Wednesday, March 2, 2016

Home Health Physical Therapists Using Yoga as a part of their Treatment Interventions

Home Health Physical Therapists
Using Yoga as a part of their Treatment Interventions

They say 'Forewarned is Forearmed', but who knew the concept would one day be successfully applied to medical aspects of illness and medication. Although we all know that the diseases that are diagnosed at an early stage have better chances of being cured, but the new discoveries put light to therapies that can stop pain before it gets out of hand. 

Why Home Health Care?

With an increased trend in the Home based health care program people tend to avoid the huge hospitals and the formalities that come with it. Among the famous practices that are now replacing frequent visits to the hospital include chiropractic, acupuncture, respiratory treatments and general pain relief. The side effects caused by the allopathic treatments and the vast amount of expenses that the hospitals charge for common pains and strains are the main reason for the popularity of Home Health Care. 

The Importance of Yoga

There have always been a gym period at school and doctors are forever in the favor of exercise, but the concept of Yoga has never been given the importance it actually deserved. Research has it that Yoga can help treat the chronic aches and the nervous misalignment that even the Physical therapies cannot cure. It's for this reason perhaps that the Physical therapists in Los Angeles have officially included Yoga in the list of their treatment practices. Here is how you can take maximum benefit of Yoga exercises.

The Safe Procedure

To take the most of something, the first step is to understand the concept.  Many people who have been attending Yoga classes for more than a decade might complain of the uselessness of the effort, while others have convinced themselves of the healthiness of exercising whether or not it makes a physical difference to them. The first step for individuals is to realize that Yoga is not merely an exercise, but a treatment that can relax their muscles, improve their blood flow and treat their posture problems.

Like medicine, the different ailments require different antidotes, and it is crucial that the patient realizes where and how they are suffering. One you have determined where the problem lies, visit renown Home Health Care Agencies so that you can rely on them. The next step is to inquire the agency of their credentials and proceed to discussing your physical infirmity with them at length. You may not realize how important this procedure is, for Yoga if used without official advice may lead to the physical condition getting even worse.

Benefits of Yoga in Home Health Care

Whether you are past the retirement age or still young and fit, exercise classes would help retain your healthy attire for a longer period of time and lower the chances of swollen bones and rigid muscles. Here are a few other reasons why Yoga is essential for your health.

Yoga can help prevent and lower:
  • ·        Sugar level.
  • ·        High blood pressure.
  • ·        The breaking of your cartilages.
  • ·        Pain in the joints and spinal cord.

Yoga can improve:
  • ·        Your structural balance.
  • ·        The flexibility of your body.
  • ·        Your metabolism.

Yoga can maintain:
  • ·       Your nervous system alignment.
  • ·        Better posture.
  • ·        Increased breathing system.

Saturday, February 6, 2016

4 Things You Need to Know about Fall Prevention

Falling can be dangerous for any individual, but it is especially dangerous for seniors and the elderly. As we age, our bones become less and less dense, making them more fragile and susceptible to breaking, even with just a simple slip or tumble that would have left us just with bruises when we were younger. Preventing falls should be the primary concern of any senior or any person who is a caregiver to an elderly person. Here are four things you need to know about fall prevention:

1.      You can ask your doctor about the best way to prevent falls. Not only will your doctor know which of your medications could potentially make you more likely to fall (many medications have dizziness as a side effect), he will also know about your fall history and if you have any conditions (like a heart condition) that might make you more likely to fall.

2.      You need to wear better shoes. Not all shoes are created equally. There is a reason that you often see seniors wearing the same types of shoes—shoes with thick, heavily-treaded soles and plenty of cushioning. These shoes make it much less likely that you will slip on a slick floor or lose your footing on a step, which significantly lowers your chance of falling and breaking something; an injury that is much more serious at fifty, sixty, seventy, and beyond than it is at ten or twenty.

3.      Staying active is actually one of the best ways to prevent a fall or to keep a fall from being severe. It might sound like the safest way to prevent a fall is to sit in your home and avoid going outdoors or walking around. The opposite is actually true. If you stay physically active, not only will you preventing the natural loss of bone density, you will also be improving your coordination and flexibility, which means fewer falls and a much lower chance that the fall will be serious.

4.      You need to make your home fall-proof. This doesn’t mean that you have to move into a padded room, it just means that you should be mindful about hazards in your own home, like cords, rugs, loose floorboards, and boxes. You will be far less likely to fall if there are fewer things in your home to trip over.

We at the Center4PT Services, Inc. can arrange for a Home Safety Assessment, a session to discuss specific Fall Prevention/Recovery Strategies, and or the proper use of adaptive equipment such as walkers and canes in an effort to prevent falls and other injuries in the home.  Call us to schedule a home visit.


Wednesday, January 27, 2016

Edema and Home Health

Edema and Home Health
By Ralph Santos, Center4PT Services, Inc.
January 2016

In the home health setting we often encounter cases of edema which typically occur in the bilateral lower extremities.  This edema can often deter the patient’s ability to perform their activities of daily living (ADLs), can cause a decreased active range of motion (AROM), can contribute to pain or discomfort, can negatively affect our clients emotional well being, can disrupt our clients circadian rhythms, can induce harmful stress levels and so much more.  As home health therapists we need to understand what are the causes of the edema, how to properly assess and document the edema and how to properly treat the edema.

