Transcription:
Differences between Physical Therapy and Occupational Therapy?

Melanie Cole: Welcome to Say Yes to Good Health with Memorial Hospital. I'm Melanie Cole, and today we have a panel for you, and I think it's gonna be so interesting because not everybody knows the difference between a physical therapist and an occupational therapist. So today joining me is Tonya Dooley. She's a physical therapist and Chevie Lay. She's a registered occupational therapist and they're both at Memorial Hospital.

Ladies, I'm so glad you could join us today. And Chevie I'm jumping right in with you as the OT. I would like for you to kind of go over the differences between a physical therapist and an occupational therapist, just in a broad overview, and then we'll get into some of the differences in the training that you receive and the conditions that you both work.

Chevie Lay: Okay. Hi, I'm Chevie. So the main difference between PT and OT, we get this question a lot, but physical therapy focuses on movement and improving the person's ability to move their body. Whereas as an occupational therapist, I'm more focused on what we. ADLs a person's ability to complete their everyday activities. The things that they need to do want to do are expected to do on a daily basis. So there is a lot of overlap, but our lenses are focused on two different areas there.

Melanie Cole: That's interesting to me as an exercise physiologist, I see the functional aspect of what you do Chevie. So Tonya, tell us a little bit about the differences in training between the two of you. If you're doing rehab injury prevention, I mean, it kind of seems to me that we're all kind of doing similar things.

Now didn't used to be that way, but now athletic trainers and EPs and PTs and OTs and chiropractors, we're all kind doing such similar things now. But tell us a little bit about the differences in training that a physical therapist receives versus an occupational,

Tonya Dooley: therapist?

Well, as far as my training I'm old school, so I do have a bachelor of science and physical therapy. So, I went to St. Louis university and we had the kinesiology neuroanatomy, that one got a lot of people. Cardiac. We really were trained in a broad area. And as far as what we're doing here at Memorial, we don't see outpatients, we only treat inpatients.

So, my arena is, as Chevie was mentioning, improving mobility, improving function. We see people here who have acute illnesses. They might come in with pneumonia. COVID they might have a total joint replacement. So we're getting in there as soon as possible. And just trying to help them move better try to ease pain as we can use modalities if necessary where the OT.

They're kind of focused on, Hey, let me see you put your socks and shoes on can you let's see how you to it. Some of those ADLs as Chevie was mentioning, so that's kind of, I'm not sure how Chevy was trained, what all courses that she had to take. But as far as my training, just anatomy, kinesiology movement those types of things.

Melanie Cole: Chevie, why don't you chime in here? Tell us a little bit about what you did a little bit different than what Tonya was just describing.

Chevie Lay: Yeah. So I have a bachelor's of science in psychology, and then I went to Washoe in St. Louis to get my master's degree and they still offer a master's and a doctorate program, but they are transitioning to primarily requiring a doctorate for occupational therapy too. And so I would say I had very similar class topics, neuro anatomy, kinesiology, things like that, but I also had psychosocial classes and as well as addressing cognition as well.

So I would say it's a very holistic approach. And at the end of the day, we're doing a lot of what I would call activity analysis to determine how all of those different factors, a person's strength, cognition, mental health, how all of those factors can interplay, with the different roles and habits and routines that a person has. And how that affects their performance. And ADLs IDLs.

So cooking, cleaning, laundry work. All the way to how they feed themselves, how they dress themselves how they interact in school settings. I primarily work with adults, older adults but OTs can work just like physical therapists in a variety of settings and age groups. But here at Memorial, we're just inpatient and we do see Individuals at an assisted living facility too. So yeah, that older adult population primarily, but yeah,

Melanie Cole: Hearing you guys talk about that takes me back to my graduate school days, because I mean, I really had all those same classes and I kind of got the combination because we had cognitive function classes and all the Kinese and all that. I hated the math classes. Well, I don't know why we had to take those, but biomechanics and then adding into ours was more some of the exercise science end of it, of the body's response.

But all of us, similarly in the field of trying to get people back to a better quality of life. So Tonya, when we're speaking about the goals of PT, as you see it in patient, and you're seeing these patients, when you're working with them, what are you doing? Are you doing different exercises? Do they work in the gym? Are these bed exercises? And tell us a little bit about some of your outcomes.

