Infinity Rehab Clinicians Present at Colorado Health Care Association Annual Convention

On September 18, 2013, four clinicians from Infinity Rehab presented at the 50th Annual Colorado Health Care Association and Center for Assisted Living Convention and Exposition. Their topic covered integrating person-directed culture and principles into post-acute settings. Specifically focusing on the wants, needs, and preferences of the individual. Read more below:

Integrating Person-Directed Culture & Principles into the Rehabilitation Systems for the Post-Acute Client & Nursing Home Resident

Presenters from Infinity Rehab

  • Tyler Keeter, P.T., D.P.T., M.H.A.
  • Julianne Cooper, O.T.R.
  • Jennifer Lo, O.T.R.
  • Greg Young, P.T., O.C.S.

Person-directed principles revolve around the wants, needs, and preferences of the individual in question. Through this approach, decisions and actions involving care honor the choices of all individuals residing in the living environment – whether short term guest or long term resident. The culture and approaches have proven to actually improve the clinical outcomes of the rehabilitation episode of care. This session will explore ways to bring the ideas, values, and practices of culture change into the rehabilitation operations, so that everyone who is a part of the organization benefits from person-directed practices.

Seminar Objectives:

Participants will be able to describe the mindset of the therapist that is required to integrate person-directed principles into their practice.

Participants will review unique set of systems that support a culture of person-directed rehabilitation, and will receive a “roadmap” for their own rehab departments.

Attendees will be able to understand and implement the peer-reviewed literature related to person-directed rehabilitation with both nursing home residents and post-acute clients.


TYLER KEETER PT, DPT, MHA is the Colorado and Nebraska Area Rehab Director for Infinity Rehab, a rehabilitation company serving elders in independent living, assisted living, and long term care communities, as well as post-acute care rehab operations. He is also Adjunct faculty for Regis University’s Doctor of Physical Therapy program, teaching courses in business planning, professional advocacy, and service learning. As a member of the Colorado Culture Change Coalition since early 2009 and as an Eden Associate since 2010, Dr. Keeter has learned much about Culture Change and person-directed principles and has applied them to the rehabilitation operations he oversees. He has presented these concepts and systems to groups of Health Care Administrators and interdisciplinary teams, the Nebraska chapter of Leading Age, at Infinity Rehab’s 2013 Continuing Education Symposium, and in August of 2010, the Colorado Culture Change Coalition.

JULIANNE COOPER, OTR, is a Director of Rehabilitation for Infinity Rehab and Clermont Park Retirement Community and Rehab in Denver, CO. Julianne has 10 years of experience serving elders and is a certified Eden Alternative Associate.

JENNIFER LO, OTR, is a Senior Director of Rehabilitation for Infinity Rehab at Holly Creek Retirement Community and Rehab, in Denver, CO. She has 15 years of experience severing elders and is a certified Eden Alternative Associate

GREG YOUNG, PT, OCS, is a Director of Rehabilitation for Infinity Rehab at The Johnson Center and Village in Centennial, CO. Greg has 13 years of clinical experience serving elders throughout the continuum and serving the general population in outpatient/sports medicine settings. He is a certified Eden Alternative Associate and an APTA board-certified Orthopedic Clinical Specialist.

24-Hours in Their Shoes: A Journal from a Therapist Turned Patient

On July 22, 2013, Melissa Riehl, Certified Occupational Therapist Assistant and Director of Rehab at Good Samaritan Society – Loveland Village, spent 24 hours as a resident. At the insistence of her Area Rehab Director – Ty Keeter – she took on the challenge in her spare time to gain a first-hand perspective of what life is like for the individuals she treats on daily basis. After communicating to her co-workers at the Loveland, CO skilled nursing facility about her educational pursuit, Melissa created a patient profile for herself.
Melissa chose to be non-weight bearing on her left leg, unable to walk and bound to a wheelchair, used an elevated leg rest, and ate a Level 3 diet, which is mechanically altered for easier digestion and to provide added nutritional benefits. Melissa sought to fully immerse herself in the life of a patient. She restricted her movements and relied on the full support of the care staff. During those 24-hours she kept a journal detailing her experience.

