Physiotherapy is usually provided in a clinic or a hospital but sometimes you have to visit a patient in their home to provide therapy.
The protocol remains the same at home as well. You have to assess the patient, get a history, create a plan and then start treatment – the same as you would do in the clinic. But home sessions have a few additional factors that you have to be mindful of.
Most physiotherapists who are new to home visits are often a bit lost in the beginning. If that’s you, then you’re in the right place.
In this article, we’ll share practical tips to help you prepare for physiotherapy in home settings from the experiences of multiple physiotherapists who provide home sessions.
What Is Home Physiotherapy?
Providing physiotherapy services to patients in their homes is called home physiotherapy. Some physiotherapists do this exclusively while most provide both in-clinic and home services.
It’s ideal for:
- Patients who have mobility issues that make it difficult to visit a PT clinic for therapy
- Geriatric patients
- When you want the patient to progress in a familiar environment, usually for those who require life-long physical therapy
- Providing patients more comfort than what they’ll get in a clinic
- For personalised care that’s not available in a clinical setting
- Patients who don’t have the time to commute to and from the clinic and wait for their appointment
It’s also great for physiotherapists because they get to work in different settings and help their patients progress in the comfort of their homes where they spend most of their time.
10 Tips To Prepare For Physiotherapy In A Home Setting
Ever since the pandemic, home visits and virtual physical therapy sessions are becoming more and more common.
There are a few differences between an in-clinic session and a home session. If it’s the first time you’re going to a patient’s home, then these are a few points you need to be mindful of:
1. Don’t Go Into the Session Blind
Get a rough history of the patient when they book an appointment whether it’s over the phone or online. You need to know what kind of physical therapy they require such as chest physio, musculoskeletal, paediatric, or neurological.
That’ll help you bring the required assessment forms with you and mentally prepare for what to expect when you arrive at the patient’s home.
Here are some questions you can ask for this purpose before your visit:
- What’s your medical diagnosis?
- What’s your primary complaint for which you require my services?
- Can you tell me a bit about your medical history?
During your first visit, gather a detailed history and perform an assessment similar to what you would do during an in-clinic physiotherapy session.
Fill out the forms so you have a baseline to compare your results to and design a treatment protocol around the condition and goals of the patient.
2. Polish Your Knowledge of the Patient’s Condition
Since you won’t have fellow therapists around to guide you in case you need help, you should spend time revising the details of your patient’s condition, potential treatment approaches and the level of recovery you can expect.
That’s especially important for complicated cases or conditions in which you don’t have much experience.
You might not realise how reassuring it is to have senior physical therapists around in a clinic, even if you don’t need their help.
Many new physios say that not having colleagues around in a home setting shakes your confidence, at least in the beginning as you get used to home sessions.
By brushing up on your knowledge about the patient’s condition, you can be prepared for providing physiotherapy and feel more confident in your service.
3. Always Carry PPE With You
Some clinics provide gloves, face masks and other protective equipment you might need for a home session. But other times, the physiotherapist has to buy their own PPE.
Hygiene is extremely important for patients and therapists so you can’t compromise on that just because you’re providing physiotherapy in a home setting.
Oftentimes, patients opt for home sessions because they don’t want to be exposed to the infections that are common in hospitals. You need to ensure that you don’t bring those infections home to them. PPE protects both you and the patient.
4. Make Sure You Have the Necessary Modalities and Equipment
Although most physical therapy sessions involve manual therapy and exercises, your patient might also require some equipment for monitoring and treatment.
You should prepare a bag with the necessary equipment that you might need for physiotherapy in a home setting. This could include a TENS/ EMS machine, hot-cold pack, K-tape, oximeter, resistance band or anything else specific to your patient.
5. Bring an Assistant if You Need One
You’ll require another person to help you treat patients who are immobile or obese. You can ask the patient’s caregiver at home to help you out or bring a physiotherapy assistant with you.
Asking the screening questions before your first session will allow you to determine if you need an extra pair of hands.
Going to a session without the necessary help will result in sub-par service and wasted time for both you and the patient.
It’s wise to inform the patient or their family that you’ll be requiring an assistant so they can either arrange one at home or be prepared to pay you for the second therapist that you’ll bring.
6. Discuss Goals and Prognosis
Similar to the way you talk to patients about their prognosis in a clinic or hospital, you have to discuss your patient’s goals and treatment options with them in a home setting.
It’s likely that your home patient hasn’t seen other people with a similar condition. So they might not know the level of improvement that’s possible. Hence you need to manage their expectations and educate them about what’s possible in terms of improvement.
Discuss their goals and explain the prognosis in a language that they can understand.
7. Pay Attention to the Ergonomics of the Home Environment
Proper setup for providing PT is important for you as a physiotherapist.
If the patient’s bed is too low or soft or there’s no treatment table available, then you need to improvise and be creative in finding a place to do physical therapy in the most ergonomic fashion.
You can also suggest changes to prepare the patient’s home for physiotherapy. For instance, they can get a yoga mat if they need to exercise on the floor or an orthotic mattress for the bed if you think that’ll help.
8. Don’t Neglect Documentation
It’s easy to forget or delay documentation when you’re providing physiotherapy at home. That’s because you might get busy when you leave and then forget to do it.
Set out some time to document the progress of your patient when you’re back in the clinic and be consistent with it.
Your reimbursement might depend on the number of sessions you provide or the time you spend with the patient. Documentation is also necessary for legal reasons and insurance purposes.
Not only that, it helps you keep track of what works for the patient and what you need to do in the upcoming sessions.
9. Ensure Your Safety
Going to someone’s home to provide physiotherapy has its downsides and safety is one of them.
To ensure your safety, you should only work with reliable organisations that vet their clients before sending you there for treatment. If you’re an independent physiotherapist, then you need to do this yourself and only accept patients that come from a trusted reference.
You could also ask for identification ahead of time and share your patient’s address and the time you’re supposed to be there with a trusted colleague or your agency.
10. Establish Professional Boundaries
Patients who require home physiotherapy sessions often don’t have much contact with new people or the outside world. They interact with the same nurses, home aides, and family members day in and day out. (Reference)
So it’s easy for them to want to become friends with you and share personal details or ask personal questions but you need to be as professional as you can.
Draw a line at personal questions and politely steer the conversation in some other direction if you feel that the patient is getting too personal.
You should also be careful about accepting gifts and being included in their family affairs. If your subtle hints aren’t working, be prepared to have a direct conversation about your professional boundaries.
The Takeaway
While home physiotherapy is a great way for you to work with patients one on one in different settings and step out of the mundane clinical work, you also have to remember the challenges it comes with.
While preparing for physiotherapy at home, make sure that you’ve thoroughly read up on the patient’s condition and that you ensure your’s and your patient’s safety.
If you need assistance, ask for it rather than trying to do it solo. Establish a professional relationship with your patient and don’t cross personal boundaries which can get blurred in a home setting.
Want to talk to seasoned physios about a situation you’re facing with a home physiotherapy patient? Contact us today and let us guide you from our experience.
Disclaimer: This article is for informative purposes only. We provide well-researched and authentic information. Do not consider this personalized health advice. Please contact a licensed healthcare professional for medical issues and health concerns.
