For the next few issues we will be discussing how therapy services help a senior with an illness, disease, or disability and a few tips on what to ask when your carereceiver needs these services. We will also answer some commonly asked questions.

Therapy services are offered in hospitals, nursing homes, hospital outpatient and community clinics as well as home health agencies.

Community clinics may offer all three therapies and some may specialize in just one type of service. For example, a back clinic may have physical therapists, and a speech and language clinic may be staffed by speech-language pathologists.

A physical therapist designs and implements therapeutic programs to maximize client's mobility. Goals in therapy may include increasing independence in transferring from bed/chair/car/toilet, walking, improving balance and coordination, wheel chair use, decreasing pain, increasing strength, flexibility, endurance and equipment prescriptions. A physical therapy department may have assistants and aides to help with the program.

Occupational therapists design and implement programs which help individuals become as independent and productive as possible in performing their activities of daily living (ADL). A few of the tasks they work on are; cooking, eating, dressing, personal grooming, leisure activities and community reentry. If you think of the term "occupational" as what occupies time, it seems a more logical term.

A department may also have assistants and aides to assist.

Speech-Language pathologists design and implement programs to maximize individual?s communication and cognitive skills. Goals may include understanding conversation, speaking, reading, writing, basic math skills (e.g. balancing a checkbook), attention and memory. They also assess and treat swallowing disorders.

All therapeutic programs should include input and participation from the client, family and caregiver. Your Physician will often initiate a referral for therapy(ies) and the therapist will send periodic progress reports. If more than one therapy services is needed it is usually best to receive the services in one facility so the continuity of the program is ensured. Therapists will work together to treat the "whole person" to achieve the goals needed to reach the highest level of independence. This is called an interdisciplinary approach and is often accomplished through meetings, family conferences and sharing plans of treatment.

Most insurance programs will cover therapy services if they are considered "medically necessary" and realistic goals can be achieved in a reasonable amount of time. However it is important that you understand the "rules" which are stated in your policy or you can call the company to get clarification as to what is covered and if there is a limitation (number of sessions or dollar amount). The therapy provider will assist you, but it is your responsibility to understand what is covered in your policy. Medicare and Medicaid will usually pay for therapy if recommended by a physician. If your carereceiver has Medicare Part B (outpatient) services, 20% of the fees are paid by the recipient. If there is a supplemental or secondary insurance, the 20% may be covered. Always know what is covered by your insurance and what your financial obligations are before you start the program.

Therapy training programs all offer instruction regarding special issues related to seniors. Don't be afraid to ask the therapist about his/her experience. You can ask for references and talk to others who have used these services. You can also contact the national associations or state boards for assistance and referrals.

The regaining of skills is often related to the illness, disease or injury. Goals must be realistic and if regaining complete function is not possible, the therapist will teach compensatory methods to help achieve the highest level of independence. Sometimes the program may consist of family/ caregiver training to make it easier to care for the person.

Every individual has different needs. Each program should be designed to meet those particular needs. A program should include excellent clinical intervention and recognition of each person's needs, feelings and life style.