Home health is one of the many areas involved in physical therapy. To qualify, one must be referred to by a physician, an MD, DO (Doctor of Osteopathic) or DPM (Doctors of Podiatric Medicine). Populations tend to include geriatrics, pediatrics and sometimes adults who happen to be in a car accident or recovering from a major surgery. On Sounds Good, Tracy Ross speaks with physical therapist Kamran Nabavi of Baptist Health Home Care about navigating help through physical therapy.
Nabavi says diagnoses tend to involve total joints, hips, knees or shoulder replacements, major fractures or traumas. He says hospitalizations for chronic obstructive pulmonary disease (COPD), diabetes, major surgical procedures, gall bladder surgeries, pneumonia and strokes are also all things he's encountered in his 30 years in various aspects of the field.
Physical therapy is wide-ranging, Nabavi says, from geriatrics to pediatrics. spinal cord injuries, room care from minor traumas to athletics sports medicine. He says the theory is to try to return the patient to their prior level of function, to help them get rehabed and stronger so they can return to their daily activities of living.
In the home care situation, he says it's the bridge between when they are hospitalized and come home but not strong enough yet to go to an outpatient or sometimes able to come home from a nursing home facility but not strong enough to be able to leave the home on a regular basis, where leaving the home is difficult.
In home care treatment, he works as a team involving nursing, occupational therapy, physical therapy, speech therapy and home health aides and social workers. Nabavi says his focus tends to be on gross motor movement: strength, stamina, endurance, balance, transfer trainings.
Treatments start with a home safety assessment. The first thing is making sure the patient is safe in their home when returning, for instance making sure throw-rugs are removed. He helps create a clear path so the patient can maneuver around potentially in an assisted device. They provide training for the device. He tells patients that steps are one of the major issues of safety he tries to address.
In western Kentucky, he has seen steps built with about eight or ten inches of a step height that makes it difficult without a railing. While not necessarily recommending a ramp, he advises a step platform that can be built to increase the step heights to no more than three or four inches and have a railing on at least one side.
Nabavi says he loves working with home patients because they really want to get outbound. No one really enjoys being stuck in their homes.
