering on their own, gardening or going to church or the store again. They may believe falling and losing function are an inevitable part of aging. But they aren’t. You may be surprised at what you can accomplish after physical therapy. We’ll empower you with tools to help you continue safely achieving your goals after physical therapy ends.

99% of Amedisys home health care centers are rated 4+ Quality Stars.

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MISCONCEPTIONS ABOUT HOME CARE PHYSICAL THERAPY

There are many misconceptions about physical therapy, especially in the home health setting. Here are a few misconceptions as well as the facts:

  • 1. Physical Therapy is Just Prescribed Exercise

    Some people think physical therapy is just a series of exercises that they can’t realistically maintain on their own. But it’s much more than exercise, especially in the home environment.

  • 2. Physical Therapy is Only Useful to Recover from a Surgery or Injury

    In addition to helping people recover from injuries, accidents and surgeries, physical therapists can also help prevent injuries and falls and improve patients’ abilities to do daily tasks. By addressing problems early on, patients can save money and minimize their risk of surgery and hospitalization later.

  • 3. Physical Therapy is Too Painful

    The goal of physical therapy is to reduce pain, not add to it. Your physical therapist may ask you to move in ways you aren’t used to, but treatment should not hurt. There’s no need to delay care to avoid making pain worse. Your physical therapist should check in with you about your comfort level, so be sure to tell them if something bothers you.

  • 4. Physical Therapists Are Basically Massage Therapists or Personal Trainers

    Massage and exercise can be part of physical therapy, but physical therapists can do much more. Physical therapists are movement experts who improve quality of life through prescribed exercise, hands-on care and patient education. They have specialized knowledge and skills and have completed an accredited physical therapy program with a bachelor’s, master’s or doctoral degree in physical therapy. Physical therapy assistants (PTAs) have completed an associate or bachelor’s degree. Both PTs and PTAs are also licensed by the state.

  • 5. Physical Therapy Only Helps for a Little While

    The purpose of at home physical therapy is to empower patients to manage their condition on their own. Physical therapists teach you the tools to take control of your illness or recovery. With home health care physical therapy, you learn to use tools and equipment that are readily available in your own home. If you do your daily PT activities, the benefits can last long after therapy sessions end.

     

IN-HOME PHYSICAL THERAPY COST

Does Medicare cover physical therapy at home? If you’re eligible for home health and your doctor orders physical therapy as part of your plan of care, the in-home physical therapy cost is typically covered by Medicare, Medicaid and some private insurance plans.

ARE YOU ELIGIBLE FOR HOME HEALTH PHYSICAL THERAPY?

To be covered by Medicare and Medicaid, you must meet eligibility criteria for home health care. These include:

  • You’re considered homebound. This means it’s very difficult for you to leave home and you need the help of a supportive device (walker, wheelchair, etc.) or another person to do so.
  • You need part-time or intermittent skilled care. This may include physical therapy, skilled nursing, speech therapy or an ongoing need for occupational therapy.
  • Your doctor orders home health for you.

Ask your doctor if home health care is an option for you.

If you don’t meet these home health criteria, you can still get private physical therapy at home if you pay for it out of pocket or through private insurance. Or you may want to consider a local outpatient clinic.

HOW TO FIND IN-HOME PHYSICAL THERAPY SERVICES NEAR YOU

Since home health physical therapy requires a doctor’s order, many patients find in home physical therapy services through their healthcare provider. Your doctor may refer you to a home health provider like Amedisys.

Here are a few considerations when choosing a physical therapist:

  • Does the physical therapist have experience or specialized training in the issues you’re facing?
  • Can the physical therapist come to your home?
  • Does the provider accept your insurance?

Physical therapy can help seniors with a wide variety of health concerns. If you’re recovering from a surgery or injury or living with a chronic disease, ask your doctor about home health physical therapy. You can also call the Amedisys home health agency near you to find out how physical therapy can help you maintain your independence.

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