Specialty Programs

Integrated Chronic Care Management TM (ICCM)

Home Therapy is pleased to offer a different approach to the traditional medical model used to address chronic care management. Generally, home health clinicians “treat and teach” patients about their chronic illness and move on. This approach has not proven to help the patient manage his or her own care and the result is a revolving door to the doctor’s office or hospital. Realizing this fact, we went in search of effective approaches being used throughout the Country and found Integrated Chronic Care Management TM. ICCM is a comprehensive, patient-centered practice that is offered by the Sutter Center for Integrated Care in Northern California. Home Therapy team members received training from one of the two creators of the evidenced-based approach in August, 2012.

So what does “patient-centered” really mean? It means that we listen to you, the patient, and become your partner. It means that our work with you is directed towards the goal or goals you have for your life if you could consistently manage your disease. We begin where you are, what you know and what you want to know. Together we talk about the roadblocks preventing the management of the chronic condition.

We are your guide, trainer and advisor. We become your chief cheerleader. We are your partner not only while we work with you but, for life. That means you always have us in your corner. Yes, we will monitor your disease and treat the symptoms as ordered by your doctor but, ICCM goes beyond those needed activities. Key components include:

  • Knowledgeable, accountable and supportive clinicians
  • Emphasis on providing meaningful information in an understandable way
  • Emphasis on care coordination with all doctors and other health care providers
  • Attention to barriers; understanding why behaviors do not change
  • Help to self manage and reinforcement for that using personal health information
  • Focus on personal goals
  • Support of family caregivers
Conditions addressed include Diabetes, Congestive Heart Failure, Chronic Obstructive Pulmonary Disease, Hypertension, Cardiovascular Disease and others.

For more information, please call our Chief Nursing Officer at 512-637-1550. To refer fax the doctor’s order to 512-637-1551.

Transition of Care

One of the most vulnerable times a senior can experience, is during the transition from one care setting to another. This might occur when a person is going from home to the hospital, from a hospital to a rehab facility or other post acute facility and certainly from the hospital back to the home. National research statistics tell us that unless the transitions are well handled that there are preventable poor outcomes such as falls and medication complications. Almost one-fifth of all patients discharged from a hospital are readmitted within 30 days.

Home Therapy Austin offers a Care Transition Program to help facilitate the smooth and safe transition from the hospital to home. The Program includes securing patient records from the hospital so that the home care team has a good understanding of the care provided there and for what reason, assistance with making a follow up appointment with the Primary Care physician, disease and recovery education, medication reconciliation and administration plan development and specific attention to the prevention of other potentially avoidable events.

To us, Transition of Care means there must be exceptional communication and coordination between the various health care providers. We take on the responsibility to make it happen.

For more information on our Transition of Care program or to request the services, please call 512-637-1550.

Balance Therapy / Vestibular Rehabilitation

Balance disorders are a leading cause of falls among the elderly. According to the National Institute on Deafness and Other Communication Disorders, approximately 12.5 million people over the age of 65 have dizziness or balance problems that significantly interfere with their lives.

There are many types of balance disorders caused by a variety of medical conditions. The source of many balance disorders is the Vestibular system or inner ear. Some statistics report that up to 80% of imbalance or dizziness are a result of Vestibular problems.

The Vestibular system is a part of the inner ear that helps maintain balance by providing the brain with information about changes in head movement. Vestibular disorders include Vertigo (spinning) and Disequilibrium (loss of balance). Other than dizziness, symptoms may include headaches, motion sickness, blurred vision, fall history, muscle stiffness and generalized fatigue.

Vestibular rehabilitation consists of an individualized exercise regime combining specific head and body movements with eye exercises designed by specially trained therapists to help compensate for a loss of balance within the Vestibular system. Vestibular rehab can be remarkably effective in a relatively short period of time.

Home Therapy has secured specialized Vestibular rehabilitation training for selected therapists and is the first rehab-specialized home health agency to offer the therapy in Central Texas. Additionally, Home Therapy is pleased to work with Bridgett Wallace, DPT, and founder of 360 Balance, www.360Balance.com, a comprehensive, specialized outpatient clinic. Ms. Wallace is well known in the region for effectively diagnosing and rehabilitating individuals with imbalance and dizziness.