1:30 PM: Started 24-hour resident experience. Very nervous, anxious, excited!
Thoughts: I will miss my family and evening routine, but can do this for 24-hours! Dinner sounds good; something to look forward to. I think the staff has the same feelings and are already asking me if I am watching them. I will be a patient with L side NWB and be in a w/c with elevating leg rest for L side. Diet Level 3 with nectar thick liquids.
3:00 – 4:45 PM: Activities and Thoughts: Tired of wheelchair (w/c) already. Have to go to the bathroom, but am embarrassed to interrupt activity because I don’t want everyone to know that I have to use the restroom. I am also in the middle of the group, so it seems like I should wait. So far staff is friendly and helpful!
5:00 PM: Dinner—Chicken Caesar salad, looked gross, but tasted like I thought it should. The salad was pureed so it looked like spinach dip. Baked beans and Wisconsin cheese soup. Nectar tea – yuck!
My table mates were interesting with very little conversation. It was gross to sit next to resident who blew her nose into a tissue, then rolled it up, put into her mouth, then spit it out! Found myself turning away from her while I was eating. She did talk some, but kept asking the same questions. The dining room was also noisy.

7:30 PM: At this point, I really have to think about not helping myself. I wait for the call light to get help with all transfers and a couple of times I have started to just get up, but no cheating.
7:50 PM: Ready for bed in PJ’s. You can understand why residents might sleep a lot! Everyone goes to room after supper, nothing much to do that is social. All is quiet and w/c is not getting any better.
8:20 PM: 20 minutes are a LIFETIME! My roommate snores. Thought I was doing a good job occupying myself, guess not.
8:45-9:30PM: Told CNA I was getting bored. She asked me if I wanted to sit in the TV room. I sat on couch for 45 minutes, but not really private. Lots of activity, not able to relax and just watch TV.
At bedtime, the CNA set up toothbrush and warm wash cloth. It is hard to accept help, but kind of nice to get help. Tried to let CNA help with socks and shoes, I still think I did most of the work.
10:00 PM: Roommate snores, bed squeaks and hard, hallway noise. I am waiting for shift change, and then might sleep, but I have cookies to snack on! Tried nectar water with lemon through a straw, yuck!
10:40 PM: Lights out
11:20 PM: Time for vital signs, BP was low and nurse thinks I need to drink more. Thought I could hear a vacuum running?
1:40 AM: CNA comes in to turn roommate
3:30 AM: CNA comes in to turn roommate and help me to bathroom
6:45 AM: Time for vital signs, BP still low, drink more! Just so they know I am not drinking any more nectar water! Did not sleep well. I am tired. 6 ½ more hours to go. The room is warm, but the nurse offered to turn fan on.
Getting ready for breakfast now. The CNA combed my hair, ouch! I never comb my hair as it is naturally curly.
7:30 AM: Breakfast, yuck! Cream of Wheat – had to add salt – scrambled eggs, nectar-thick cranberry juice, ok. Nectar coffee, smelled good, tasted bad! Nectar water, yuck! Sat in dining room for one hour, same table mates as last night with a little more conversation. I could not have bacon on Level 3 diet, bummer!!!
8:30 AM: Time for physical therapy and occupational therapy. The Occupational Therapist got me a new cushion and Physical Therapist did a balance assessment. Lots of questions and do this, do that!
9:20 AM: Activities- movin’ and groovin’, fun and energetic!
10:50 AM: Devotions. Nice group of people from a local church. Met a resident who was born in my hometown.
11:45 AM: Lunch in 800 dining room. Had regular diet and liquids. This dining room much quieter and more conversation. Finally not hungry or thirsty after a meal.
1:30 PM: Time to check out. The door to room 701-1 was shut. I asked the CNA to open MY door. Was this Acceptance or was I being sad to FINALLY be done?

As I am into my last hour of my patient experience, I can’t say that I am sorry for the residents. They have a lot to look forward to. However, I can say that this is not like home and it would be tough to get used to living in LTC as a resident. I made friends and deepened relationships with residents and staff. The residents here accepted me. That felt good and helped. I spent A LOT of time sitting and waiting, minutes sometimes seemed like hours. I am a very social person and was lacking contact from others at times. All of the staff was thorough and kind.
Do I think I got the most out of my experience? well, I could have tried harder with the diet textures and I did wheel myself to activities vs. sitting and waiting for CNA’s to help? (It’s hard work to get to and from activities and you have to be motivated) I tried two different w/c cushions, both had little comfort quality. The w/c leg rest was hard and the back of my leg was getting sore. I am thrilled and excited to share my experience with others…. once I get some sleep.