Tonya Dooley: yes. So, depending on the patient, I mean, we have had unfortunately, this pandemic that we're in, we've seen several COVID patients who, before this recent variant, they started out pretty much bedbound. And we can do exercises in bed. We can also work on just sitting at the edge of the bed, maybe transferring to the chair.

Watching monitoring vital signs as we go you know, watching their oxygen saturation, making sure they're not dropping too much. Some of these patients were hooked up to high flow, nasal cannula, oxygen. Vapotherm I mean, pretty serious stuff. When we were kind of in that, that phase of COVID.

So, part of what we did too, is kind of help educate the doctors and nurses on what therapy can do for these patients. We're not gonna go out and jog them down the holes by any means. We are just looking at where they're at at that time and treating them there. So it could be as simple as ankle pumps.

You know, having them do some marching in a chair transferring to a commode because they can't walk to the bathroom or they're hooked up to an oxygen unit that doesn't allow them t o walk that far. So, those are kind of the more basic types of things that we do. And then, on the other hand we have total knees, we have total hip replacements that we're getting out of bed.

Walking them to the bathroom, teaching them how to use a Walker safely performing transfers safely, all the safety awareness issues that we need to be cognizant of that sometimes the patient doesn't realize. And then we do have a gym, so we have weights, we have balance pads. We have stairs that we're training them on. Just we balance is really huge for us. So that is something that we really focus on.

And we're trying to pretty much. Most of the patients that we see here are definitely geriatric and probably have had a fall at some point. So we're working to reduce fall risk. So just all kinds of exercises, theraband weighted exercises, ball, tossing, balloon tossing trunk rotate. I mean, you name it. We're doing all kinds of things. Sometimes if it's a stroke patient we're working on Seated balance exercises, progressing to standing working in front of a mirror.

So it really just a whole wide realm, and that's what's great too. At the hospital, we see such a diverse population of patients. So we're getting to treat something different every day, which I love.

Melanie Cole: It does certainly make for an interesting career and Chevie, tell us a little bit about how you work with patients, because Tanya just gave us a really great overview of how she works with patients and what those goals are. Now I would like you to speak about some of the goals. We already mentioned a little bit that it's functional, but not everybody listening understands what that means.

Are you working with them? You know, you're tying shoes, putting shoes on, being able to dress themselves, brush their teeth, do in the kitchen? Tell us what you do.

Chevie Lay: Absolutely. Yeah. So this kind of comes back to that activity analysis. So my primary focus is on ADLs, bathing, dressing, toileting, things like that, but there's a lot more that goes into it than just that. So to be able to go to the bathroom, you have to be able to transfer, stand, pivot, reach, fine motor strength, gross motor strength, all coordination.

There's you have to have the initiation to do that and to sequence through that. So that's where that activity analysis comes in to break down one big activity into little parts and then addressing those. So I would say half of our time is spent in a patient's room in their bathroom, in their room, getting dressed, standing at the sink and grooming things like that. And some of it is in the gym, and working on strengthening.

Lifting weights, there, bands clothes, pins, things like that. I think that sometimes occupational therapists can be tunneled into just ADLs, but that's that's not always the case. We do do full on strengthening balance and walking too, as well. And that's where it's really nice here. We can do a lot of co-treat with physical therapy to be able to both offer our different lenses in a way that truly benefits the patient holistically.

Melanie Cole: Well, that's really what it's all about. We're treating the whole person here, right? So Tonya, just very quickly, we only have about a minute left. Where can people find out more about the physical therapy and occupational therapy services that are offered at Memorial Hospital?

Tonya Dooley: So yes, people can find more information by visiting our website at mhtlc.org.

Melanie Cole: This is an important part of what you guys do is this transitional care. So Tonya, why don't we start with you? What does that mean transitional care?

Tonya Dooley: So transitional care is if you find yourself needing some extra time maybe to recover from a surgery or an illness or an injury our swing bed program just allows you to recover in a hospital setting. that might be close to home. So sometimes we have in patients here already that have been admitted into acute care.