Contact Your Physician
If you have concerns about balance or dizziness, it is important that you contact your physician so the cause of the concerns can be identified and treated.

For more information please contact us and ask to speak to someone about Vestibular or Balance Disorders.

Low Vision Rehabilitation

Low vision is a chronic impairment that limits everyday function and is one of the ten most prevalent causes of disability in America. Low vision is permanent and is not correctible with conventional interventions such as eye glasses or surgery. Nearly 7.5 million adults age 65 and over have visual impairment severe enough to interfere with daily activities.

Age related macular degeneration, glaucoma, cataract and diabetic retinopathy are the most common eye diseases in Americans over the age of 40 years.

The Home Therapy Austin Low Vision Rehab services are customized to:

  • Maximize existing visual ability
  • Achieve specific functional goals and maximize independence with Activities of Daily Living such as personal hygiene, meal preparation, home management and community activities
  • Adapt the home environment to support safety and function
  • Support related emotional concerns
  • Provide education and training to seniors and family members.

Our Low Vision Services can be ordered by your physician, ophthalmologist or optometrist.

Joint Replacement Rehabilitation

Joint replacement involves surgically removing the bone surfaces within a joint (generally, hip, knee or shoulder) and replacing with synthetic materials, usually a prosthesis. Severe arthritis, congenital abnormalities, aging and injury are some of the conditions that could result in joint pain and loss of function, ultimately, leading to joint replacement. Advances in surgery techniques and prosthesis design and production have resulted in shorter hospital stays and faster recovery. With successful surgery and post-operative rehab, most patients can look forward to resuming an active lifestyle, pain free.

Home Therapy's Joint Replacement Program begins with your physician. We have the protocols or treatment preferences of many of the area's Orthopaedic surgeons on file. This means we have discussed their preferred treatment regime with them. Our goal is to be a seamless extension of the physician's team. If we have not previously worked with your doctor, we will contact them immediately to discuss your treatment plan. We continue to communicate with your physician throughout your rehabilitation.

We will also contact you as soon as we receive the referral from your physician or the hospital. We try to visit all our Joint Replacement patients while they are in the hospital to introduce ourselves and talk about the transition home. During this visit we will discuss our first appointment and what you can expect during your rehab with you and your family. Should a hospital visit not be possible, we will make a connection by telephone. We also encourage you to contact us once you know you will be having surgery and want to use us for your in-home care.

We will also assist you or the hospital staff in procuring any assistive devices such as walkers or crutches. We encourage you to secure the devices prior to surgery so that you have time to practice using them prior to your rehabilitation.

Other Considerations Prior to Surgery can be found in the Family Section of the website.

We believe that one of the primary reasons that patients have a positive rehabilitation experience with us is the experience and training of our rehab professionals. Further, when a therapist or home care team is assigned to you, we are committed to keeping the clinicians consistent. We know that your results are enhanced with consistency.

Beyond your treatment which will involve a personalized exercise plan and nursing, as needed, for medication management and wound care, we focus on preventing injury in and around your home. We will conduct a home safety assessment for the purpose of identifying any hazards that may be present. You can read more about these activities under the Safe Steps for Seniorssm sections of the website. Our team will work with you and/or your caregivers or family members to address any safety concerns.

Our first visit is dedicated to an evaluation. Often times, other care beyond physical therapy may be needed. We provide Occupational Therapy, Home Health Aide services, nutritional assessment and counseling, social work services and, of course, skilled nursing. We will discuss the provision of these services with you and your physician should there be a need.

Please check the Links section of the website for more sources of information on Joint Replacement.

Stroke Rehabilitation and Support

Each year about 700,000 people have a new or recurrent stroke. In 2007, an estimated $62.7 billion will be spent on medical costs associated with Stroke which is one of the leading causes of adult, long-term disability in our Country.

Stroke is a cardiovascular disease affecting the arteries leading to and within the brain. A stroke occurs when a blood vessel carrying oxygen and other nutrients to the brain is blocked by a clot or the vessel bursts. As a result of the disruption, the brain is unable to receive the blood and oxygen it needs. If a stroke occurs and blood flow can't reach the region that controls a particular body function, that part of the body will not work as well as it should.

