Aquatic therapy: How it's beneficial to clinics and clients

Kathleen Kristoff
Kathleen Kristoff

As an occupational therapist, I see things from a holistic approach. One of the ways I've been fortunate to comprehensively help clients is through aquatic therapy. Aquatic therapy is more of a functional approach because you work on so many things congruently in the water. From a benefits perspective, aquatic therapy can impact everything from a patient's mobility to their activities of daily living.  

I've seen through my experiences with patients, being hands-on in the water, that aquatic therapy really has a global effect on the whole person. It impacts everyday lives. And it's fun, too. Other treatment approaches can feel to patients like “torture”, but the water never does.

Understanding the advantages of water

The number one reason senior living communities should consider using aquatic therapy is how the principles of water benefit the patient. Buoyancy, warmth of the water and hydrostatic pressure are three components that allow physical and occupational therapists to make progress with people who otherwise could not progress on land.  

Buoyancy 
For people with joint pain or immobility, water's buoyancy gives them a freedom of movement that they can't get anywhere else. Buoyancy is at the top of my list in terms of benefits for patients, especially for those with severe physical impairments. I've seen individuals move in the water in ways that are impossible on land.

Warmth 
Physical and occupational therapists cannot create warmth in other therapeutic environments, but they can in a therapy pool. I usually recommend any therapy pool to be around 92 degrees Fahrenheit. That's a comfortable temperature, and people have better movement, less pain and generally are just very comfortable in 92 degrees.

Hydrostatic Pressure  
There is a decided decrease in edema in patients who engage in aquatic therapy. The pressure of the water supports the muscles so patients can stand longer in the water, walk better in the water, sit better in the water and have better posture in the water. The hydrostatic pressure also works as a means of natural resistance.  

Differentiating your community

While it's possible to conduct aquatic therapy sessions in a large static pool, it isn't ideal. Generally speaking, static pools are not attractive for numerous reasons. First, they're kept at a cooler temperature that feels cold to some clients. Additionally, they aren't meant for specialized aquatic exercises because they do not feature an underwater treadmill floor or resistance jets.

With a specialized pool that is part of your senior living community, you have something that's likely not offered elsewhere in your market. You can market yourself as specialized and different, and you can eliminate the concerns noted above about using another organization's pool. We've had patients that continue coming to a facility even when private pay or limited insurance parameters. They remain loyal customers and pay out of pocket because it is so helpful to them.  

6 considerations when starting an aquatic therapy program

  1. Know your market. Do other senior living facilities have specialized therapy pools with underwater treadmills, jets, video capabilities, etc.? Find something that makes your aquatic therapy stand out.

  2. Stay in touch with the orthopedic surgeons in your area. See if they are familiar with aquatic therapy. They can be a wonderful referral source, so getting their buy-in is key.

  3. Look for alternative revenue sources. Contact your local schools. Athletes want to get back to the field after an injury, and they are willing to pay for aquatic therapy. Collaborate with the schools themselves if they have the needs of developing a program for post-injury to get their athletes in the game faster without compromising safety.

  4. Contact the pain management doctors in your area. They have a patient population that you can easily serve in the water. If you can educate those doctors and let them know you can help their patients who have chronic pain, they're going to listen.  

  5. Make sure your staff understand the best practice policies and procedures of working at a facility with an aquatic therapy component. Ensure they have training specific to aquatics so they know who goes in the therapy pool, who doesn't and what the contraindications are.

  6. Institute a maintenance plan. Who will take care of the pool maintenance? Who will balance the chemicals every day? Who will be responsible for changing the filters and cleaning the pool floor? Each state has different guidelines; you need to find out from your Department of Health what they are.  If you're getting your own pool, opt for a pool manufacturer with a strong, easy-to-follow start-up kit.

I've had extremely positive experiences introducing patients to the benefits of water therapy. Allow me to share this remarkable case study:

I worked with a patient who had spinal muscular atrophy from childhood into young adulthood.  This particular patient was able to continue aquatic therapy for several years — his insurance was paying — because the water provided him an environment that allowed him to move freely despite his condition.

Using the video components of our advanced therapy pool, we documented this freedom of movement and showed his doctors and insurance companies that we were maintaining his joint integrity and preventing further decline. We were also able to give him a workout for his cardiovascular and pulmonary systems that he would not be able to get on traditional “land” therapy. Insurance decided to keep paying for the aquatic therapy, even though they might otherwise put a cap on these types of services. By showcasing that we could use the water to help a patient progress, we were able to not only keep getting him the care he deserved, but to get money from the insurance carrier rather than making him pay out-of-pocket for continuing sessions.

It's gratifying to be able to work in aquatic therapy for many reasons. Any senior living community that decides to pragmatically take the plunge is setting the stage for incredible results and rewards.

Kathleen Kristoff is regional director at Athena Therapy.

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