Targeted Population Health Utilizing Direct Referral to Home-Based Older Person Upstreaming Prevention Physical Therapy From a Community-Based Senior Center

Abstract

Purpose: An older adult's ability to remain safe and active in the community is multifactorial and includes physical and social determinants. The purpose of this study is to describe outcomes of the Home-Based Older Person Upstreaming Prevention Physical Therapy program targeted toward older adults referred from one community senior center. Methods: Older adults identified as “at risk” for decline or becoming homebound were referred by senior center staff. Home-Based Older Person Upstreaming Prevention Physical Therapy is a 6-month in-home preventative program entailing 6 in-person and 3 telehealth visits administered by a physical therapist (PT). Wellness, cardiovascular health, social integration, and frailty metrics resulted in interventions inclusive of cardiovascular and balance exercises, home safety, and community reintegration. Results: Participants (n = 30) demonstrated significant improvements in: Timed Up and Go (P = .02), Four Stage Balance Test (P = .003), STEADI Fall Risk Level (P = .002), Home FAST Assessment (P = .001), self-reported fear of falling (P = .001), Modified Falls Efficacy Scale (P = .01), and a Health Behavior Questionnaire (physical activity [P = .03], fruit and vegetable consumption [P = .03], and recommended weight [P = .01]). Conclusion: Home-Based Older Person Upstreaming Prevention Physical Therapy provided early access to preventative PT services in the homes of older adults. Positive functional, environmental, fall risk, and wellness outcomes were achieved when leveraging direct referral partnerships between community senior centers and PTs.