During my recent travel to Japan, I had the amazing opportunity to shadow a Japanese day rehab. While I had emailed the World Confederation of Physical Therapy and the Japanese Physical Therapy Association months prior to my trip to Japan, I found it was difficult to get much of a response to set up a time for me to shadow and/or share my experiences with physical therapists in Japan. Luckily, through my work in Norfolk, VA, I had worked with an OT (stay with me here…) who had connections to a PT who initially became a PT in Japan, then met her husband and moved to the US. She then connected me with her old PT colleagues in Japan, who were then able to coordinate a time for me to observe (after a bit of a scheduling conflict). It was not exactly an easy task to coordinate, but for me, it was necessary!
In Japan, the public transportation system is top-notch. Luckily I had navigated this multiple times and kind of felt like a pro (kind of). I was able to take a train and then meet up with one of the PTs, then we got on a bus together to head to the clinic. Now I’ll be honest, I have never been to an Adult Day Rehab in the states, but I learned quite a few things at this Japanese Day Rehab that were pretty awesome!
Of course I initially was introduced as the American PT coming to observe for the day. All of the patients waved and smiled (just about all of the Japanese people I have met and interacted with are the nicest people!). We arrived around 2 PM when they were all having a seated group warm-up. Generally speaking, these patients were in there 60s and up, all of different functional levels. The facility had 3 PTs, 2 techs, and I believe it was one RN (or equivalent) and 2 CNAs. It looked much like an outpatient facility, but also had more area for the patients to socialize and spread out. Immediately after their warm-up, the patients spread out into their respective areas. Some went to the bikes, some started their home exercise program, and then others went to sit on the couch to watch TV or the table to drink coffee. Everyone was busy! The patients, techs, CNAs…everyone! But despite being so busy, everyone took so much pride, had smiles on their faces, and treated everyone respectfully.
In one corner, the PTs each had their own patient. From what I had heard, each patient had 20 minutes of one-on-one time with the PT. Then, each patient would have their own exercise program that they could perform on their own or with help from the techs/CNAs (I could never really tell which one). Timers would be beeping and techs were running to stop them, and then someone would need an hot/ice pack while sitting on the couch watching TV, and then someone would need help transferring from their wheelchair to the mat. These techs and CNAs were all over the place and on point!! It was amazing. Everyone was working together, and documenting in each patient’s book.
At one point, I looked up and saw a lady who was of a very low functional status in the corner with a CNA having her oral care done. Again, while she wasn’t with the PT, she could have other necessary things done! Not to mention take a rest after and watch some TV. I mean people were actually taking naps between sessions (whatever works, ya know!) They even had a metronome station where patients would sit and improve their coordination. The patients would record their scores on each piece of paper.
It was pretty amazing the independence the patients had, their willingness and motivation to get better. Not to mention the motivation all of the staff provided to them. The atmosphere of the rehab center was very relaxed, and again, allowed for many things to happen at once. The patients also genuinely looked like they were enjoying themselves. You could see some of the old ladies who were the “troublemakers” and always laughing, and then the others just enjoying talking to each other in front of the TV. It really seemed to make therapy an enjoyable experience (not that it isn’t, but you know what I mean..).
I observed the afternoon session, which was about 3 hours long. At the end of the session, everyone helped take vitals of all the patients and write them down in each patient’s book. The patients got to take them home with them! Not totally sure, but maybe it was their exercise program, how they progressed, what to do at home?! Then, every patient was brought to their respective car and the physical therapists/CNAs/techs drove them home! Yes, they took them in their cars and dropped them off at home. That’s one way to get people to come to therapy 😉
Now I am very aware of the differences with insurances and policies and the differences in the way we practice between the USA and Japan, but I think, regardless, it was great to see our profession at work in another country! I really appreciated this opportunity and all those who made it happen for me.
I encourage everyone to attempt to shadow/observe a PT clinic in another country! The only way we can all get on the same page globally is to share our knowledge and experiences with one another. We all have different cultures, different practice acts, different people that we treat, yet we are all working towards the same goal!
Until next time,