What is Outpatient at Home
Occupational Therapy?
Outpatient at Home Occupational Therapy is actually just what is sounds like - outpatient-level care provided to you at home. We function just like a clinic you would walk into in your neighborhood, we take the same insurance, and run by the same rules, but we provide our care to you in your home. Read on to learn more about what we do, and what makes Healthy Aging so special.
Why do we treat you at home?
Accessibility
We know it can be hard to get out to a clinic, so we bring the clinic to you. Most of the people we work with either no longer drive and would need a ride, or getting up and ready to go and out the door is challenging enough that by the time to they get to a clinic, they may not have the energy to participate fully in the session. When you throw in a New England winter and world-wide pandemic to the mix, care at home becomes a far more accessible option for the people that need it the most.
Attention
Treating you at home allows us really to focus on you - and for you to really focus on us. There aren’t other patients or therapists around that require our attention, or phones ringing and people bustling about causing distraction. When we work with you in your home, you have our undivided attention, and you can really get the most out of each session.
Fall Prevention
We love to see our patients where they feel most comfortable, and home is where the heart is. It’s also where they tend to have the most falls. Approximately 60% of falls happen at home and by working with you in your home, we can help troubleshoot any problem areas and make meaningful suggestions to make it safer. Our occupational therapists are expert in home safety and can help you make some really helpful changes to make your home more accessible.
What about the gym equipment?
Sometimes people wonder if they need to be in a traditional clinic because of the equipment choices they offer. All of our therapists travel with a trunk full of rehab supplies so you can feel confident they will bring what they need to give you the best care possible. We have many specialty items we bring to try with you like walkers, rollators, U-Steps, transfer devices and Cubii seated ellipticals. If there is something we think you would really benefit from using that we don’t have access to, we will work with you to find you a clinic that can provide that service.
What do you work on?
Self-Care and Household Management
First and foremost, Occupational Therapists love to work with you on your ability to take care of yourself (ADLS or Activities of Daily Living) and your home (IADLS or Instrumental Activities of Daily Living). Self-care encompasses everything you need to do to clean an groom yourself, dress yourself, feed yourself and maintain your health and wellness. Home Management is all the stuff you have to do to keep the house up and running. More specifically, we work on ADL and IADL tasks like:
Toileting: How you get on and off the toilet, perform your personal hygiene and any adaptations that might make this process easier.
Grooming: How you perform things like hair care, oral care, nail care and skin care to keep yourself clean and groom yourself.
Showering: How you get in and out of your shower, bathe yourself and we assess for any adaptations that might make this safer or easier.
Dressing: How you take on and off clothes, use buttons, zippers and other fine-motor tasks that are involved with dressing and undressing.
Self-Feeding: How you feed yourself meals and stay hydrated; this may include trialing adaptive utensils, plates and cups or strategizing energy conservation techniques if self-feeding causes fatigue.
Meal Planning and Preparation: Meal planning and preparation is a tough task! It not only requires planning and preparation, but also fine-motor control and organization. Occupational therapists work with you on the skills you need for each step of the process and can work right alongside you in your kitchen at home.
Housekeeping: Like meal planning, housekeeping tasks can be pretty complex, but also require significant strength and balance. Occupational therapists work on both the physical prerequisites (strength, balance, endurance, coordination etc.), and on the actual tasks to help you find ways you can complete these chores more efficiently and with less fatigue.
Bill Paying and other Functional-Cognition Tasks: Occupational therapists are also great at helping you find ways to keep track of your household management systems - grocery planning, bill paying, caregiver management and more. They will also assess your ability to manage your medications, use the phone and access transportation effectively, and will help you improve these areas if needed. Many older adults experience some degree of memory loss and slowing of cognition, so these tasks can be increasingly difficult. Our occupational therapists can help you use compensatory strategies to get these tasks done consistently and successfully.
