The Home Setting: A Clinician’s Perspective

By Ashleigh Carey, PT, DPT

Physical Therapist

The outpatient on wheels experience, as I like to think to think of it, is as rewarding as it is challenging. After getting comfortable with managing caseload and the unknown of treating in someone’s home, therapists can appreciate the autonomy and ever-changing environments.

Treating patients in their own homes establishes improved therapist-patient relationships and allows for clinicians to provide direct functional treatments geared toward maximum function and independence.

The idea of individualized skilled physical therapy, occupational therapy, and speech-language pathology services within patients’ personal settings is innovative and not yet well understood.

Some may relate this to home health. Yes, this is treating patients in their homes, but is essentially a mobile outpatient clinic with a primary focus on individualized care for each and every patient we serve, which has been shown to lead to improved functional outcomes.

Let me give you a glimpse as to what my experience in this setting.

THE HOME SETTING – MAXIMIZING FUNCTION

Instead of going into the same clinic every day, I am on the road visiting patients within their own homes.

Because I am in my patients’ homes, I can formulate specific treatment programs that pertain to each and every one of their varied needs. I am able to assess their overall health and home environment, make recommendations on equipment, address potential barriers in the home, and create a program that is most beneficial to the patient.

I have found that this insight allows me to design a much more specific plan of care for each patient compared to treatment in a traditional outpatient environment.

In this setting, I’ve been able to focus my treatment on my patient’s true functional ability and personalized goals. Each and every one of my patients is addressed with dignity and respect.

There is also a certain amount of awe. It is amazing what our geriatric patients can achieve given the right push.

HOME SETTING – FOSTERING RELATIONSHIPS

One of my favorite aspects of this setting is the personal relationship I am able to create with each of my patients.

In general, I come to know them very well and vice versa. We share stories, dreams, and lots of laughs.

I have come to realize that when you are able to create this type of patient-clinician connection, therapeutic outcomes can improve because you are able to truly personalize treatment sessions and gauge how much you can appropriately push your patients.

When it comes to time of discharge for most of my patients, I am both very happy and very sad. I am thrilled that they have met their functional goals but saddened that I am no longer going to be seeing them on a weekly basis.

When my previous patients request to maintain contact after their treatment is finished, it makes my day!

We are able to achieve unbelievable function and independence. I truly have come to believe that anything is possible if you have the drive and determination (and sometimes a little push).

While the people in this photo are a real FOX clinician and patient, they are not mentioned in this article.