Like maybe some of the COVID patients is that we were discussing earlier and after. So many days they've medically improved to where maybe they're off the oxygen or they've decreased the level of supplemental oxygen needed, but they're just not strong enough. They're not ready to go home.

And depending on home situation, some of them might live with a spouse. Some of them might be alone. So if they need some extra time for strengthening and to just regain all of their prior level of function, that's what our swing bed is.

Melanie Cole: Okay. So Chevie, based on that, tell us a little bit about some of the complex patients that are a good fit for that kind of transitional care?

Chevie Lay: Right. Yeah. Just like Tanya said, it could be anybody. That's recovering from an illness, an injury, a surgery. And just like she said, they're not they're, they don't need to stay in a hospital, but they don't need to go to a nursing home for that long term. They just nee this two week kind of boost to get them back to where they need to be to transition from the hospital to home safely.

So like she said, we've seen COVID. We've had some of our hips and knees stay and transition to swing bed for a very short amount of time. We've had people have fallen or pneumonia or really the it, everybody ,we've kind of seen it. Older adults specifically, but yeah in this county, there's not a single nursing home in this county.

And so this has been huge for our community and having an opportunity to stay here longer, versus just pushing someone out the door to get the next person in. That's not the case here. Really giving them that additional time and support that they need to ensure that they go home and they stay home safe.

Melanie Cole: So Tonya what's involved then as Chevie just said, if there are no nursing homes in the area what's involved in getting into this transitional care, this swing bed program? Because what a great program. But I know sometimes, and in some places, even around where I live, they fill up. So, how does all that work? How does the referral situation work?

Tonya Dooley: Yes. Well, we have a terrific social worker discharge planner, who she might get a referral from an outline hospital. And again, in this pandemic there's just there's not anything close sometimes. So even sometimes we've had patients that maybe live in Quincy but there's nothing in Quincy for them.

So they've made a referral to us. The social worker reviews their paperwork, their chart, their acute stay. Sometimes the nursing director will look over it. And then physical and occupational therapy will look at those notes to determine if that patient might be an appropriate candidate for our swing bed unit.

So, yeah, we can get referrals from really all over and maybe somebody has gone to a more distant hospital to, to have a surgery or some type of procedure that you know, that we can't do here at Carthage, but yet they want to come back to their home area so that family can visit. They can be in a supportive environment that's familiar to them.

We're a close knit community, and our hospital staff we're Family. So patients really like we have private rooms that are just beautiful. We have a, a wonderful hospital here that was built in 2009. So we have a lot of nice amenities and patients just they really get focused unique care that's just for them.

We have patient care meetings, care meetings every week with the patient and their family. And they meet with the social worker, the dietician, the pharmacist physical therapist. there's a meeting and sometimes the doctor is present too, so that we can talk about their progress and the care that they've received.

And if they have any questions, just everything is really focused on getting them better. And most of these people's goal, we always ask what's your goal. Well, they wanna go home. So that's our focus. That's what we want them to be able to do safely.

Melanie Cole: Sounds like a place they wouldn't wanna leave. Because It's so nice. Oh man. As you guys are all like family to them and these nice rooms now Chevie, I'd like you to tell us what a day is like for them? Do they have daily, physical, occupational and even speech therapy? Are you working on breathing wound care? Tell us about what a day is like for them?

Chevie Lay: Absolutely. So, we have an initial evaluation that we do that kind of talks about. what does home look like? What were you responsible for at home and what your goal is? We build a treatment plan based on that. And then depending on the patient what physically, how they're physically performing at that time, we'll either see them co-treating PT and OT together occasionally.

Most of the time separate, but we usually ride our treatment plans for twice a day, five days a week. And so if we see our patients separately, They have four treatment sessions in a day. It is very rigorous. It is intense. It's way more intense than acute. I would argue it's more intense than skilled nursing as well, but that's just what it takes in this environment to maximize the time that we have, which is an average of seven to 10 days to get somebody back to where they were.