Think About These Experiences:
1. Staff coming from behind and rushing me to the bathroom. Pushing me very quickly down the hall, only telling me what we are doing once we were going towards room. Staff did not introduce self.
2. Staff coming from behind and putting pills (actually applesauce) in my mouth. Did not introduce self and stated “Time for pills.” It was hard to swallow. The staff member then began to massage throat, while saying “swallow.” This made it very difficult to swallow.
A lot of staff members have asked me if I liked my experience. Like is the wrong word. It was a good experience. I only had one disability, I have been thinking a lot about not being able to speak up for myself. That would be hard.
I can empathize with those who are manipulative to get needs met. It did not take me long to try to get stuff from the staff, due to being hungry, tired, or thirsty. I cheated on the diet textures, but what if I couldn’t? I did not see myself from my nose down in a mirror for 24 hours. Again, Level 3 diet does not include bacon. SAD!!!

My Experience:
Did it kill me? NO! Am I a better person, probably? Will I think about the way I treat residents, YES!! I have already changed my approach in small ways to make myself a better caregiver. I am the only therapist who has done this experience at our building, but many of the CNA’s and therapists have said that they would love the chance. So I say, if you would love the chance then ask if it is a possibility!
PLEASE ask me what I have done to change the way I treat our clients. Daily, I use my experience to make myself a better caregiver.

Augmentative and Alternative Communication Devices: Enhancing Communication through Technology

By: Jessie Moss, MA CCC/SLP

Augmentative and Alternative Communication (AAC) technology has grown tremendously over the past several decades, but it tends to be overlooked as an option when working with individuals in the geriatric population with communication limitations. It is my goal to increase awareness of how this mode of communication can enhance the communicative abilities, independence, and overall quality of life for some of our patients. When a person cannot use speech to communicate effectively in all situations, there are options.

AAC is an umbrella term that encompasses the communication methods used to supplement or replace speech or writing for those with impairments in the production or comprehension of spoken or written language. Manual sign language is one of the earliest forms of AAC, but owing to rapid developments in technology, interactive devices are available that greatly enhance the user’s ability to clearly communicate whereas they were unable to before.

Today, there is a variety of AAC devices ranging from the very basic to sophisticated. Basic AAC devices are ones with static screens. The user can access a button or cell that is programed to relay a message. The screen does not change and the specific button/cell speaks the same message each time. Higher-tech devices can be modified and the options seem endless. These devices are dynamic and used to create interactions in a conversational style. Stephen Hawking, a renowned physicist with Motor Neurone Disease, is arguably one of the most famous users of high-tech, device-assisted AAC. Over the years, Hawking has retained his original synthesizer voice, saying that he prefers it because it has come to identify him. Today, users of AAC devices can choose from a number of voices with a range of accents.

Here is a great video that gives an overview of AAC devices:

Some AAC devices allow the user to type a message and the device will speak it. The majority of dynamic devices have touch screens with a specific number of cells that can range in number and size depending on user’s ability. When these cells are activated, it may speak a message or change to another screen with more cells and options to select. For example, a patient with visual impairments may have six large cells on the main page, with one cell labeled My Needs. Once selected, the cell reveals another page with six large cells labeled food, medical needs, clothing, hygiene, etc. Each of those cells could then reveal even more granular options for the user to relay.

Dynamic AAC devices offer a variety of methods for selecting communication cells based on the user’s ability. For example, if the user’s motor coordination for touch selection is not accurate there are many accessories to assist like a joy stick to scan and select a button. There are AAC devices out there with the capability to read the user’s eye movement and make a selection based on blinking patterns or the eye looking at a specific cell. Breathing and minute muscle movement can also be used to activate AAC devices.

I encourage all of us therapists to adhere to the old adage of not judging a book by its cover. We shouldn’t write someone off because we think someone lacks the abilities to use an AAC device. I have had great success teaching patients who are unable to consistently answer yes/no questions to use one of these devices with an eye gaze accessory to navigate through 2 to 3 pages to make requests. After implementing AAC devices with different patients I have observed increased spoken communication, increased initiation of communication, and decreased overall frustration.

