15 Oct Frequently asked Physical Therapy Questions About An LTACH Stay
Q: How many times in a day are patients seen for Therapy?
A: Once a day by either PT or OT or both as patient is able to tolerate. Speech Therapy will see them 2-3 times a week.
Q: How many hours of therapy a day?
A: About 15 minutes to one hour depending on patient tolerance, medical stability and functional level prior to admission.
Q: When will patients start walking?
A: Rehab and Respiratory Therapist work closely to assist the patient. The primary goal is to wean off the ventilator. Often, we are unable to work aggressively because of their compromised respiratory status. Meanwhile, we do focus on sitting balance/ tolerance trunk control, standing tolerance, weigh shifting and the progress to walking.
Q: Why are they in bed and not in a chair?
A: Patients who have out of bed orders by MD do get out of bed for about two hours once a day. Sometimes patients are on bed rest due to medical reasons per MD orders.
Q: How long do they have to stay in a chair?
A: We encourage patients to sit in a chair for up to 2 hours. Sitting in the chair helps with mobilizing the secretions and weaning them off the ventilator. To prevent skin breakdown we limit time in the chair.
Q: Can they sit in a wheelchair instead of geri-chair?
A: The geri chair allows us to recline patients back and elevated their legs when respiratory status is compromised, blood pressure becomes unstable and or fatigue sets in. In case of an emergency we are able to transfer patient back to bed safely and efficiently from a geri chair. When possible, patients are allowed access to a wheel chair.
Q: Can we wheel them around in the hallway or to the patio?
A: Yes, under supervision of a family member. This is possible if they are off isolation, off ventilator and able to tolerate sitting upright in a wheelchair.
Q: When will they be allowed to eat/ drink?
A: Every patient is different. Generally speaking the patient will be considered for a swallowing evaluation by a Speech Pathologist when he/she is tolerating O2 with the trach collar around the clock and is using a passy muir speaking valve. There are exceptions of course, and evaluations may be considered prior to this time.
Q: How can they communicate with everyone?
A: Our patients are frequently unable to speak due to the presence of a ventilator and/or tracheostomy tube. We have communication boards available for use, some patients write with a pen/ paper, and sometimes we use an adaptive device such as a adaptive switch so they can signal for assistance. Some of our patients with a tracheostomy use a Passy Muir speaking valve allowing them to produce voice.
Q: When will they be able to speak?
A: If the patient has a tracheostomy and is on a trach collar, they may be able to tolerate a Passy Muir speaking valve which allows for voice production. In certain instances, the Passy Muir speaking valve may be utilized while on a ventilator.
Q: How long will it be before they get better?
A: Every patient progresses at their own rate making this answer difficult to predict.
To read more about the Physical Therapy team at Specialty Hospital of Central Jersey, click here to read “Notes From a Physical Therapist at Specialty Hospital of Central Jersey.”