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VNA of Ohio: Comprehensive Rehabilitation Services at Home

What began more than 100 years ago as a group of 13 Cleveland women dedicated to home health care now includes more than 700 professionals providing comprehensive home healthcare, hospice and rehabilitation services throughout Northeast and Central Ohio.

Patients leaving the supervised care of their physicians are generally at risk for poor compliance with follow up instructions. Too often the result is hospital readmission. Enlisting the services of Visiting Nurse Association of Ohio provides critical support to extend the continuum of care, enhance patients’ recovery process and decrease patients’ return to the hospital.

“VNA of Ohio therapists are the physicians’ eyes and ears in their patients’ homes. We work under physician orders to provide all components of home care, which includes physical, occupational, and speech therapy, as well as skilled nursing, home care aide and social work services,” says Wendy Fishman, PT, MS, Director of Rehabilitation Services at VNA of Ohio.

Patients with multiple diagnoses are eligible for rehabilitation services if certified as homebound by their physician. As a Medicare-certified organization, VNA of Ohio delivers skilled therapy to qualifying patients.

When therapists engage patients, they assess whether the home environment is conducive to a patient with limited mobility and reduced independence. Therapists identify areas of risk which may lead to navigation problems and falls. They also look for accessibility to exits in the event of an emergency.

“We conduct home safety assessments and identify areas where patients may need help to ensure their safety at home,” Fishman explains. “They may require assistance from a skilled professional, or they might benefit from simple modifications, such as grab bars in the bathroom or Hoyer lifts for transfers.”

Physical Therapy

VNA of Ohio’s physical therapy services help patients who have difficulty ambulating. This may be due to amputation, cancer, cardiovascular conditions, chronic pain, multiple sclerosis, spine surgery, or a number of other neurological or orthopedic disorders.

Therapists develop individualized plans of care, including exercises to optimize strength and endurance. Physical therapists utilize pain management techniques to supplement exercise regimens that help patients function through chronic or post-operative pain. These plans empower patients to be full participants in their own rehabilitation.

Specialized programs, such as Therapy Connect, are designed for patients recovering from orthopedic surgery. Physical therapists begin working with patients within 24 hours of discharge and continue daily for a two-week period.

Lymphedema Therapy

Lymphedema therapy, another specialized program, provides relief to patients who suffer from chronic swelling. Because of anomalies in the lymphatic system, blood clots, chronic venous circulation disorders, lymph node removal, radiation or surgical procedures, these patients are at a higher risk for wounds, falls and rehospitalization.

To reduce swelling to manageable levels and educate patients about diet, skin care and limb elevation, VNA of Ohio’s certified lymphedema therapists initially visit patients three times a week. “Education increases patient compliance, which in turn improves outcomes,” Fishman points out.

These therapists use a number of therapies, including compression garments and short stretch wraps for affected areas. They may also choose to use manual lymph drainage – a technique of pushing lymphatic fluid back to lymph nodes, where it drains to the venous system and is excreted by the kidneys. In addition, a lymphatic pump may be used to drain excess fluid.

Occupational Therapy

VNA of Ohio occupational therapists make life easier for patients with mobility deficits caused by rheumatoid arthritis, brain injury, multiple sclerosis or other issues. These patients often need assistance with activities of daily living, such a bathing, dressing, eating, grooming and toileting.

Home modifications and special adaptive equipment, such as a long-handled shoehorn or raised toilet seat, are simple solutions to assist with mobility for those with physical needs. Patients with a behavioral health diagnosis, such as depression or schizophrenia, present different challenges.

“VNA of Ohio occupational therapists create plans to reduce anxiety that many of our behavioral health patients face,” Fishman says. “Sometimes these patients focus on their anxiety and by helping them focus on something else – in most cases, structured daily activities and routines – we can significantly improve their lives.”

No matter the diagnosis, VNA of Ohio occupational therapists offer solutions to help patients return to their maximum independence.

Speech and Swallowing Therapy

While physical and occupational therapists focus on returning patients to a higher level of independence, speech therapists work to improve patients’ interactions and communications with their loved ones.

Certain conditions make speech unintelligible due to stutter, speed or raspiness. VNA of Ohio speech therapists use a number of techniques to improve speech clarity and vocal quality, helping patients to express themselves.

Many patients suffer from neurological conditions affecting their cognitive abilities to focus, understand and retain information. Speech therapists use techniques, such as memory cues, books or communication systems to improve the way patients absorb and convey information.

Patients with neurological conditions may also need help with motor controls associated with the mouth and throat. Problems with swallowing or drooling can lead to complications such as pneumonia. Various diet modifications, including thickened liquids and pureed solids, can help alleviate choking risks and the associated problems.

To facilitate safe swallowing, three VNA of Ohio speech therapists are also certified to offer VitalStim therapy.

“VitalStim is an electrical stimulation unit that delivers low-dose stimulation to the muscles of the throat,” Fishman explains. “Stimulation improves muscle contraction and swallowing function.”

Fishman emphasizes that all of VNA of Ohio’s rehabilitation therapies are individualized according to each patient’s needs.

“We build treatment around each patient,” she says, “and we work with primary care physicians to facilitate optimal outcomes.”

For more information about VNA of Ohio or to make a referral, visit or call 216-931-1400.

Call VNA of Ohio Today

*content was repurposed directly from MD News, Cleveland/Akron/Canton edition, July/August 2014 issue.