Total Care Therapy: Physical Therapy Ready for Dementia

As a memory care community, we spend a lot of time educating our residents, families, and community on dangers of cognitive decline. We talk about how you can care better for your cognitive health from eating better to fitness goals. But as we get older, we are still more prone to injury, even as we take care of ourselves. When injuries happen, they can be completely debilitating. Our systems are not able to heal as easily as they once did so injuries last longer and put the rest of the body in danger. Physical therapy is an important part of regaining strength after a major injury in order to promote mobility and allow our residents to live healthier lives.

In memory care, these services are outsourced. In many places, residents are sent somewhere to receive physical therapy. Many of these providers do not have the training or the understanding of how working with those with dementia might require a different skill set and approach.

At Kemper House Worthington, we recommend and use Total Care Therapy for our residents when they need physical therapy. To get a good picture of what they do and why we use their services, we spoke with Adam Hill, a physical therapist assistant for Total Care Therapy. Beyond physical therapy, he also runs training on transfer and body mechanics as well as specifics of dementia care.


The most important reason we use Total Care Therapy is because they specialize in working with those suffering from dementia. “To care for our patients to the full potential it is very important to understand their mental capacity for following instruction and staying on task.” Working with patients with dementia is not going to be the same as with those who do not suffer from cognitive decline. Adam describes the way they approach each of their patients, “To provide therapy for someone with dementia, one must be patient and understand that your patient may not be able to follow one step instruction, they may become very agitated and even combative, they may be very fearful, resistant, and confused about what is being asked of them. For me to succeed in helping my patient improve, many times it is a matter of trial and error with how to interact with my patient.” This is exactly the kind of understanding we want to hear. We wouldn’t recommend a group that doesn’t have this level of compassion and thoughtfulness when it comes to our residents.

Adam further describes the work he does with our residents and the importance of building a relationship and trust with them. “Many people with dementia need frequent redirection to stay on task. We must be creative with our approach to hold our patients’ interest and build trust.” This trust is built in learning what the patient likes and dislikes and what motivates them and helps them stay calm. Adam says further, “Treatments can sometimes be unproductive when a patient is unable to stay on task or is unwilling to trust my instruction.” This is something we are very familiar with in our community, and only welcome people in that are going to do their best to earn and keep trust. “If a therapist cannot find the correct way to interact and instruct their patient due to cognitive deficits, it was a missed opportunity for a patient to gain strength, improve balance and ultimately improve their quality of life.”

Onsite Care

Another huge benefit of working with Total Care Therapy is that they do their work onsite. They come to our community to do their physical therapy with our residents. This is a huge benefit as it decreases confusion for our residents and allows them to be in a comfortable space that they are familiar with. This gives Adam and others at Total Care Therapy a better chance of building the trust they need to provide the best care for our residents. Many companies do not offer this service because they are not built to provide those with dementia the care they need.

The Human Factor

Since we pride ourselves on finding people who truly enjoy the residents we care for, we asked Adam to talk about what brought him to this profession and working with this population:

“I worked in skilled nursing home for several years and had always appreciated patients with dementia. I think I can appreciate the genuine nature of many people with dementia. Many times they cannot hide their emotions so I am blessed to be able to see their true self upon our first impression. I love getting to know my patients personality, their background and what motivates them. Also, I feel that it is helping me to improve my skills to explain step by step exercise instruction because if you fail to explain something clearly, many times your patient will not make assumptions about what you may have meant. Every instruction must be simple and concise for successful execution.”

He sounds just like the kind of person we want to be working with. Someone with a passion for our residents that cares deeply about improving his skills in order to provide better care at all times.

Total Care Therapy is a wonderful group and we are proud to be working with them to help take care of our residents and give them the mobility they need to stay healthy while they stay with us. Adam summed up his work nicely when he said, “I love my job so much. Our company really focuses on treating a whole person and not just symptoms or a diagnosis. We take the time to learn our patients and what makes them happy, motivates them and it brings us so much joy to be able to improve lives!” That truly is the level of care we should all aspire to provide.