On November 16, 2017, Rachel McDermott, PTA, former Director of Rehabilitation at Stonehill Care Center, presented a webinar on expanding aquatics programs. “How to Maximize Utilization of a Senior Aquatics Program” was a great look into how to get the most out of a therapy pool for multiple applications.
As Rachel states, there are a million reasons to put a senior in a warm water therapy pool, but she feels that these are the most important:
- It provides a pain free environment.
- It allows physical therapists to treat patients with weight-bearing restrictions.
- It offers a safe environment to challenge patients.
- Treating patients sooner and longer results in quicker rehabs.
- It is a safer modality for staff when treating those with concerns such balance or obesity challenges.
Specifically, there are wonderful applications for skilled patients, independent and assisted living residents and even opportunities to expand into outpatient.
Benefits of aquatic therapy for skilled patients:
- Aquatic exercise can combat 3 of the top 4 causes of chronic diseases among seniors (heart disease, stroke, diabetes) that lead to 95% of healthcare spending.
- Aquatic programs are perfect for these seniors because they can get moving in a safe, pain-free environment and can tolerate longer durations of physical activity.
- Aquatic therapy leads to quicker rehabs, less down-time from injury and less chance of reinjury.
- Aquatic programs are ideal for skilled and long term care because they improve compliance, treat weight-bearing restrictions, offer a safe place to challenge patients, allow physical therapists to treat patients sooner and for longer sessions resulting in quicker rehab.
Rachel continues the webinar by discussing the other applications for which aquatic therapy can provide benefits in a senior living community, such as Stonehill Care Center, particularly for:
- Independent and assisted living residents
- Community wellness programs
- Outpatient aquatic therapy programs
- Pre and post- op programs
Expanding to other options with warm water aquatic therapy provides multiple avenues for helping the community reduce falls, improve RUG scores and drive census. Rachel explored each of these applications and provided ideas for programs, scheduling and gaining referrals.
There are many changes in healthcare as a whole right now that create the ideal environment for implementing warm water aquatic therapy into a senior community. “Having aquatics makes you relevant.” Here are a few of the changes that apply :
- Resident classification system. The longer they are in skilled the less money facility can be charged. Patients being discharged to skilled will likely be lower functioning and will only go 5 -10 days and then home.
- Decrease in discharges to skilled. Many higher functioning surgical patients will be discharged directly to outpatient.
- Reduce readmission standards. Those discharged in outpatient can’t be sent back to the hospital in within 30 days.
- Increase in same day surgery centers for joint replacements. This means that surgeons are now sending patients home and to outpatient centers in 2 days.
- Full continuum of care. The medical community wants a full continuum of care, with high-level, fast and reliable results
After the webinar, Rachel took some time to answer great questions. Below are a few of her answers:
When you see patients in the water and on land – have you seen denials?
- Stonehill Care Center always did pool and land together. They would do more pool in the beginning and then transition more to land later. We would always show progression and that we were working toward land-based therapy. We did not see denials. It is so much easier to show why the skills of the therapist are needed in the pool vs. simple land therapy such as sitting on an omni-cycle.
Can you charge for Occupational Therapy in the pool?
- Absolutely! If we would put a patient in and work on balance or high-level exercises, I would always throw something in related to OT that is similar to what we do with residents that are in OT. You can do occupational therapy activities in the pool on a noodle or standing on one leg in front of jets, which makes it much harder to do.