Strength + Stability
To get you to function at your best, we also spend a lot of time teaching you how to exercise to improve things like your strength and stability. For example, showering each day requires considerable strength, balance and aerobic conditioning. We all lose muscle strength as we age, so even if you weren’t doing any regular strength training yet, it is critical to make strength and stability training a regular part of your weekly routine.
Aerobic Endurance
Aerobic exercise is also a really important part of keeping you healthy as you age. Not only does it support heart and lung health, but it improves things like your mood, your sleep and you help you better manage your blood sugar. It is recommended that you regular perform 150-300 minutes of moderately intense physical activity each week for optimal health and aging - we work with each of our patients to find a way to make this happen in a way that both feels good and is enjoyable, so this becomes a consistent habit and part of your everyday life.
Balance, Fall Prevention + Fall Preparedness
We love to see our patients where they feel most comfortable, and home is where the heart is. It’s also where older adults tend to have the most falls. Approximately 60% of falls happen at home and by working with you in your home, we can help troubleshoot any problem areas and make meaningful suggestions to make it safer. We work first on figuring out what may increasing your fall risk (is it strength, postural control, dizziness, low blood pressure, medications or a mix of everything combined?), and then we work alongside of our Physical Therapy partners on these areas to improve your balance, your ability to respond the right way if you do lose your balance, and we take it one step further and teach you how to fall safely if you are going to hit the ground.
Pain Management
Unfortunately, getting older is often associated with its fair share of aches and pains. This can be due to number of factors including changes in posture, reduced overall activity, arthritic changes and joint wear and tear, falls and fall-related injuries and neurologic changes like neuropathy and central pain syndromes. Fortunately, many of the aches and pains associated with aging can be significantly improved through corrective exercise and increasing your overall activity level. We will work with you on identifying the root-case of pain you may be experiencing and will address it with specific therapeutic interventions that will help reduce the pain and teach you better pain management skills for pain that may be more chronic in nature.
DME + Assistive Devices
DME stands for Durable Medical Equipment and Assistive Devices are things like reachers, long-handled shoehorns and sock aides and that you can use to make your self-care and household management tasks easier. We will help you try different assistive devices if we think you would benefit from using one. We also often work with our patients to modify their homes using things like grab bars, bedside commodes or raised toilet seats, and adapted shower benches to make reduce risk of falls and increase ease with mobility and self-care tasks.
Health + Wellness
Above all else, we believe our job is to help you achieve a state of good health and wellness no matter what disease, disability or diagnosis you are living with. By applying a holistic approach to our patient care, we look at your life and the way you live in a wider lens and work with you to adopt changes that will help you age well. Sometimes this is working on you to improve your strength and balance, and sometimes this is working with you understand you need more help and helping you figure out where to find it. At the core of every Healthy Aging plan of care is YOUR goals. In fact, it’s the very first thing we’ll ask you on day one - What can we help you with? What would make your life better? What is your ‘big goal’? And then, we work with you to reach it.
Can you treat my condition?
More than likely, yes! We have therapists with a wide variety of backgrounds, and some even have advanced training and board-certifications in Orthopedics, Geriatrics and Neurorehab. We keep a list of the conditions we commonly treat here if you’d like to read more. Overall, we specialize in working with Older Adults, so we are all well-versed in working with people with age-related decline, injury and chronic illness. We also have a number of specialty programs that we are pleased to offer including our Parkinson’s Disease Program, Vestibular Rehabilitation Program, Functional Vision Assessment + Treatment Program and our Clinical Driving Assessment and Treatment Program. You can read more about each of these by clicking on the program name.
How long will you see me?
It depends.
The punchline to every good therapist’s favorite joke is ‘It Depends.’ It is a mantra we are taught in graduate school, because every good therapist knows that the key to effective patient care is treating each and every patient as an individual. This means that we don’t know how much or how long you’ll need us until we perform our evaluation. The duration of your care depends on many factors including your diagnosis, your impairments, the severity of your functional limitations and also, on your potential to improve. After we finish our evaluation, we will tell you how often we think you’d benefit from therapy and how long we think you’ll need it. This number is not set in stone; it depends, again, on how you respond to the therapy, how well you commit to making the changes we recommend, and the progress we see when we reassess you.
