Prosthetists and orthotists play a key role in a rehabilitation team.
However, not everyone understands how important they are for mobility.
So I sat down with Jason Auyer, Licensed and Certified Prosthetist Orthotist and owner of Alliance Prosthetics + Orthotics.
In today’s blog post, I’ll share our conversation about what prosthetist orthotists do and how they help keep seniors safe at home.
Let’s get started.
In technical terms, prosthetists and orthotists are healthcare professionals who provide clinical assessment, prescription, technical design, and fabrication of prosthetic and orthotic devices.
One who is licensed and certified in both prosthetics and orthotics is an LCPO.
The acronym P&O (prosthetics and orthotics) is used to refer to this field. As part of the health professional team, they help set patient rehabilitation plans and goals.
Prosthetics and Orthotics are separate disciplines. However, they are often seen as cooperative entities because of their goals and purpose.
Learn more about prosthetics and orthotics here.
Jason: For senior care, the LCPO takes care of any bracing, from diabetic shoes and inserts to braces for spinal cord injury.
We work with diabetic patients with wounds and ulcers. We also work with upper and lower limb amputations.
Regarding the orthotist side, we do AFO braces customized for patients with spinal cord injuries. We also help anyone with poor balance, weakness, or stroke patients.
Our goal is to help the elderly maintain mobility for as long as possible and prevent fall-related injuries.
Jason: Our goal for our diabetic patients is to try and prevent amputations down the road. We also aim to provide good offloading so that wounds can heal better.
Often LCPOs work together with different health professionals: wound healing centers, podiatrists, vascular doctors, home care therapists, and nurses.
We want to make sure wounds heal properly.
However, there are times when gangrene sets in and causes infections in the bone, called osteomyelitis.
In these cases, amputations may be required to save the life of a patient.
Jason: Because I’m an LCPO, every day can look different.
Some days are diabetic shoe clinic days. We’re one of the few clinics in the area that offer diabetic shoes.
We dedicate a day to Medicare patients to make the application process more efficient.
Some days I deal with amputees to check on their progress. We also help with educating patients before amputations.
Talking with the patients does two things. First, it answers questions for potential and future amputees and ensures they have hope. It also assures them that they have a rehabilitation team for support.
Most days are spent working with doctors and teams to ensure we’re on the same page.
Sometimes we work on patients with different needs: stroke patients, people with instability, foot drop, and other mobility issues.
Usually, I see 8-12 patients a day. Some sessions last from 30 minutes to two hours, depending on how in-depth the patient’s situation is.
We communicate well with doctors and the rehabilitation team to discuss patient cases.
Doing so helps us understand how to design prosthetics that support the patient’s mobility and functional goals.
Most patients visit us upon their doctor’s recommendations. However, most have little to no idea why they need the consultation.
As the LCPO, I aim to help patients understand why they need our services. We sit with them and find out how to give them the support they need.
What we do is more than find the right device fitting. We also want to celebrate with patients as they accomplish their personal goals.
Jason: It can be daunting and frustrating for patients to get diabetic shoes.
Most of them are not familiar with the process of getting diabetic shoe prescriptions.
Paperwork requirements can be a bit testy. So we set up two locations with designated days to make it much easier for patients to get what they need.
We also prepare a packet of information that we give to patients for doctors to fill out. These documents help provide medical justification for the shoe prescription.
Sometimes extra documentation is needed. But in the end, the goal is to provide the right diabetic shoe fit for the patient.
Diabetic shoes can have a huge impact on preventing amputations. That’s why we try our best to educate patients about its importance.
Unfortunately, there are times when diabetic patients get frustrated with the process and skip it. Eventually, they end up with an amputation which could have been avoided if they got the shoes.
Jason: Typically, it’s the doctors who decide if there’s a need for the patient to get diabetic shoes.
Most would think because they were diagnosed with Diabetes, they would automatically get a free pair of shoes.
But that’s not the case.
The patient needs to be treated under a comprehensive plan for diabetics. They also need to prequalify for conditions like poor circulation, peripheral neuropathy, wounds or calluses that can turn into wounds, and previous amputations that make them eligible.
Their physicians help identify this.
Sometimes patients are not educated about the qualifications for diabetic shoes. But it’s best to talk with their doctors if they have certain conditions like hammertoes or calluses on their feet.
More than anything, patients also need to be proactive about this. It’s best to talk to their doctors about Diabetes or foot problems to check to be eligible for diabetic shoes.
Jason: We see a lot of gaps in the treatment, especially when dealing with the geriatric population and their caregivers.
For example, the patient falls and then gets admitted to the hospital. Once treatment is done, they get ready for discharge and are sent back home.
Homecare therapists and nurses visit at home, but communications get lost along the way.
That’s why patient advocacy is so important for continuous treatment and healing.
Patients do best when they have advocates to ask the right questions.
Advocates are those who assess a patients needs and help follow the prescribed course of care.
These advocates make sure the patients understand the medications they take and how these relate to other conditions the patients may have.
The problem is most people don’t know what questions to ask. Patients and their caregivers also get overwhelmed with all the information they must take.
Not everyone has a person that helps with recovery at home. So patient advocates must fill in the gap.
Fall risks are a huge thing for geriatric patients. Often they go back to routine after recovering from the hospital. But eventually, they get into another accident after forgetting the changes they need to make.
It’s frustrating, especially for someone who is used to being so independent all the time.
The older men find it more difficult to ask for help at most times. Female patients often bring someone along to see if they can have some help.
I think it’s time to take down that stigma that you become less of a person because you must ask for help.
That’s why we need more patient advocates that can ask the necessary questions and do assessments at home.
Doing this will help ensure that our geriatric patients get back safely at home and stay independent for as long as possible.
Learn about patient advocates here.
Jason: Don’t feel bad about asking questions when you’re with healthcare providers.
Never assume that doctors and other medical professionals know it all. But the truth is, you should ask questions and relay the right information.
The more specific you are with the patient’s medical history and other information, the better the treatment will be.
The key is to communicate honestly and effectively so we can all be on the same page with the proper course of treatment for the patient.
Jason Auyer is a Licensed & Certified Prosthetist Orthotist and owner of Alliance Prosthetics + Orthotics.
A graduate of BSME from Cedarville University, his career began in 2005 as a technician at Atlanta Prosthetics and Orthotics.
While working, he received his certification in Prosthetics and Orthotics from Northwestern University.
Jason also received his orthotic and prosthetic residency under the supervision of his mentors, Marc Kaufman, Jim Hughs, and Will Holbrook.
While working on his national certifications, he got promoted to clinic manager for AP&O until its acquisition in 2014.
Jason has always dreamed of opening his practice and providing quality patient care and space for practitioners' growth and development.
Today, he has successfully fulfilled that dream.
Jason has his national certification through the American Board For Certification in Orthotics, Prosthetics, and Pedorthics and is licensed in Prosthetics and Orthotics through the state of Georgia.
He also specializes in the pediatric community as well as dysvascular amputees.
He is married to Rachel Auyer and is a father to four sons.
In his spare time, he enjoys the outdoors, Syracuse football and basketball, recreational soccer, and hanging with his family.
Check out his business here and reach out if you or a loved one is in need of his services.
That's all for today.
Take care, keep mom safe and have a great day!