Introducing The Rehab Therapy Team

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We’re celebrating at our house this week! My daughter, Sarah, passed her national boards and will soon begin her career as a physical therapist. I’m so proud of her, and I’m excited to see what lies ahead as she goes out into the world to serve others.

With this in mind, I decided it’s a good time to write a post about the rehab staff we commonly see in nursing homes. I know there’s sometimes confusion as to who does what and where to go with questions about a resident’s therapy program.

Physical therapists, occupational therapists, and speech-language pathologists all work together to help residents reach their highest possible level of function following an illness, injury, or surgery. While there is some overlap in their services, they do have primary differences.

Physical Therapy

The main focus of PT is to help a resident improve their movement and mobility. They work with residents on activities such as balance, strength, flexibility, and endurance.

Physical therapists also work on pain management, wound care, and bladder control issues. In addition, they recommend appropriate assistive devices such as walkers or canes.

Educational requirements for a physical therapist have expanded over the years from a bachelor’s to a master’s degree, and now most new grads come out with a doctoral degree. The physical therapist needs to pass a national licensing exam prior to entering into practice.

Occupational Therapy

OT primarily helps residents become as independent as possible in self-care activities. They often work with residents on tasks such as dressing, toileting, or eating. They also recommend adaptive equipment such as splints and eating aids.

Furthermore, if the goal is for a resident to return home, the occupational therapist will help the resident with activities such as cooking and other household tasks.

Most occupational therapists possess a master’s degree, but doctoral degrees are becoming increasingly popular. They also need to pass a national licensing exam.

Speech-Language Pathology

I think this is the most poorly understood service in the rehab department. Most people know that an SLP works with residents who have difficulty speaking. However, these professionals also help residents with challenges related to swallowing. They might recommend a modified diet or work with a resident on swallowing exercises.

SLP’s also work with people experiencing difficulties with cognition and memory. This often includes helping residents find ways to compensate for their deficits.

A master’s degree is required to work as an SLP and many hold a doctoral degree. They also need to pass a licensing exam.

OT and PT Assistants

These members of the rehab team work under the direction of occupational and physical therapists to carry out a resident’s rehab treatment plan. These careers generally require a 2-year associate degree and candidates must pass a national exam.

OT and PT Aides

Aides generally don’t require a college education, and they receive training on the job. Their role is less hands-on as compared with an OT or PT assistant. An aide’s job description might include transporting residents to and from therapy, clerical duties, and managing equipment.

Restorative Aides

These are specially trained Certified Nursing Assistants who work with residents to maintain their current level of functioning. They follow through on a plan of care developed by the rehab team after the resident has stabilized in their formal rehab program.

Here’s an example of what a rehab program might look like in the nursing home: 

David comes to the nursing home from the hospital after experiencing a CVA (stroke). He has lost some of the use of his right arm and leg. Additionally, his speech is slurred and he has difficulty swallowing.

The physical therapist evaluates David and learns that one of his goals is to regain his ability to walk independently. After developing a treatment plan, the therapist works with David on strengthening exercises and gait training. S(he) also provides David with a specialized type of walker. The physical therapist assistant helps David with his exercises under the direction of the physical therapist.

Working on a goal of helping David return home, the occupational therapist helps David relearn how to dress himself and do his daily grooming tasks. (S)he also provides adaptive equipment so David can feed himself again.

The speech-language pathologist works with David on his speech skills. After recommending a modification in David’s diet due to difficulty swallowing, (s)he also helps him with swallowing exercises.

David makes significant progress in his rehab program and regains more use of his right arm and leg. However, he is unable to regain complete independence.

With input from the care team and his family, David decides to remain at the nursing home. He is discharged from formal rehab services, but the restorative aides continue to work with David to help him maintain his regained abilities.

Of course, an individual’s rehab journey varies greatly depending on their diagnosis, goals, and payment source. But many people who enter a nursing home experience a greatly improved quality of life with help from the dedicated team in the rehab department.

Please check out these other articles in my “Did you know?” series.