Dr. Tamisha Gittens CES, DPT, BscPT

History  Over 12 years of working in hospitals, poly-clinics and as a private practitioner. I noticed the need for home care.

Demographics  Current population  Current male population (49.6%)  Current female population (50.4%)

2016 Population Pyramid

Health of the nation study: Core findings 2015 policy brief Morbidity in Barbados  1 in 5 adults (18.7%) have diabetes  The same number have undetected diabetes  Over age 65, 1 in 2 adults have diabetes  1 in 3 women are on treatment for hypertension (HTN) (additional11% untreated)

Health of the nation study: Core findings 2015 policy brief  1 in 5 men being treated for HTN (additional 18% untreated)  Over age 65, 78% are hypertensive  Increased risk of cardiovascular disease  Increased morbidity Morbidity in Barbados

 ≈49 strokes/month occur in Barbados  Greater number of strokes reported for women than men in those aged ≥75 yrs  Proportion of undocumented stroke status (whether first ‐ ever event or not) still too high  Heavy work load for 2 therapist in the community and 3 who cover the neuro team at QEH

Relation to demographics  The aging population will peak in less than years  Demand increasing for rehabilitation services as the population continues to age  Limited community health resources in Barbados  Increasing awareness the importance of physical therapy

Polyclinics community rehab Year # of new assessments # treatment sessions per

Community based rehab  Community health- 2-3 months waiting period in hospital and polyclinics  1 therapist to 4 polyclinics  10 therapist for our general hospital  1 therapist for the main geriatric hospital

Community based rehab  Insufficient staff to cover rehabilitation needs of the community patients in Barbados.

Rationale For Mobile Physical Therapy (MPT)  Thus, just based on the aging population and a look at morbidity and stroke, there is a need for community based physical therapists.  This continues to be the basis for the existence of MPT and for the future expansion into an agency.

Inspiration  Home care agencies in the USA  Growing multiple sclerosis community  Increased number of nursing homes  Patients’ desires to have me come to their home after hospital stay.

Preparations  Community work- NIFCA, Panamamerican games, Common wealth games, CAC games, volunteering, health fares.  “Entrepreneurship for New Business Ventures” certificate: Kaplan University.  Youth Entrepreneurship Scheme (YES) Business program (awarded for innovation for “Excellence in Medical Services”).

Beginning  Company was formed June 2012  Officially started in September 2012  Private hospital provided most of the clients at this time.  Introductions to doctors, hotels, nursing homes

Marketing - “With Alffing around to the max” Website - - mobile physical therapy

Mobile Physical Therapy (MPT)  We offer home care rehab.  We utilizes clinic space.  We currently have one therapist and 1 part time therapist.

Mobile Physical Therapy (MPT)  Clients are referred  Within 1 to 3 days a therapist assesses the patient and implements a treatment plan.  The treatment plan always has a home exercise program (HEP) component.  Care-givers and relatives are encouraged to be present at the first and other visits for the education session and to learn how to assist in the HEP component, transfers and general care of the patient.

Our Goals  Help persons retain and regain their independence.  Helps persons to stay safely in their homes rather than having to go into nursing homes.  Educate family on how to care for disabled.

The benefits of MPT? Back pain Decline in function Amputations Heart failure Falls Difficulty walking Joint pain Patients who have experienced the following:

Multiple sclerosis Spinal cord injuries Recent surgery Arthritis Stroke Cancer (palliative care) Chest infections or COPD The benefits of MPT? Clients who suffer from:

Why Use MPT?  Reduced loss of productivity as patients could get care sooner and thus have less time away from work  Convenience  Less costly  Reduces complications due to recumbency in bed ridden or elderly patients

Why Use MPT?  Reduces fall risks for the elderly and the at risk  Smooth transition from hospital to home or nursing home  Transfers what was learnt in the hospital or clinic to functioning in the home environment  Education for care takers and family

Conclusion  MPT satisfies the need for private community based rehab.  It helps to ensure compliance with HEP and confirms that patients understand what was taught.  It reduces health care costs as patients remain in their homes safely.  Boosts the limited supply of rehab offered.  The need continues to grow.

Questions