Can you see me forever?
This is a question we get frequently. Most people love having occupational therapy. They feel better after their sessions, they look forward to the next one and fear they’ll go back to square one after we leave. However, our role as therapists is NOT to fix you, but to teach you how to take better care of yourself. Occupational Therapy is meant to be temporary; we are there for a period of time, to address any issues we find, help you achieve your maximum functional potential and guide you to make changes to your life that will promote your health and wellness long after we leave. We are also bound by guidelines provided to us through your insurance company to provide services only when therapy is both ‘medically necessary’ and ‘reasonable.’
To be ‘medically necessary’, means that we must be able to prove (through our evaluation and ongoing treatment notes) that therapy is something your body truly needs. If you're experiencing pain, difficulty moving, or recovering from an injury, physical therapy becomes necessary because it can significantly help improve your health and well-being. We must be able to demonstrate that occupational therapy is essential for your recovery.
We also must demonstrate that our choice of intervention, frequency and duration of treatment is ‘reasonable.’ ‘Reasonable’ means that the occupational therapy recommended is practical and makes sense for your situation. It aligns with established medical practices and is a sensible approach to addressing your health concerns. It takes into account your individual needs, the nature of your condition, and what is known to be effective in similar cases.
So, when your healthcare provider says occupational therapy is "medically necessary and reasonable" for you, it's a way of ensuring that the treatment is not only important for your health but is also a sensible and appropriate choice based on the best practices in healthcare.
How can I keep up my progress after therapy is over?
We understand that it can be hard to keep up with all the exercises and suggestions we make so we work hard to make sure you have a plan in place to follow after your discharge. If you are highly motivated and capable, you may be able to keep up with your exercise plan without much help, and that is great! But if you feel like you’d like some help, we have a few options for you. You can choose to pay privately for ongoing care and participate in our Wellness Program with our PTs and OTs, or sign up for Fitness Coaching with one of our HAPT-trained fitness coaches. You can also join us at class! We offer a wide variety of group fitness classes both online and at local senior centers, so you’ll have plenty of great options to stay active after your course of therapy is done. You can read more about these options here.
How do I pay for my care?
Insurance-Based Care
Healthy Aging is IN-NETWORK with Medicare Part B and Blue Cross Blue Shield. This means we can see ANYONE that has one of those plans. Medicare Part B covers 80% of your care; if you have a supplemental or ‘Medigap’ policy, that usually covers the rest, or you may have a small copay. If you do not have a supplemental or Medigap policy, you will be responsible for the remaining 20% of each visit, which is usually around $25 a visit. If you have MassHealth as your secondary policy, this coinsurance amount is waived.
Healthy Aging is OUT-OF-NETWORK with all other providers. This means that if you have a plan that has Out-of-Network benefits (most PPO Plans do), you can use this part of your benefit to cover your care and we would be happy to see you. We frequently see patients with Tufts Managed Medicare, AAARP/UHC and Harvard Pilgrim Health Care this way. If you are not sure if your plan has Out of Network benefits, go ahead and fill out a New Patient Registration form and we’d be happy to find out and let you know.
Private Pay-Based Care
If you do not have an insurance policy that will cover your care with us, or your care is not medically necessary, you can choose to pay privately to have us come out. Sometimes you can submit these claims to a Long-Term Care policy for reimbursement or use HSA or FSA benefits to pay. We also often see patients who are currently being seen by a VNA or are on hospice; in this scenario, we cannot bill your Medicare plan, but you can elect to pay privately if you would like additional session to what you are being provided by these agencies. Our rates for private care are as follows:
Evaluations: $200
Follow Up Visits (1 Hour): $150
Follow Up Visits (45 Minutes): $112.60
Referrals and Prescriptions
We do require a doctor’s prescription or referral to be on file for your Occupational Therapy. Please have your doctor send us a prescription for your therapy via fax. Our fax number is (781) 262 - 3337.