Dear Jeremy,

My husband was recently hospitalized for a bad case of pneumonia. He’s recovering but he’s going to need rehabilitation after he leaves the hospital to get back on his feet.

He’s a little nervous because he has no idea what to expect. Can you give me some examples of therapy exercises? I think it would help put his mind at ease.

Lori T.

Columbus, OH

Physical, Occupational and Speech Therapy Exercise Examples

Dear Lori,

I’m glad to hear that your husband is making good progress in his recovery. The fact that he needs some therapy is nothing to worry about. In fact, we see a lot of patients at our rehab center this time of year with generalized weakness, which is common when people get sick with the flu or pneumonia.

What we’ll do with people in his situation is work on strength and medication management. Patients receive personal training and therapy, and that—in addition to healthy meals—helps them to gain their strength back.

As requested, here are examples of the three types of therapy exercises typically provided to older adults: physical, occupational and speech therapy.

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Related: Ask the Expert: Post-Hospital Rehab Insurance Questions

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Physical Therapy Exercises

A good way to think about the difference between physical and occupational therapy is that it’s like dividing the body in half. Physical therapy exercises work on everything below the waist while occupational therapy exercises work on everything above.

With physical therapy exercises, we work on ambulation (walking) and gate training. We’re focused on getting the patient as mobile as possible, so we’ll work on things such as their range of motion, their balance, their ability to climb stairs, sit-to-stand transfers (such as getting out of a chair) and so on.

We’ll also do some leg strengthening exercises with leg weights, exercise machines and bikes.

Another common physical therapy exercise is to work on transfers from the floor in case the person has a fall at home. We show patients how to get up from a fall position, either to their feet or to a position to call someone for help.

Who Benefits from Physical Therapy?

As I mentioned above, we see a lot of patients with generalized weakness who need physical therapy. However, physical therapy is also beneficial to patients who have had procedures such as knee or hip replacements, or elective back surgeries.

Occupational Therapy Exercises

Occupational therapy exercises are designed to help patients complete common, everyday tasks.

Some examples of occupational therapy exercises we use are:

• Upper body strength exercises
• Bathing and dressing
• Light meal prep
• Medication management

Occupational therapy exercises are tailored to each patient. They’re meant to cover any type of daily activity the patient may come across.

Our goal is to adapt to whatever our patients need in their regular lives. For example, we had one patient who had a dog and needed to be able to clean up after her. We bought a scoop and some Tootsie Rolls, and our therapist practiced the chore with her.

It may seem minor, but that exercise helped the patient become better equipped to return home—and to stay safe and healthy once there.

Who Benefits from Occupational Therapy?

We see a lot of overlap in occupational and physical therapy patients. Often they need each type as part of their personalized care plan.

Speech Therapy Exercises

Speech therapy exercises help seniors who are struggling with speech, memory or swallowing issues.

Some examples of exercises include strengthening the muscles around the throat or using electric stimulation on those muscles to help with swallowing. The patient may also practice with small bites of food to decrease the risk of aspiration.

Sometimes we also work on vocalization. If someone has weak vocal cords, we use exercises to help them speak louder.

Who Benefits from Speech Therapy?

Speech therapy is typically for patients with cognition issues. If someone comes in with mild or severe cognitive deficits (either from anesthesia or a form of dementia), we work with them on recovering what memory they can. We also help them acclimate to the facility.

If someone comes in with severe dementia, we know we won’t be able to get them to remember everything. But we can get them to remember to hit their call light or put the locks on their wheelchair to keep them safe.

And, as I mentioned above, speech therapy can also help seniors with swallowing issues.

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Related: Transitioning Home After a Rehab Stay

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Therapy for Older Adults at a Rehab Center: What to Expect

The type of therapy a patient receives depends on their situation.

To give you an idea of the process, when patients come into New Albany Rehabilitation Center, Skilled Nursing & Assisted Living, they receive a physical therapy and occupational evaluation.

Not everyone needs speech therapy, so those evaluations are not routine. However, physical and occupational therapy are always needed.

The type and amount of therapy a patient receives is then determined based on the results of the evaluations. Goals are set based on what the patient wants and a surgeon’s input.

For all patients, we set family meetings to come up with a discharge plan for that patient. If a patient lives alone, we try to make them as independent as possible upon discharge.

I hope this helps! Please feel free to contact us if you have any questions.

Jeremy Evans, PTA, LMT
Rehabilitation Manager
New Albany Rehabilitation, Skilled Nursing & Assisted Living

Dear Averi:

I work at a Columbus-area hospital and am interested in learning more about your admission process. Our department often receives questions about how to admit a senior directly from home to a skilled nursing and rehab center, and we are a little confused about how it works.

Would you be able to outline those requirements for us? Any advice would be helpful.

Sincerely,

Alice

How to Admit a Senior from Home to a Skilled Nursing and Rehab Center

Dear Alice:

What a good question! Admission requirements can definitely be confusing for families. Hopefully, this overview will help:

• When an older adult wants to be admitted to a skilled care or rehab center, we need to review their most up-to-date clinical information. This includes a History and Physical, as well as a medication list. For seniors living at home, their primary care physician’s office is probably the best place to locate this information. If the senior receives home health services, their notes will help, too.

• This clinical information is what rehab centers will use to determine if the patient meets the qualifications for skilled nursing care or long-term care.

• The patient’s insurance will also play a role. Medicare requires a 3-night inpatient stay in a hospital before admission. If the senior was recently hospitalized, they may be able to use their Medicare benefit.

• Managed care insurance companies typically require therapy notes before they will be able to approve a patient’s admission to a skilled nursing center. Like Medicare, they will only pay if skilled care is necessary. They don’t cover long-term care expenses.

• Medicaid does not pay for skilled nursing care; however, it does cover room and board for long-term care. They require what is called a “Level Of Care” before a patient can be admitted.F

• Long-term care insurance may also help cover room and board for an older adult. Each policy is different though. We can help review a senior’s policy to see if theirs will cover long-term care.

If the senior doesn’t have any type of insurance that will cover their skilled nursing or rehab care, they will need to pay out of private resources. In this situation, a deposit check is typically required upon admission.

I know this can all be tough to navigate. If you have any questions, please feel free to call me directly. I can help you walk through the process!

Sincerely,

Averi Bruce

Admissions Director