The risk factors for stroke include diabetes, excessive weight, cigarette smoking and high blood pressure.

Stroke is a medical emergency. Today, there are treatments that reduce the damage of stroke if a patient receives emergency medical care within three hours of the stroke event.

The warning signs of stroke include:

  • Sudden numbness or weakness of the face, arm or leg especially on one side
  • Sudden confusion, trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination
  • Sudden, severe headache with no known cause

Call 911 should you have these warning signs.

The effects of Stroke depend on several factors including location and extent of damage to the brain. Because one side of the brain controls the opposite side of the body, the results of a stroke on one side could lead to paralysis on the other side. Other effects could include vision, speech and swallowing problems, memory loss and the inability to process language.

Please check the Links section of the website for sources of more information on Stroke.

Our Services
The Home Therapy Stroke Program focuses on three objectives:

  1. Being an effective part of the patient's continuum of care. This means we want to work closely with the health care provider before us and after us. Many times, the provider before Home Therapy is an acute care or a rehabilitation hospital. We work to understand the patient's rehab experience to date, the medical history and current medical and rehab status. We then develop a treatment plan that reinforces progress in the home setting. Rehab goals could include mobility skills, as well as communication, memory and social skills.
  2. Providing meaningful therapy that improves function and increases ability to undertake activities of daily living (ADLs) such as walking, bathing, eating without assistance and dressing.
  3. Supporting the patient's caregiver or caregivers in the home, most often family members, by better preparing them for the on-going care. We do this through regular communication, formal and informal education and resource awareness and support. (Please see the For Families section of the website for more information)

All three rehabilitation disciplines (Physical Therapy, Occupational Therapy and Speech Language Therapy) are offered. Depending on the patient all three disciplines could be involved in the treatment plan.

Additionally, we provide a comprehensive home safety and functionality assessment. Working with the patient and caregiver/family members to reduce hazards and support increased functionality. Along with any home modifications, we recommend and help procure any assistive devices that could promote the goals of rehab and independent living.

Congestive Heart Failure Management Program

Congestive Heart Failure (CHF) is a condition in which the heart's function as a pump is inadequate to deliver oxygen rich blood to the body. CHF can be caused by 1) diseases that weaken the heart muscle; 2) disease that cause stiffening of the heart muscle and 3) diseases that increase the body's oxygen demand beyond the capability of the heart to deliver. The most common cause of a weakened or damaged heart is coronary artery disease. Other common causes are high blood pressure, severe lung disease, damage after a heart attack, damage to the heart as a result of infections.

CHF is a progressive, chronic disease. The symptoms can be treated but, there is no cure.

Over 5 million people have CHF in the United States and it is the leading cause of hospitalization among seniors 65 years and older. Seniors with CHF have the highest rate of hospital readmissions as well.

There are many things a person diagnosed with CHF can do to influence the management of the disease. In fact, the more dedicated and involved the patient and family members are, the more likely there will be positive outcomes.

Life style modifications are perhaps the most important tactics that can impact the severity of CHF.

Home Therapy Austin's CHF Management Program is designed to empower and support the patient and family in management of the disease. Unlike traditional home health CHF programs that are primarily nursing driven, our CHF Management Program features an integrated approach by nursing, physical therapy, occupational therapy, dietician and, if needed, social work. The Program components include:

  • Assessment of the patient/families understanding of the disease
  • Assessment of the current treatment plan including medication review and compliance plan development
  • Consultation with treating physician regarding treatment plan and protocols
  • Nutritional assessment by Registered Dietician
  • Assessment of lifestyle practices including physical abilities and limitations as well as involvement in activities of daily living including return to work assessment as applicable; using stress test information creation of a home exercise program as well as an energy conservation plan
  • Development of an individualized daily monitoring routine of weight, heart rate, oxygen saturation, blood pressure, peak expiratory flow and blood glucose, as indicated, using the nationally recognized telemonitoring system, MedApps (HealthPal).
  • Daily review of telemonitoring results and follow up as indicated
  • Disease management education and coaching. We use the proven education method of teaching and teach back. We know it works.

