Blue Sky Therapy Blog

Clinical Aspect of In-Home Therapy

by Blue Sky Therapy

By: Lisa Chambers, MS, CCC-SLP, CHC

Lana Dorffer, MA, CCC-SLP, DCS

Jean Facteau, OTR/L, RAC-CT, ATP


Our In-Home Therapy service line offers customized clinical programming and treatment pathways based on the individual patient needs. We have a comprehensive portfolio of clinical programs that address common conditions we encounter as therapists, and we continue to develop and add to those as new industry information becomes available.

Programs for In-Home Therapy

Our clinical programs at Blue Sky Therapy are called the Centers of Excellence (COE). These comprehensive care pathways are based upon years of clinical research and data compiled by experts in the industry. Our COE currently has seven programs: Cardiac, Pulmonary, Orthopedic, Balance, Incontinence, and MIND.


We have several other diagnosis specific tracks that we have developed over the years based on patient trends and clinical needs. According to Stubbs and Haslam, 50-65% of falls occur in or around a patient’s home - read more about their research here. With that in mind, our therapist would use the associated clinical protocol in our Balance program to determine the underlying cause of the balance impairment and identify risk factors in the patient’s home. Once those are determined, our therapists would then provide evidence-based treatment pathways to improve the patient’s balance and reduce fall risk within the patient’s home. 


According to Medicare, 20% of beneficiaries who are discharged from a hospital are rehospitalized within 30 days, and 34% are rehospitalized within 90 days - read more on this article here. Utilizing In-Home Therapy services can prevent those rehospitalizations by implementing preventative measures and condition management for the patient. In-Home Therapy provides patient support, monitoring, and oversight to mitigate risk for adverse events post-discharge.


MIND Program

Our In-Home Mind (Dementia) Program begins with determining the patients’ cognitive level and best ability to function while also focusing on general safety considerations including fall and accident prevention, bathroom, medication, kitchen, food, and firearms.


Dysphagia In-Home

Our dysphagia program focuses on identifying the patients swallowing difficulties and trigger points. Our treatment plans vary based on patient need, but center around dietary adjustments, compensatory strategies, and pneumonia prevention. Our clinical speech experts have designed programs to make following dietary plans simple at home. We clear away the confusion and give functional, specific ideas to empower your loved ones to have the safest, and most convenient diet options. Sure, a medical professional knows what a puree diet would be, but does a spouse? We ensure that caregivers and patients are educated on the safest and best practices.


Maintenance Therapy

At times, a patient does not need to be experiencing a decline in function to warrant the need for therapy. Functional maintenance programs are designed to maintain a resident’s functional status and wellbeing. Our therapists routinely provide maintenance therapy, as well as educational programs to keep the patient active, healthy and functioning at their highest ability level.  


Diagnosis Specific

After our therapist determines the diagnosis specific needs of the patient they are treating, they determine if one of our current programs will help them achieve the highest level of function, or if they will need to regroup with our clinical team and create a customized pathway. We have specific protocols in place for patients with Multiple Sclerosis, ALS, and Parkinson's that incorporate the latest techniques and treatment to get them back to their highest level of function. All COE programs promote the use of standardized functional outcome measures benchmarked against industry standards to advance the quality of patient care.


Custom Wheelchair Program

Wheelchair seating and mobility is an important aspect of in-home therapy as it relates to patient posture, functional mobility, activities of daily living, skin integrity, and fall prevention in the patient’s home and community. Our therapists work with certified Assistive Technology Professional (ATPs) to provide a thorough wheelchair seating and mobility assessment and then make recommendations for equipment and training based on their findings.


Patient Success Story

At Blue Sky Therapy, we had a patient that refused to participate in therapy and other activities. After addressing environmental modifications and visual cues with him, he had several refusals to participate in therapy and needed to work on his balance, strength, and safety. The patient was staged in Speech Therapy and we applied the can do, will do, may do model and found out he used to make grandfather clocks. We were able to motivate him and decreased behaviors by initiating a “grandfather clock” book to start each session. He would tell us what the parts were and name them. We had a clock he could put the numbers on, and we would “come to his level” and gain trust and agreement through use of something he was interested in. The best part, no psychotropic medications needed! This is a part of our promise – we get to know the patient and treat them to ensure they function and recover at their highest ability level.


Future of In-Home Therapy + Teletherapy

As we continue to grow our In-Home Therapy service line, we will begin to expand into different markets and include additional focused areas of treatment such as post- surgical and sports-focused injury recovery.  Technology provides us with a platform to incorporate virtual visits, the ability to monitor and advance an in-home exercise program, and most importantly provide services to a wide variety of patients. If you are interested in learning more about our teletherapy program, click here.



Blue Sky Therapy delivers innovative physical, occupational, and speech therapy services in skilled nursing homes, assisted living facilities, home health care, and outpatient therapy clinics. Additionally we've recently launched our In Home care ant Teletherapy solution. You can now start and/or continue on with your therapy services in the comfort and safety of your own home via computer.


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