Members of the Therapy Team
Key Points
- Rehabilitation outcomes depend on coordinated interprofessional therapy roles.
- Core therapy disciplines include occupational therapy, physical therapy, speech therapy, and respiratory therapy.
- CNA observations and carryover support are essential for translating therapy goals into daily resident care.
Pathophysiology
Complex illness and injury produce multi-domain deficits in mobility, self-care, communication, swallowing, and breathing. No single discipline can fully address these interacting deficits.
Therapy-team collaboration aligns interventions so gains in one domain reinforce others, such as improved strength enabling safer ADLs or improved swallowing reducing aspiration risk.
Daily bedside reinforcement by CNAs helps prevent regression between formal therapy sessions.
Classification
- Occupational Therapy (OT): ADL performance, upper-extremity function, adaptive equipment, and independence training.
- Physical Therapy (PT): Strength, gait, balance, joint range of motion, transfer and mobility planning.
- Speech Therapy (ST): Communication disorders, aphasia support, and dysphagia/swallowing safety.
- Respiratory Therapy (RT): Oxygenation support, airway management, ventilator/CPAP/BiPAP care, and pulmonary treatments.
Nursing Assessment
NCLEX Focus
Priority questions often test which discipline is most appropriate for a specific deficit and what findings require referral.
- Identify domain-specific barriers (mobility, ADL, communication, swallowing, respiratory status).
- Observe resident tolerance and carryover of therapist-recommended techniques.
- Monitor for aspiration signs, communication breakdowns, or mobility instability.
- Report objective deficits to nurse to trigger discipline-specific reassessment.
Nursing Interventions
- Reinforce therapist instructions consistently during routine care.
- Coordinate scheduling and readiness factors (pain, fatigue, toileting) to improve therapy participation.
- Use approved communication supports (for example, word boards) as directed.
- Follow swallowing and diet-modification precautions during meal assistance.
- Communicate resident response trends to nursing and therapy staff.
Coordination Failure Risk
Inconsistent carryover or poor communication between team members can reverse therapy gains and increase complications.
Pharmacology
| Drug Class | Examples | Key Nursing Considerations |
|---|---|---|
| bronchodilators | Respiratory-rehab contexts | Coordinate respiratory therapy timing with medication effect for improved tolerance. |
| analgesics | Mobility/ADL training contexts | Adequate pain control supports participation in PT and OT activities. |
Clinical Judgment Application
Clinical Scenario
A resident after stroke has improved leg strength but continues coughing during meals and struggles to express needs.
Recognize Cues: Mobility gains with persistent swallowing and communication deficits. Analyze Cues: Recovery is uneven across domains; multiple disciplines still needed. Prioritize Hypotheses: Aspiration risk and communication barriers are immediate safety priorities. Generate Solutions: Request ST reassessment, continue PT carryover, and reinforce ordered meal/swallow strategies. Take Action: Report findings and implement interdisciplinary recommendations during care. Evaluate Outcomes: Meal safety and communication improve while mobility gains continue.
Related Concepts
- the-rehabilitation-process - Therapy-team roles are the operational core of rehabilitation planning.
- communication-within-the-health-care-team - Timely interprofessional updates prevent fragmented care.
- assisting-with-ambulation - PT-guided strategies shape daily mobility assistance.
- promoting-joint-mobility-and-activity - OT/PT goals are reinforced in routine activity.
- assisting-clients-to-transfer - Transfer methods depend on therapist assessment and progression.
Self-Check
- Which therapy discipline should be prioritized for new swallowing difficulty?
- How do CNA observations influence therapy-plan adjustments?
- Why is interdisciplinary carryover essential between formal therapy sessions?