Physical Therapists Trying To Adapt To Parkinson’s

The cause of brain disorder Parkinson’s disease is widely unknown with an incredible 85-90% of cases classified as sporadic and not genetic.

Board-certified geriatric clinical specialist Chris Childers says there is little understanding around people with cognitive issues like Parkinson’s, which limits much needed physical and occupational therapy and requires PTs and OTs to better communicate with patients, with each other, and with those deciding how many therapy visits to allow. Some insurers are so restrictive that every patient regardless of diagnosis gets at most 3 or 5 visits per episode. Part of it is the insurer mindset to force healthcare practitioners to document progress and demonstrate the medical need for more therapy. “I do know that many of our Parkinson’s patients are able to get therapy several times a year if they can show the need, particularly due to the progressive nature of the condition, but it’s still in small increments each time” said Childers.

For highly complex patients, there is a range of annual physical therapy visits that are clinically appropriate based on the medical condition, like a stroke, hip replacement surgery, or dementia.

Nick Panaro, a physical therapist at Northern Blair Therapy, stresses the importance of treating patients with the appropriate level of care needed in order for them to remain safe in their home and reduce chance of an adverse event or hospitalization. With the integration of the new payment model in home health in 2020 many physical therapists have had to adapt to new guidelines. “It’s presented some challenges to visit patterns but we have always urged to continue treating our patients as their condition requires.”

For example, a highly complex patient that requires multiple disciplines in the home for restorative care requires constant and consistent communication amongst the members of the care team to provide appropriate and necessary Home visits for the patient to meet their goals,” said Panaro. His agency has held bi-weekly case conferencing to keep the full therapy team in the loop on each patient’s progress, and is currently piloting a high-risk patient conference call weekly in some of its counties to determine if it improves patient outcomes and reduces the 60-day hospitalization rate.