9.3 Members of the Therapy Team

In a short-term stay unit of a long-term care facility, there is typically a therapy gym where rehabilitation interventions are performed. Therapists may be employees of the facility or may work for another health care organization that contracts with the long-term care facility to provide therapy to its residents.

The therapy team is part of the interprofessional health care team as previously discussed in Chapter 2.3, “Members of the Health Care Team and Nursing Home Structure.” It is helpful to understand the roles and responsibilities of each type of therapy discipline, especially if you work on a short-term stay or rehabilitation unit. Occupational therapists, speech therapists, and physical therapists are the most common types of therapists. Respiratory therapists may be present in long-term care settings that have specialized ventilator units.

Occupational Therapists (OT): Occupational therapists assess, plan, implement, and evaluate interventions to help clients achieve their highest possible level of independence in completing their activities of daily living (ADLs) such as bathing, grooming, eating, and dressing. OTs also teach clients how to use adaptive devices to complete their ADLs. Adaptive devices include long shoehorns (to assist clients with putting shoes on), sock pulls (to independently pull on socks), adaptive silverware (to facilitate independent eating), grabbers (to pick items up from the floor), and special devices to manipulate buttoning so the client can dress and button their clothing independently. These devices are further discussed in the “Promoting Independence During ADLs” section. OTs may also assess the client’s home for safety and their need for assistive devices when they return home (if they are able to do so). For example, OTs may recommend home environment modifications such as ramps, grab rails, and handrails to ensure client safety and independence.^[1]

Physical Therapists (PT): Physical therapists are licensed health care professionals who assess, plan, implement, and evaluate interventions related to clients’ functional abilities in terms of their strength, mobility, balance, gait, coordination, and joint range of motion. They supervise exercises tailored for a client’s condition and teach them how to use assistive devices like walkers and canes.^[2]

Speech Therapists (ST): Speech therapists assess, diagnose, and treat communication and swallowing disorders. For example, clients with expressive aphasia understand what other people say but struggle to get words out, speak in very short sentences, and omit words. They may say, “Want food,” or “Bathroom go.” Speech therapists teach these clients how to use word boards and other electronic devices to facilitate communication. STs also assess clients with swallowing disorders (i.e., dysphagia) and determine if they require thickened liquids or a modified diet to prevent aspiration of substances into their lungs. STs collaborate with other members of the health care team, including nurses, dieticians, and health care providers.^[3]

Respiratory Therapists (RT): Respiratory therapists treat respiratory-related conditions in patients. Their specialized respiratory care includes managing oxygen therapy; drawing arterial blood gasses; managing patients on specialized oxygenation devices such as mechanical ventilators, CPAP, and Bi-PAP machines; administering respiratory medications like inhalers and nebulizers; intubating patients; assisting with bronchoscopy and other respiratory-related diagnostic tests; performing pulmonary hygiene measures like chest physiotherapy; and serving an integral role in maintaining a client’s airway during cardiac and respiratory arrests.^[4]