This article is just an introduction to the idea of bringing AAC to our population and it may have created more questions than answers. I am available to help in any way that I can. Please contact me with any questions or comments. My email is


Jessie Moss, MA CCC/SLP, is a therapist at Good Samaritan – Spokane Valley.

Wheelchair Screening: How to Make Changes (pt. 2)

wheelchairIn the previous article – Screening for Wheelchair Seating and Positioning Needs – we identified individuals that could benefit from a change in their wheelchair seating system. There are several choices for a replacement wheelchair:

  • Change to a facility owned unit
  • Private pay option
  • Request for a specialized wheelchair seating system through the Department of Social and Health Services

Before you order a new chair, you need to determine why the current seating system is not working for the individual.

Most facility owned wheelchairs are a sling seat-back style of wheelchair. This type of wheelchair is not designed for long-term, extended use as it typically does not provide adequate support. If the wheelchair is an older style both the seat and backrest material stretch over time. The seat, even with a cushion, assumes a scoop appearance, like sitting in a hammock all day. This does not provide adequate pelvic support and can increase pressure to the lateral pelvis and thighs.

If the backrest is stretched out you will notice that it increases the pelvic-trunk angle greater than 90º which places more pressure to the coccyx and ischial tuberosities as the individual assumes a sacral (posterior pelvic tilt) sitting posture. This area is prone to shearing and potential skin breakdown. Adding an anti-sling pad, or an anti-sling type of cushion, can provide the necessary support. A solid seat base with a curved or personal backrest system is the ideal solution as it provides the best overall support.

Back to the Basics: How to Measure for a Wheelchair

Seat Width: Measure the width of the patient’s hips and add 2”

Potential problems:

excessive width – results in added difficulties in reaching over the armrests to self-propel the wheelchair using the UE’s, does not provide adequate support of the torso and pelvis and which may result in a right/left lateral lean

too narrow – results in increased pressure to the lateral hips/thighs and is an area of increased pressure and potential for decreased skin integrity. Too narrow of a wheelchair is also impacted and accentuated if the person wears bulky clothing.

Seat Depth: Measure from the posterior buttock to the popliteal fossa and subtract 2-3” (if they self-propel primarily with BLE’s you want to allow sufficient LE excursion, then subtract the 3”)

Potential problems:

too short seat depth – failure to support the thigh adequately, may impact LE circulation due to increased pressure from the front edge of the seat into the posterior thigh

too deep seat depth – may compromise posterior knee circulation due to pressure of the leading edge of the seat against the popliteal fossa, may increase instance of sacral sit postures (posterior pelvic tilt) with resulting increased pressure to the coccyx and ischial tuberosities with potential for skin breakdown

happy wheelchairBackrest Height: The backrest height will vary depending on the amount of support the patient needs and torso length. Measure from the seat platform to the lower angle of the scapula, mid-scapula, top of the shoulder depending on the amount of support desired. Seat cushion depth must be added to the patient measurement. Custom backrests can be requested with lateral supports for those individuals who are unable to maintain an upright posture in the wheelchair.

Potential problems:

too low backrest top level of the backrest lies distal to the lower angle of the scapula.  Insufficient support to the upper trunk causing increased pressure and potential for skin breakdown to dorsal spinous processes. Lack of upper torso support increases tendency for sacral sit postures.

too high backrest may prevent the patient from limit UE excursion needed for self-propelling, may increase forward flexed postures, may alter head/neck position.

Seat Height: Minimum clearance between the floor and footplate is 2”

Potential problems:

too high seat-floor w/o footrests – increases sacral sit postures as patient attempts to assume a foot flat position on the floor. This is also the problem with leg rests that are too long.

Too low seat-floor w/o footrests – places knees higher than hips and increases pressure to coccyx and ischial tuberosities. Makes self-propelling the wheelchair difficult due to limited LE excursion thereby limiting their mobility and independence. This is also the problem with too short of footrests (want to attend to this with patient’s s/p THA)

Armrests: Measure the patient from the seat platform to just under the elbow held at 90º with shoulder in neutral position. Armrests can be locked or adjustable, fixed or removable depending on the age of the wheelchair.

