Reflections of a New Grad: Delivering Telehealth and In-home Services.

What Telehealth Made Me Realize

I met my first patient as a physical therapist through Telehealth. The camera angles were all over the place, the video was blurry as the wifi kept cutting off, and the parents were overwhelmed. It was in September and parents in my school district had to become teachers and therapists while still being parents for all of their children and balancing a work schedule. I never met any of the parents during my clinical rotation at a school based setting, so this was a new experience for me, but it also shaped me into a much better physical therapist because of it.

Even if you are not a school physical therapist, I feel as though there is a definite disconnect between PT sessions and the reality of what the patient goes through on a daily basis. I had children who were safe with stair navigation in their school environment based on their documentation, but would practice unsafe behaviors in the stairs while in their home. Children who were able to follow directions effectively during therapies at school, but in the home would want to play on their Ipad instead of participating in therapy.

Even more unfortunate, I had children that due to their neurological condition became severely deconditioned due to lack of daily activity that they would have gotten in a school day.

It was also interesting to learn how unaware some parents are of their children’s condition, most specifically Autism, many parents were frustrated on how their child wasn’t able to learn how to perform a new task in the same session that I introduced it in and I had to educate them on how children with Autism learn things differently.

It frustrated me as well that even though as a school physical therapist I can help a child negotiate their school environment, only a fraction of what I teach the student will make it back to their home.

Fulfillment in the Home

I had clinical rotations in the outpatient, inpatient, school, and home care setting. While it is because of my school rotation I fell in love with the pediatric population, it was my home care rotation that I felt the most fulfilled.

I work as a school PT, but I also deliver EI services in the home. So far, I entered homes that ranged from large playrooms with endless amounts of toys to a parent who only had a couple of toys for their child to play with.

Last week, as I was about to head out, I had a mom hand me her phone and asked me to translate for her because she wanted to rent an apartment. The person on the phone yelled and told me she would never rent it to someone who doesn’t speak English. The mom has a child with DS who is on a feeding tube and she just wanted an apartment with extra space for her child to learn how to walk.

This was just one story of many ways home care can really let you into your patient’s actual lives. More so than when I take history in the clinic, but actually experiencing their life with them. It makes me aware of how I can best help them with the resources they have available.

There are benefits of receiving therapy outside of the home since it is a place to try out different equipment that I would be unable to bring inside the home. Moreover, it is beneficial for the child to explore various environments and meet new people. Patient/caregiver education is given (hopefully) and can be given in any setting; however, whenever I am able to adjust their home environment and also make use of the resources they have available in the home, it brings me so much joy that I can’t even begin to explain it.