So for example, I usually do about an hour. Mostly ADL treatment session in the morning. And then in the afternoon, work, working on strengthening balance, endurance things like that, whatever that person obviously needs. Everybody looks differently, but it is intense. So you can expect two to four treatment sessions a day, Monday through Friday. We don't treat on the weekends, but that's why during the week it can be pretty intense.

Melanie Cole: But it does the job.

doesn't it?

Chevie Lay: Yeah, absolutely. It does. Yes.

Melanie Cole: Gets them, it gets them back to a functional capacity and Tonya that's where my next question is kind of going, is you're working with the patient and you have hospital level nurses and you have this home environment and all of you great specialists. What about working with their family and their care team where in this continuum of care is actual transition to home, worked on as Chevie was saying, that we find out what were they doing at home? What were their responsibilities? What do they need to get back to? But where does that fit in? And do you work with the family as well?

Tonya Dooley: Absolutely. We love when family members are present, we hated those times of COVID where we couldn't allow visitors, that was detrimental to our patients. So, I mean, we can make phone calls, but it's not as good as if they're right there in front of you and they can kind of sometimes the patient might be a little Ory or not wanna give all information.

So we can kind of double check with the spouse, Hey, is that true? Was he doing all that? So it's really great to have the family reporting as well, what that patient was doing at home. And so they're on board too. It's not just sometimes it's a daughter or son. We have all kinds of situations, but family members are very important to our treatment plans.

And we have actually started something, when we feel necessary for the patient. We will go and do a little home visit prior to the patient's discharge. So the patient is allowed to go out on a pass with their family. The family has to drive them home and then. Someone from physical therapy and someone from occupational therapy would both go out separately and do a home assessment.

So we would see, okay, how many steps do they have to get into their house? How many stairs? What's their sidewalk situation outside their home? Is it bricked paved? Is it crumbly? Is it cracks on the sidewalk? How tall are the steps to get into the home? What does their bathroom situation look like? What kinds of adaptive equipment would we recommend for them?

Do we recommend a shower chair? Do we recommend a toilet riser? I know I was in one home and, and the gentleman had a bed skirt around the bottom of his bed. Well, that's a trip hazard with his Walker. His Walker gets caught up in it and he could fall to the ground. So picking up, throw our rugs, making sure there's no cords on the floor, just all of those safety things.

We can look at that in a home and say, Hey, why don't you take care of this? And you know, family members right there, taking our recommendations and then they can have that ready for the patient when they return home.

Melanie Cole: Wow. Such comprehensive care. And we just have about two minutes left and I'd like for each of you to give a final thought, so Chevie, benefits to the community in the surrounding area, what would you like them to know about Memorial Hospital swing bed and the role of physical therapists and occupational therapists?

Chevie Lay: Yeah. So we're a small hospital, a small community, but that does not negate what we do here. And we can provide truly comprehensive quality care in your hometown or close to your hometown. You don't have to go to a big city to get big results. So I just want everybody to know that you can come here, trust the process, trust us to provide the best care and improve you or your loved ones quality of life, ensuring that they return home safely.

Melanie Cole: Wow. I don't know Tonya, if you can beat that when she said you don't have to go to the big city to get big city quality care in hometown. I love that. That was just awesome. You wanna repeat that Chevie? What you just said again about that.

Chevie Lay: You don't have to go to a big city to get big results. It's a small town, small hospital, small community, but that is our strength. That is truly who we are.

Melanie Cole: Oh boy. What a great, great thing. Well, I thank you ladies, both so much for joining us today and really telling the community and the surrounding area about all the services that you offer, because it is amazing. And I can tell by the passion in both of your voices, you're both very good at what you do. And compassionate.

So thank you again for joining us and for more information, call 217-357-8575, or you can visit mhtlc.org, search treatments, transitional level care, swing bed. And you can find out more about all of this that we've been talking about today. That concludes this episode of Say Yes to Good Health with Memorial Hospital.

We'd like to thank our audience and invites you to download and subscribe, rate, and review when this is a podcast on Apple podcast, Spotify, Google podcast, share these shows with your family and friends on your social channels, because we are all learning from the experts at Memorial Hospital together. I'm Melanie Cole. Thanks so much for joining us today.

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