Causes of edema.  Edema or swelling is the accumulation of fluids in the tissues which can be attributed to either a systemic cause.  The organs that generally contribute to the systemic related edema are the liver, the heart and the kidneys which can be related to excessive sodium levels.  Another cause of edema related to the liver and the kidneys can be a decrease in albumin levels. 

Pitting Edema versus Non Pitting Edema.  Edema is often measured by two subjective tests:  (1) how deep is the space on the limb after you release pressure with a finger and (2) how long will it take for the limb to return to its resting state.  Pitting edema can be seen by applying pressure with ones fingers to the affected limb or in many of my patient’s case, by removing their shoe or socks and looking for what appears to be a tourniquet or indentation caused by the shoe or sock.  In non pitting edema, the skin does not indent and one of the major causes for non pitting edema can be the diagnosis of lymphedema which affects the lymph system.  My own experience is that with lymphedema the cause is related to breast cancer with a subsequent mastectomy, lymph node surgery, radiation therapy and or an increased stress level.  Other reasons for non-pitting edema may be a low thyroid level or a deep vein thrombosis (DVT).

Here is a scale that I found in the 2015 Corridor Group Therapy Quickflips:

Edema Score
Depth of Pitting
Response time to Refill
0.6 cm (0-1/4 in)
10-15 Seconds
0.6 – 1.3 cm (1/4 in – ½ in)
1-2 Minutes
1.3 – 2.5 cm (1/2 in – 1 in)
2-5 Minutes

I can honestly say that assessing edema can be quite subjective but this scale and others like the:

1.  O’Sullivan, S.B. and Schmitz T.J. (Eds.). (2007). Physical rehabilitation: assessment and treatment (5th ed.). Philadelphia: F. A. Davis Company. p.659

2.  Hogan, M (2007) Medical-Surgical Nursing (2nd ed.). Salt Lake City: Prentice Hall

3.  Brunner L. (1982).The Lippincott Manual of Nursing Practice. (3rd ed.). Lippincott Williams and Wilkins, Philadelphia. p.36

are other options, with the bottom line being that we as home health therapists need to be consistent when documenting edema.

How to treat edema?  The conservative edema reduction strategies can include: 

(1) Teach and encourage active range of motion exercises (AROM) to help with circulation and assist the heart in pumping excess fluid.

(2)  Elevating the affected limb above the level of the heart.  I usually tell my patients to elevate their limb(s) when going to sleep since we spend half of our lives in bed.  I also tell my patients to avoid dependent positions during the day using chairs with arm rests, splints and other external devices for positioning.

(3)  A very superficial massage where you elevate the limb above the heart and massage the fluids back towards the heart may be helpful.  When I was going to school, this was often referred to as a retrograde massage and when I got my certification in lymphedema, I learned that the lymph system is very superficial and a light massage is often very effective.

(4)  Compression via TED Hoses or other garments.  These garments provide a certain amount of MM Hg (millimeter of mercury) and are often prescribed by a physician.  The only problem with these garments is the actual donning/doffing process but otherwise it will help with preventing fluid from collecting in the tissue.

(5) Skin Hydration.  I always tell my patient’s to keep their skin clean and well moisturized.  I usually recommend an aloe vera based lotion during the summer months and a butter based lotion during the winter months.  I myself stay away from thick oil based lotions such as A&D, unless there is a certain medical reason to use said lotions.

(6) Salt.  Reducing the amount of foods that contain sodium is essential.  A television dinner, a microwavable noodle soup, and other foods that our patients consume due to ease of preparation contain a ton of sodium and this will only contribute to their edema battles. 

Finally, the physicians will often look at other treatments such as using diuretics which have their own pros and cons.  My thought is that we as home health therapists need to be cognizant of the causes of edema, how to properly assess/document edema, and how to teach our patients to incorporate conservative edema reduction strategies. 

1.  Therapy Quikflips, The Corridor Guide for Home Health Therapists. 2015.

As a clinician and active owner of the Center4PT Services, Inc., I believe that client care is the utmost priority with our company being on the leading edge with its customer care!  We are home health staffing agency that partners up with skilled home health agencies and hospice agencies in the Los Angeles County to provide skilled Physical Therapy, Occupational Therapy, Speech Therapy and Social Work Services for homebound clients.  Our mission is to be the leading provider of in-the-home Therapy Services in the Greater Los Angeles area by providing Timely, Quality, Efficient, & Competent Therapy Services to all of the Clients that we Serve!

Our focus is on the rehabilitation of our clients and ensuring that our clients get better and progress towards independence!  We know that through hard work and through perseverance our clients get better, stronger faster!  We also realize that in today's medical model we have to do more with less with often medical insurers authorizing less visits and demanding more functional results.  We have made many adaptations to include using on line resources for our clients and making those vital phone calls to ensure that our clients indeed are making gains with our staff.

I cannot stress enough how important it is for our staff to be competent and compassionate towards each other and towards our clients.  If you are looking for a solid home health company with lots of experience and lots of support, then the Center4PT Services, Inc. is your new home!

(626) 683-9959 Office                                                               Email:

(626) 683-9969 Fax                                                                   Website: