The Centers for Medicare and Medicaid Services (CMS) allows the use of a portion of CMP (civil money penalties) funds to be used as grant money by an organization that wants to complete a project that will improve the life of nursing home residents and their quality of care and quality of life. At Whispering Oaks, we started the CMP grant process in October of 2018, through our Quality Assurance (QA) process establishing equipment and therapeutic requirements, and we were approved in December. Once we submitted the formal request application to the Agency for Health Care Administration (AHCA) and it was approved, we had to forward the request to CMS. After it was approved by CMS, we purchased the electrotherapy equipment, and we submitted quarterly reports, case studies, and a final report. Overall, it was a relatively simple process to apply for the grant.
After we were approved for the CMP grant, we began our project on the effects of electrotherapy on residents with joint pain, muscle weakness, spasticity, edema, and the potential to decrease the use of narcotic pain medication. With the help of the therapy department, led by Jessica Roca, we had significant results. The main objective of this project was to observe the affect on residents with pain, in addition to, the use of standard therapy exercises. The electrotherapy machine was a tool to aid the residents in achieving their goals, and we had 11 out of 15 trial residents achieve those overall goals. We found that 13 out of our 15 residents had a decrease in pain while receiving the electrotherapy treatment and we found a significant overall improvement with range of motion, ambulation, and transfers. We also found that 6 out of 6 residents who were being treated for ambulation improvement did have an improvement through the course of treatment. In addition, 5 out of 7 residents had an improvement with transfers, and 6 out of 7 had an improved range of motion.
While the effects of electrotherapy on the muscles and pain only lasted for a few hours, the residents participated in therapy during that pain-reduced time frame and were able to exert themselves more strongly than they would have been able to with the full effects of the pain, maximizing their therapeutic benefit. This is allowing for greater success and progress during the therapy sessions. Since they can progress farther and do more exercises during therapy, the long-term effects are greater due to the increase in independence regarding transferring, activities of daily living, and ambulation. We also saw that residents were more motivated to participate during therapy and improve their functionality with the pain relief. One resident who participated in the program stated, “I was excited to participate because I’d heard about it from friends who had good results. It was a huge help and even though it didn’t help right away, it got me closer to my long-term goal and it built my confidence up.”
The electrotherapy modality, when used 3 to 5 times per week for 20 to 30-minute sessions, decreased pain for a few hours after therapy. This allowed the residents to participate in exercises and activities that increased their independence and quality of life. The use of the electrotherapy modality allowed us to speed up the therapy process by maximizing the potential for regaining function and the resident’s ability to tolerate an extensive amount of therapy and exercise. The residents who participated in the electrotherapy program progressed much faster than those who did not.