October is National Physical Therapy Month and Granite VNA is extremely fortunate for our team of physical therapists (PTs) and physical therapy assistants (PTAs) who provide quality compassionate care to our patients.

Most recently, Russell, a PT who has been with our agency for nearly 14 years, offered a first-hand account of one of his days.

Each morning, he starts at our main office in Concord, and picks up folders and supplies as needed. Once he receives his patient assignment, he maps out his day, and calls each patient to finalize his schedule.

“Getting that first visit is always a challenge for us,” Russell said. “Some patients prefer morning visits while others like afternoon visits. Once you get that first visit, you kind of get a little momentum.”

Mobility exercises
Russell’s first stop of the day was to visit a home care patient who has vascular dementia, a disease caused by a lack of blood flow to the brain. People with vascular dementia have challenges with reasoning, planning, judgment, memory, and other thought processes.

During the visit, Russell guided the patient to the kitchen and completed hip abduction, knee flexion, and toe raise exercises with her at the counter. They continued their light activity when they walked outside from the house to the mailbox multiple times, walked up and down the home’s stairs, and practiced getting in and out of bed. All of the exercises are designed to help the patient increase mobility and improve strength and balance.

Additionally, Russell practiced pursed lip breathing with the patient to help reduce anxiety and increase relaxation. They also practiced abdominal breathing to help relieve shortness of breath.

Before leaving, Russell recommended the patient continue the light activity program and educated her caregiver as well.

One step at a time
On the way to the next visit, it started to rain, a common theme this year. “One of the next patient’s goals is to get on his tractor,” Russell said. “That is a familiar goal. With the rain though, I don’t know if we will be doing that today.”

Upon entering, the patient reported to Russell that he has experienced an increase in pain while standing and walking. After asking him a few questions, Russell worked with the patient on some leg exercises that he recommended to continue on his own in between his next visit.

Meeting a new home care patient
Typically, start of care visits take longer because of the number of questions clinicians have to ask new home care patients. “If all three disciplines, nursing, physical therapy, and occupational therapy are ordered, then you have to wait for the nurse to admit,” he said. “If it is a therapy-only (physical, occupational, and speech) referral, then any of the therapy disciplines can admit.”

Russell started the visit by introducing himself to the patient who was diagnosed with Bell’s Palsy. After comparing the patient’s medication order to all of the medications the patient has been taking, Russell asked a series of questions to help him get a better understanding of what is needed and any barriers to improve quality of life that may exist.

Once completed, they walked inside the home and practiced some light exercises. Before leaving, Russell provided some valuable tips and stressed the importance of continuing light activity in between visits.

A little extra help
Russell visited his next patient who is recovering from shoulder surgery. She was sitting in her living room with her husband of 49 years and a friend. Her friend is a nurse and the patient expressed her appreciation for her help since being discharged from the hospital.

After completing the medication review and asking her questions during the start of care, they moved to the kitchen to complete range of motion, biceps curls, and pendulum exercises. This simple exercise requires a person to hold onto a chair or table with their good arm, bend forward a little, and let their injured arm hang straight down.

Once those exercises were completed, they discussed how the patient was going to sleep. She expressed some concerns sleeping in a bed and noted that she has slept in a living room recliner since returning home. Using a wedge that lifts a person’s shoulders and head, Russell demonstrated how she could get in and out of bed so she would not have to sleep in the recliner.

Before leaving, Russell worked with the patient on scheduling his next visit.

At the end of the day, Russell expressed his personal satisfaction for playing a role in helping people recover and get stronger as well as meeting a variety of people in his travels.

“I could go to one house and help someone who was a captain of a boat,” Russell said. “I could go to another house and help someone who was a plumber. In my next visit, I may help someone who was a CEO of a business.”

“You see a lot of people who are in the last chapters of their lives and I enjoy listening to their stories and wisdom they have gained through the years,” he added. “It’s really quite interesting.”

Granite VNA is proud to have Russell along with 60 other physical therapists and physical therapy assistants as part of our team. Their work is vital to the care of our community.