Potential problems:

too low armrests – cause excessive shoulder depression. Patient posture in the wheelchair as they attempt to rest UE’s on armrest will be a forward flexed posture.

too high armrests – will cause excessive shoulder elevation. May notice that the patient will remove UE’s from the armrest and place UE’s to their side. If they have diminished trunk stability then the UE becomes pinned between the armrest and trunk causing excessive and prolonged pressure to the UE and potential skin breakdown.

This is a lot of information, and certainly there are variations and other issues to address, but these topics are just some of the basics. These are also your justifications in your documentation. Look at the patient in their current wheelchair and ask yourself the cause and effect of how they are seated.  You know your anatomy. If there is pressure to an area, what structures lie underneath?  Nerves, arteries?  And, if you have to, sit in a wheelchair and assume the position you are seeing to identify pressure areas. Can you imagine sitting in that posture, without moving, for an hour? 2 hours or more?  You have your justification.

Check out part 3 of our wheelchair assessment series.


Keri Poffel is a Physical Therapist and Master Clinician with Infinity Rehab. She earned her Master’s in Physical Therapy from Eastern Washington University. She joined the Infinity Rehab family soon after graduation and has practiced at Avamere Olympic Rehab of Sequim since December 2003. Keri became a board certified Geriatric Clinical Specialist in 2008 and earned her Clinical Instructor accreditation from the American Physical Therapy Association in 2009.




Screening for Wheelchair Seating and Positioning Needs (pt. 1)

This article is an introduction to the process of screening those long-term care individuals in our facilities that may benefit from a more personalized wheelchair seating system. You don’t have to be a wheelchair expert to determine when there is a need for better seating and positioning. As therapists, we are the best eyes in our facilities as we walk the halls numerous times a day to attend to our next patient.

happy wheelchairWe have all seen the patients/residents who are leaning to one side with an upper extremity either hanging over the armrest or trapped between the armrest and their trunk. Or maybe you have seen someone in a sacral sitting position looking as if at any moment they are about to slide out of their wheelchair (and sometimes they do!). How about those individuals who sit in a forward flexed posture as if they are intently staring at their lap or the floor? We know these people. Many times we treated them when they first came into our facilities, or they might be on active caseload right now.

These are the individuals who would benefit the most from our attention as they are at risk for shearing and pressure sores. Optimal wheelchair seating and positioning can also enhance their interactions with their environment. Maybe, by providing a wheelchair that addresses their needs, they can tolerate longer time in their chair so they can participate in facility activities, or visits from their families. Improved positioning in a wheelchair can positively affect one’s ability to eat and swallow. And let’s not forget about breathing. How well can you breathe when you are slumped forward? Good wheelchair seating and positioning can also diminish an individual’s complaint of pain.

So, what are the steps you need to take to secure the right wheelchair for a patient? If the wheelchairpatient benefits from Medicaid, a wheelchair request can be submitted to Department of Social and Health Services (DSHS) in Washington; or check with your state health department on how to submit a request. For private pay, approach the family to assess their willingness to pay out of pocket for a personal wheelchair. I cannot speak for all vendors, but the wheelchair vendor I use has “gently used” wheelchair frames at a lower cost. The styles of backrest and pressure relief cushions are new and added to the overall cost of the wheelchair. Ask your vendor if this option is available.

We created a screening form (click here to print your own!) to determine the need for a personal wheelchair. The bottom portion of the form acts as your MD order. You can designate whether the order is for Physical Therapy or Occupational Therapy. Once the signed MD order is returned, you can coordinate with your wheelchair vendor for a consultation. You can also check with the facility to see if an appropriate wheelchair is available.

Infinity Rehab therapists are required to submit two evaluations; one for the facility through ROX (our internal therapy management software) for home office approval and one for the state-level department of health. When the department of health evaluation is completed it must be submitted to the attending physician for their signature and include their credentials. Once the signed state evaluation form is returned, it can then be faxed to the vendor (the vendor provides their documentation along with the completed, signed department of health evaluation). The entire order process can take up to six weeks to be approved. Be prepared to provide further justification to the state at their request. I find the more thorough I am in my documentation, the fewer requests I receive for justification by the state.

