Community physio has a wide range of programs designed to keep the elderly population in the community active, mobile and out of hospital. Abilities classes are targeted for neurological patients and classes can have a range of patients from parkinsons, to stroke, to dementia. Some of these classes are high level function, concentating on imporving blaance, muscle strength and ambulatory function under supervision. Others are low level function and consist of high falls risk patients that need help to maintain a baseline level of transfers and balance to stay out of nursing homes.
One class i am currently attending is a very low level balance group. The class consists of 8-12 patients with a high involvement of dementia as well as one patient (only in her 50's) with cerebellar ataxia. There are 5 patients in the group who require close standby assistance or use of a chair or aid to keep balance. The patients are situated around the room in an oval shape and the majority of the exercises are performed in sitting. It is however, vital to incorporate a balance component and lower limb strengthening in standing so that these people can remain mobile.
On Friday, the physio and i, we were busy trying to ensure that all patients were safe in the activities. One patients, with dementia, forgets that she is unable to stand unassisted, so in commencing standing exercises, she jumps from her chair and tries to walk around her chair. The physio has to be there straight away to stop her and prevent her from falling. 4 other patients in the same group need chairs in front of them for stability and cannot walk around their chairs to do so. The phsyio must move chairs aroudn the room everytme the group stand up.
I was sitting in amazement watching the physio run this class. She had to be watchful of every patients movement and was unable to stand near all the patients that needed assistance. In order for these people to remain in the community, the classes are vital for function. Yet when so many patients are a high falls risk, the physio has a huge responsibility. So my question is.... is there a role for PTA's or carers to provide assistance in such classes to increase the class outcome and safety of patients and physiotherapist.
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I reckon that there would be a role for PTA's to help out in community physio classes. Just to have another pair of eyes to be able to spot anyone having triuble would be beneficial. However, unfortunately the real world never works the way we want it to, and there probably wouldn't be the funding and such for a paid position. Maybe it would be good for the person's carers (if they have any eg husband or wife)to attend the class with them, which would also give added benefit because the carer would possibly be able to encourage the pt to do their home exercises. Of course, then the necessary education would have to be provided for the carers.
Maybe that's one of the reasons why they get a student to help out, so they get an extra pair of hands!
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