For more information regarding our CHF Management Program including information on telemonitoring, please call us at 512-637-1550.

Safe Steps for Seniorssm

Falls and the fear of falling are among the most serious concerns of the elderly. Home Therapy is committed to helping our patients and other senior citizens prevent falls.

The following statistics reinforce why fall prevention is such a critical part of our focus:

  • One in every 3 adults, 65 years old experience a fall each year
  • Falls are the leading cause of injuries, hospitalization and deaths among the elderly
  • Two thirds of those who fall do so again within a year
  • Falls account for 87% of all fractures treated in emergency rooms among people over 65 years of age
  • Twenty percent of elderly with hip fractures die within the year
  • Falls result in over $62 billion in medical costs each year

In an attempt to address the high incidence of falls and the associated medical, psychological and social consequences, Home Therapy developed Safe Steps for Seniorssm, a comprehensive fall prevention program. Safe Steps for Seniorssm involves multiple activities designed to identify and address fall risk factors in the patients we serve.

The Steps include:

  1. Balance Screening and Training
    - Vestibular rehab
  2. Strength Assessment and Training
  3. Gait and Mobility Assessment and Training
  4. Functional Vision
  5. Functional Hearing
  6. Depression Screening
  7. Medication Review
  8. Cardiovascular History
  9. Blood Pressure Screening
  10. Home Safe Homesm (Safer Home Assessment)
  11. Home Modifications
  12. Exercise Planning and Follow-Up
  13. Education of Patient and Caregivers

We know that the risk of falling increases as the number of risk factors increase. Home Therapy completes a Fall Risk Profile and Intervention Report on each patient and provides a copy to the patient's physician. We review the information with the patient/family and work to alleviate any concerns.

To request Safe Steps for Seniorssm services or for more information, please call us at 512-637-1550 or 800-865-6487.

What You Can Do To Prevent Falls

Some of the things you can do to reduce your risk of falling include:

  • Get your vision checked once a year
  • Have an annual physical exam including a hearing exam
  • Exercise to improve strength, balance and coordination
  • Wear properly fitted shoes and always keep your laces tied
  • Always wear rubber-soled, low-heeled shoes, not just socks in your home
  • Have your doctor review your medications. Tell your doctor about ALL of your medications even your over the counter medications. Never begin taking medications without informing the doctor of all the medicines you are taking
  • Always take medications as directed
  • Use night lights
  • Be sure all your lights work
  • Keep a flashlight next to your bed
  • Remove all clutter from your floor
  • Remove throw or scatter rugs
  • Remove extension cords
  • Make sure all flooring is even and secure
  • Use non-skid mats or strips in the bathroom and other places where the floor may become wet
  • Have grab bars installed in the bathroom

Finally, consider the use of a personal emergency response system in case you should experience a fall and have a need for assistance.

Safe Steps for Medicationsm

The adherence to a proper medication regimen is a challenge for many older adults. It has been found that as many as 55% of seniors are non-compliant with their medication regimen and at risk of adverse outcomes as a result. A recent study by the Center for Home Care Policy and Research found that during a course of a sixty day home care episode, nearly 25% of all patients age 65+ experienced one or more symptoms or signs related to their drug regimen.

There are many reasons that older adults have difficulty with medications. The sheer number of medications often complicates correct usage. We know that patients with chronic disease take as many as 6 to 8 medications daily with 20% taking 9 or more medications. More than 90% of older Americans have at least one chronic disease.

Also contributing to the challenges related to safe and simple medication management is the fact that patients are receiving prescriptions from different doctors treating different symptoms. When there are multiple providers treating a patient, there is an increased chance that harmful interactions or omissions will occur. Many times, instructions on how to take the medication are not explained, explained fully or explained in understandable terms. The older adult may not be compliant with the drug regimen due to poor vision, forgetfulness, confusion, fear of side effects, perceived non-efficacy, concern about cost and an inability to pick up the medication from a pharmacy.

The complications associated with medication mismanagement are numerous and include but, are not limited to:

  • Dizziness and imbalance
  • Weakness
  • Falls
  • Headaches
  • Nausea
  • Swelling
  • Bruising
  • Visual impairment
  • Hallucinations
  • Loss of appetite
  • Even death

Home Therapy of Austin, LLC is focusing on the issues an solutions to the challenges of medication management through our service, Safe Steps for Medicationsm. This multi-component program is designed to identify and address medication issues of individual patients. Two of the components are geared toward enhancing the communication with and between health care providers.

