Catherine Scully: senior community physiotherapist in Co Offaly was also responsible for setting up the service
I've been working as a community physiotherapist, based in Tullamore, for the past four years. As I was the first community physiotherapist in this area, it was my responsibility to set up the service. There are now three of us covering an area within a 20-mile radius of Tullamore.
My workday generally begins at 9 a.m. I may see patients right away but it's preferable to sort out a schedule for the day first. This involves liaising with other health professionals about patients, paperwork and organising appointments. We take referrals from all health professionals and directly from patients and their families.
We don't operate a waiting list as we try to see new patients as soon as possible, even if it means re-arranging the day for an urgent visit. With my schedule in place, I set off to see patients. Sometimes, if they're able to travel I'll get them to come in to use equipment in the physiotherapy gym in Tullamore hospital.
My caseload is varied. I see people in the over-65 age bracket and adults with neurological conditions, for example, stroke, head injury or multiple sclerosis. However, I will see anyone who has a problem travelling to the outpatient department for physiotherapy regardless of their diagnoses.
An initial assessment is carried out on each patient. This includes assessing strength, range of movement, balance and mobility. I will also look at transfers, for example, how they manage getting out of a chair, bed or bath and off the floor or toilet.
I'll make a referral to the occupational therapist or public health nurse if I feel there is a need.
Treatment is tailored to assessment findings and can involve providing mobility aids, developing a suitable home exercise programme (to improve balance, strength and flexibility while standing at the sink), falls prevention, patient, carer and family education, providing orthotics and treating soft tissue injuries.
Generally, I'll spend 30 to 45 minutes with each patient depending on their needs. I keep a box of equipment in my car so I can supply exercise bands, sticks etc, where necessary. People can need a lot of support following hospital discharge especially those with neurological conditions who may find it difficult to adapt to being at home again as they can feel isolated.
We try to be as accessible, supportive and understanding as possible to make the transition easier. Apart from home visits, I also give an exercise class in a local day care centre once a week. I have noticed huge improvements in the flexibility and strength of the people participating in this class even though the average age is 80.
People need encouragement to continue exercising as they get older as it provides huge physical and psychological benefits regardless of age. There are often meetings to attend as I am a member of a falls prevention project team in the Midland Health Board and the PROP (Physiotherapy Research on Older People) group based in Trinity School of Physiotherapy.
I attend regular in-service continuing education in the physiotherapy department as it is important to keep up to date with the latest developments.
As community physiotherapists, we also meet regularly to discuss service development - currently we are looking at initiating pulmonary rehabilitation and falls prevention exercise groups. My working day generally ends at 5 p.m.