Some advice for rural residents on accessing physical therapy: tap into your 'sheer cussed determination'

Living in a rural area makes it much harder to access physical therapy, to the point where "sometimes it takes sheer cussed determination and good neighbors to help get us back on our feet," Donna Kallner writes for The Daily Yonder. Kallner, a fiber artist living in rural northern Wisconsin, writes that she had a hard time accessing PT after she was hit by a drunk driver in 1998.

"For many people in rural areas, reaching these services might take a longer journey than the 52-mile round trip required where I live," Kallner writes. "More than 40 percent of rural residents spend more than 30 minutes traveling to rehab, compared to 25.3 percent of urban residents. And the distance is an even greater obstacle when you can’t drive yourself."

Some rural residents give up on much-needed PT because of the logistical nightmare involved. Kallner acknowledges rural residents' tendency toward independence, or "pure cussedness," as she calls it, and advises those who need PT to consider the following questions when deciding whether or not to do it:

• What are my options? Visiting nurses or telemedicine therapy might be available. 
• What would be required of me and my family, medically and financially? Medicare could pay for inpatient physical therapy.
• Is it something you want to do? Ask your doctor what the consequences will be for your quality of life if you don't do PT.

Once you commit to doing PT, Kallner advises patients to keep the following in mind:

• Communicate your PT goals clearly to your therapists, especially if you see different ones at some appointments. 
• Ask your physical therapist to explain if you don't understand something.
• Be honest with your physical therapist about whether you've done assigned exercises at home; they can tell anyway, and it affects your care. Bonus: if you have been doing your homework, you might not have to come in as frequently.
• Be realistic about what exercises you can do at home. If they've assigned you a lot of different exercises, review the whole list with your physical therapist and ask if you can discontinue some.

"Even with specialized rehabilitation services, it helps to throw some sheer, cussed determination into the mix," Kallner writes. "But that doesn’t mean you have to do it all on your own. Be honest with family, friends and neighbors about what you need, and grant them the blessing of letting them help."