Safe Steps for Medicationsm Includes:
  1. A Patient Evaluation and Assessment of Compliance Ability
  2. Medication Reconciliation – A Medication Reconciliation Report is provided to the patient's physician/s. The Report documents the medication regimen before, during and after an acute care experience.
  3. Medication Discrepancy Report – The patient's referring physician receives immediate notification through this formal Report on any discrepancy or issue identified.
  4. Patient, Family and Caregiver Education – a five week series
  5. Personal Health Record – a document containing medical and medication information designed for use by the senior to facilitate information exchange and enhance collaboration among providers. The ultimate purpose is to help assure more efficient and effective health care services and outcomes for the patient.
  6. Medication Management Plan – an individual administration regimen using a provided 7 day medication planner or other mechanism if deemed more appropriate.
  7. Medication Monitoring and Tracking of Adverse Events – conducted by a Registered Nurse or Licensed Vocational Nurse
  8. Assistance with Medication Management Resources – involvement of a Medical Social Worker as needed to identify and access needed resources for ongoing assistance or alternatively Private Duty Medication Administration Services. Safe Steps for Seniorssm was designed with the Medicare-eligible home care patient in mind. Others interested in the Program should call Home Therapy Austin at the number below to discuss participation.

To learn more about Safe Steps for Medicationsm please call us at 512-637-1550.

To refer a patient, fax a signed physician order for "Skilled Nursing for Medication Assessment and Management" to 512-637-1551.

Lee Silverman Voice Treatment (LSVT) LOUD and BIG

Inspired by Lee Silverman, a woman with speech and voice deficits resulting from Parkinson Disease, physicians in Scottsdale AZ developed an innovative treatment known as the Lee Silverman Voice Treatment (LSVT) in 1987. Now a globally recognized treatment, the LSVT LOUD treatment has proven effective in restoring oral communication in Parkinson's patients by focusing on increasing vocal loudness.

Speech Therapists must be specially trained and certified to provide LOUD therapy. Home Therapy Austin has had a certified LOUD therapist since 2008.

The LOUD program requires one month of intensive therapy (4 times per week for 4 weeks) and then continued homework (5-10 minutes) ongoing on a daily basis to keep the voice active. The therapy centers on a very specific therapeutic target of increasing vocal loudness. This key target acts as a trigger to increase effort and coordination across the speech production system. LSVT LOUD has been scientifically studied over 15 years with $5M dollars in NIH funding and is considered the first speech treatment with Level 1 evidence for individuals with Parkinson Disease.

Based on the successful methods of LOUD, the LSVT organization applied the same principles to address the physical deficits associated with Parkinson's by changing the patient's sensory awareness and their movements. The movement therapy, LSVT BIG, works to train sensory awareness by having the patient focus on making "big" movements through a specialized sequence of movement patterns that target functional deficits commonly associated with Parkinson Disease.
BIG is also a four week commitment, four days per week.

Home Therapy Austin had the first BIG certified therapist that focused on home based treatment and continues to offer the therapy.

For more information on the LSVT therapies, visit www.LSVTGlobal.com or call us at 512-637-1550.

Memory Support Services

The purpose of our Memory Support Services is to support the treating physician in his/her assessment of and plan of care for patients with various types of dementia. Our multi-disciplinary team of rehabilitation professionals along with Social Work, RN and Registered Dietician offer the following:

  • Evidence-based assessments and clinical observations
  • Assessment of the ability of the patient to benefit from skilled interventions
  • Foster independence and interdependence in daily living tasks
  • Maximize functional gains from residual skills
  • Assess diet and provide nutritional consultation
  • Assess and help address the home and occupational safety of the patient and caregiver
  • Assess the fall risk of the patient
  • Assess medication compliance and management needs; develop plans, train
  • Support caregivers to reduce caregiver burn out by offering coping strategies and training

To discuss the types of assessments or obtain additional information, please contact us at 512-637-1550.