JOHNSTON — As someone who has benefited from physical therapy on an outpatient basis for five years, it has been a revelation to engage with a physical therapist who works for Briarcliffe Manor, who has been patiently guiding me in my recovery from an inadvertent dance with a full-sized refrigerator.

I keep learning new tricks about how to improve my own capabilities to manage things like getting in and out of bed, how to walk properly with both a walker and trekking poles, — and how to climb stairs to decrease the chances of falling or stumbling.

Quite simply, you can teach an old dog like me new tricks — but it requires the ability to listen and to coordinate the learning conversation between my brain and my legs, to develop new good habits and not fall back into familiar but bad patterns.

Every time I sit down on the stationary bike to stretch out my calves and ankles, it allows my own thoughts to swirl about. One distinct point of conversation has been my attempt to learn more of the stories of the people who are delivering care — the people most responsible for my successful recovery and return back home.

The physical therapist Jessica Rosa, with whom I have been working for the past 20 days, was willing to answer some questions for ConvergenceRI about the challenges of caring for patients engaged in short-term rehabilitation, and how she views her work.

It is a way that ConvergenceRI can capture the importance of the care givers who are the bedrock of the health care delivery system in Rhode Island.

ConvergenceRI: How is the profession changing for physical therapists as the patients age?
ROSA: It’s not so much changing but we focus on chronic condition management, such as educating patients on how to manage diabetes, congestive heart failure, muscle weakness,  etc. We focus on fall prevention strategies, and functional things such as getting out of bed, stairs, and walking.

ConvergenceRI: What is the difference between outpatient physical therapy and in-house physical therapy as a profession?
ROSA: Outpatient is more for people who can manage their lives alone at home and can get around.

Inpatient is more so for serious injuries and complex cases like strokes, congestive heart failure, dementia, mobility problems, acute knees, hips — for patients who can’t really function alone at home without help and rehabilitation

ConvergenceRI: What is the most rewarding part of your job in working with patients?
ROSA: It’s rewarding when you watch someone get stronger day by day and be able to do the simple things we take for granted, such as getting out of bed alone, doing the stairs. Things they couldn’t do when they first arrived.  

I had a patient with Guillian Barre (Syndrome); it’s almost as if he was paraffin from the neck down. Months later, he left walking with a rolling walker. About a year later, he came back to thank us, no walker and I could barely recognize him as he stood so tall. It was amazing to see.

ConvergenceRI: Is there a way to share practice developments across a broader spectrum of physical therapists in Rhode Island? If you could design such a learning group, what would it look like?
ROSA: We as therapists are always learning. We have Inservices every couple of months; we create PowerPoints on a subject that we research,  and we talk about new ways to treat patients with certain illnesses.

ConvergenceRI: Why did you choose to become a physical therapist as a career?
ROSA: I used to be a personal trainer. The human body is very interesting to me. I guess I wanted to be a better version of a personal trainer — more educated. And, I wanted to help people get stronger, not just for a physical appearance.

ConvergenceRI: What is the hardest part of your job today?
ROSA: Getting someone up that has given up on life, and convincing them to keep pushing.

ConvergenceRI: How do you manage the expectations of patients, yourself, and your career?
ROSA: I try to stay realistic on what I can and can’t do. But I also never give up on people who try their hardest to do something as simple as walking

ConvergenceRI: What questions haven’t I asked, should I have asked, that you would like to talk about?
ROSA: Every person that comes here has to want to get better. I can lead only so much. There are not always happy endings. Some never make it out of the nursing home whether it be death or they simply cannot stay home by themselves.

Some families are very hard to deal with because they expect too much and can be very unrealistic. Some patients hate us no matter how nice we try to be, how hard we work, and how much progress they’ve made even if it's small.

It can be hard when a patient has a progressive disease and you know deep down that eventually they will regress, but regardless,  you keep up the hope for yourself and that patient.