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My sister was hospitalized last fall and was sent home with orders for physical therapy. The physical therapist was knowledgeable but did not address the safety issues in her home. When it was determined by the family that there were many safety issues not addressed by the physical therapist and that possibly a consultation from an occupational therapist might be the most appropriate service to meet her needs. In checking with other sources it seems that physical therapy is the service of choice by home health care providers, when occupational therapy would be a more beneficial first service. How do we get providers to provide the best service for patients and family and prevent many falls, and other safety issues related to taking care of one's self in the home. It certainly seems more cost effective?

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Occupational therapy and physical therapy are entirely unrelated specialisms. You're right, they do get lumped together, but they have about as much in common as dentists and gum guard manufacturers do.

The physical therapist is part of your sister's ongoing health care team. The therapist will identify and treat physical problems that your sister might have with balance, mobility and pain, and provide her with information and exercises for continuous improvement. There are also specialist PTs who can help with such things as breathing difficulties and many other chronic symptoms.

Occupational therapists assess the environment that the person is living in, identify particular or general problems that the person might encounter with activities of daily living, and recommend adaptations such as hand rails, bathing aides, removal of obstacles and so on; as well as suggesting different ways of doing things - such as cooking or bathing - that will be easier and safer for the person to manage independently.

So it's just not an either/or choice. Depending on your sister's particular needs, she is likely to benefit from both. But I am surprised that her discharge team did not recommend a home visit from the OTs prior to her going home - how did they know it was a safe environment for her?
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Each time mom was in the hospital the last 18 months of her life, she was prescribed physical and occupational therapy as well as a personal assistant...each twice a week.

I'm guessing your mom's outpatient occupational therapy and personal assistance either fell thru the cracks, or, for some strange reason, that particular hospital or her physician doesn't prescribe that regime. Another example of why we must be proactive when care taking our loved ones.

In mom's case, the occupational therapist recommended grab bars in and around our walk-in shower and even had a name and number of a man who could reasonably install them . . . She showed me how to get mom out of bed . . . How to more easily help her get dressed . . . How mom could safely do any number of things . . . Very helpful.

Medicare paid for the personal assistant (for bathing), occupational AND physical therapist, and nurse -- each twice a week. The visits lasted WEEKS until, usually, I would stop them -- rather than the service saying, "We don't think your mom needs us anymore." It was a Godsend.

In my opinion, every senior should have a few visits (at least) from an OT. They are soooo helpful both to the senior and, even more importantly, to the caretaker.

It's unfortunate that, like sooo many things in life, we don't find out "the ropes" until after the fact. That's why sites like this are so invaluable.

Good luck to sis!
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