Physiotherapy can improve functional ability, prevent falls and reduce pain for older adults in nursing homes. Our team works together with the Residents, families and medical staff to create an environment of healthy living through expert rehabilitation with a gentle care approach and philosophy. Our Physiotherapist (reg. Physiotherapist) and assistants (PTA’s and Kinesiologists) have a special interest in Geriatric Care and are highly qualified with years of experience in Long-Term Care.
Long-Term Care Home Residents
- All Residents are assessed on Admission, quarterly and if a significant change is noted. We do not require an order for Physio
- All Residents on program will have a care plan in place – RPN on the units have access to this, and can tell you what programs are in place
- Progress notes with a summary of the assessments are also completed for every Resident and are accessible by the RPN’s
- The Physiotherapist reviews Residents requiring therapy to determine if further programming is appropriate (Nursing Restorative) and will send a referral to the Rehab Coordinator
- Residents are seen 2-3 x/wk if on a physiotherapy program
- If Residents are deemed palliative, Physio programming will be discontinued, however we will continue to monitor Residents related to positioning and pain (preserving skin integrity, etc)
- If a Resident does not require a therapy program but would benefit from maintenance exercises, they are referred to group exercise classes run by the activity team 5x/wk
- Most Residents will come to us with a PT referral in place – This is outsourced by the LHIN to home care physiotherapists who usually get very limited visits (3-6 visits)
- If no PT referral in place, RPN on the unit will send one to the LHINs. We require a Physicians order prior to referral being sent. RPN’s will put into Doctors book for this
- Physiotherapist and/or Rehab Coordinator review for transfers, etc
Retirement Home Residents
- There is no longer additional funding for retirement home Residents for physio
- Should a Resident require PT, the RPN will need to get a Physicians order and complete and fax referral form to the LHINs
- A case worker will contact the Resident, family and/or the home to discuss the referral. Most often, they want Residents to go to Out-Patient therapy in the community. We typically need to be firm (advocate the needs of the Resident) to get a
- Therapist to come into the retirement home
- When visits are granted, they are very limited. Sometimes only 3-6 visits
- Visits are usually only granted for those Residents with fractures, significant changes, etc. Issues such as aging, decreased mobility, and pain are often difficult to warrant physiotherapy. If a Resident is denied physiotherapy visits from the LHIN, there is an opportunity for a Fiddicks employed physiotherapist to identify treatment and therapy at an additional cost
- Currently our Nursing Restorative team are offering exercise classes 5x/wk. We do not receive any funding for this
- VON smart program is provided weekly for group class (Wednesday)
Assistive Devices Program (ADP)
A Licensed Registered Physiotherapist is an authorizer for the Assistive Devices Program (ADP). They are authorized to provide Ontario Residents who have long-term physical disabilities, access to personalized assistive devices appropriate for the individual’s basic needs. These may include wheelchairs, walkers, etc. Devices covered by the program are intended to enable people with physical disabilities to increase their independence through access to assistive devices suited to their individual needs. The ADP can fund up to 75% of the cost of such equipment.
Long-Term Care Home Nursing Restorative Care Program
Nursing Restorative Care refers to nursing interventions that promote the Resident’s ability to adapt and adjust to living as independently and safely as is possible. This concept actively focuses on achieving and maintaining optimal physical, mental, and psychosocial functioning. More specifically, focusing on activities of daily living. This program is ran by our Rehab Coordinator and the RAI/MDS Coordinator and is carried out by the Nursing Restorative Assistants. Staff carrying out programs are required to be PTA’s, Kinesiologists or equivalent.
Assessments are completed by the Rehab Coordinator (with input from Resident) to determine if a Resident may be appropriate for Nursing restorative programming. These are completed on admission and as needed.
The following criteria is used:
- Residents that the nursing team has established are at risk for functional decline
- Residents that have potential to increase function
- Residents that the nursing team has identified a deficit or decline and have established need
Occupational Therapy (OT), Speech Therapy (SLP) and Social Work (SW)
If a Resident in LTC or Retirement Home requires OT, Speech or Social work, the Residents Physician will complete a referral to request services. Referral will be sent to the LHIN and determination will be made by the case worker on which services may be appropriate and what services are covered for the Resident.
Dementia Care/Butterfly Model
Our home has a dedicated secure dementia care unit where the Butterfly Care Model is implemented. It emphasizes a transformation in the way Residents are cared for, with a focus on their emotions and the creation of home-like environments and daily activities they enjoyed earlier in life.
Behaviour Supports Ontario (BSO)
Aims to improve the lives of Residents with behaviours associated with complex and challenging mental health, dementia or other neurological conditions living in long-term care homes or in independent living settings.
Geriatric Mental Health Outreach Team (GMHOT)
The goal of this service is to enhance the quality of life for older age adults with complex mental health needs living in a long-term care home, retirement home and community. The team comprised of a Psychiatrist, Registered Nurses, Social Worker and an Occupational Therapist that provide psychiatric evaluation and care within the Long-Term Care Home, Retirement Home and Community settings. The team works with the Homes staff and family to support the client with stabilization.