For more, be sure to check out part 2 and part 3 of our wheelchair assessment series.


Keri Poffel is a Physical Therapist and Master Clinician with Infinity Rehab. She earned her Master’s in Physical Therapy from Eastern Washington University. She joined the Infinity Rehab family soon after graduation and has practiced at Avamere Olympic Rehab of Sequim since December 2003. Keri became a board certified Geriatric Clinical Specialist in 2008 and earned her Clinical Instructor accreditation from the American Physical Therapy Association in 2009.

Why We Work at Infinity Rehab…

The comment below is from a recent employee survey.

“Infinity Rehab provides a workplace environment where patient care and positive clinical outcomes remain a priority even in the midst of continued changes in the Medicare System. I have not felt that patient care or treatment has ever been InfinityRehabNewcompromised in order to achieve greater fiscal gains.

Employees also have numerous opportunities for growth and development because of the many CEU (Continuing Education) courses, webinars, and other training programs that Infinity offers.

My workplace environment is professional, yet fun. I feel valued as both an employee and as a person by my DOR (Director of Rehab). All team members put patient care as their absolute priority and interdisciplinary communication within our department is ongoing and beneficial.

As a whole, I have been very satisfied as an Infinity Rehab Therapist and I am confident that my DOR recognizes that I bring 15(+) years of clinical experience as well as over 5 years of management experience to our department. I have been able to use my knowledge and expertise in ways that continue to challenge me as a clinician and, in turn, promote my growth as a therapist and as an employee.”

Infinity Rehab Appoints Vice President of Human Resources and Director of Professional Development

The mission of Infinity Rehab – to enhance the life of every person we serve – extends beyond the patients the organization’s therapists treat to also enhancing the life of its more than 2,000 employees, according to Holly Winick. MPH, SPHR.

Holly Winick

Holly Winick

Winick, the past Director of Human Resources for the contract rehabilitation company, will now serve as the Vice President of Human Resources. “Our business is service – and our employees are our most valuable asset. It’s imperative for us to help each therapist reach their full potential to provide quality clinical outcomes – in fact, it’s the only thing that distinguishes us from others,” says Winick.

Derek Fenwick, PT, MBA, GCS will fill the newly-created role of Director of Professional Development. “We believe developing our people is paramount to our continued success as a market leader,” says Fenwick.

Derek Fenwick

Derek Fenwick

The former Area Rehab Director for Infinity Rehab says the company has always made significant investments in its employees – from holding the largest annual continuing education event for therapists in the Pacific Northwest to maintaining competitive benefit packages during times of industry contracture. “My new role allows me to have a one-on-one connection with our therapists so I can assist with achieving both professional and personal goals,” says Fenwick

“Having these two accomplished individuals in these roles reaffirms our commitment to attracting and retaining top talent,” says Infinity Rehab President Mike Billings, PT, MS, CEEAA. An annual goal for the organization is a greater focus on retention and a reduction in turnover. “Our recruitment team does a fantastic job of hiring the best Physical, Occupational, and Speech Therapists from across the country, and we want Infinity Rehab to be so attractive and rewarding that they have a life-long career with us.”

First Annual SW Symposium: Therapists Beat the Heat by Staying in the Classroom

Thank you to all our Southwest Symposium attendees for making our first SW Symposium a success.  We had 113 therapist in attendance, which nearly matched the high temperature of 115 in TempSW Symposiume, Arizona that day!

Attendees had the chance to earn a total of 7 CEUs by attending these courses:

A Potion for Locomotion (Kay Wing, PT): What does research say about neuroplasticity as it relates to motor learning? What is the evidence behind gait training and the benefits of body weight support systems? What is the 6th vital sign?

Allen Cognitive Testing (Michael Rackham, OTR): Can you assess a person’s cognitive level? What does that level signify regarding goals for therapy and discharge placement? Come learn how to assess your patient!

Cardiopulmonary Considerations in Rehabilitation (Donald Shaw, PT): Do you really understand how to treat that patient with CHF or COPD? What vital signs should you be looking at? Can you help keep patients from being readmitted to the hospital with cardiac and pulmonary issues?

Click here to view photos of the event.

Subscribe to the blog for future dates and locations of 2014 Infinity Rehab Continuing Education Symposiums.

Warm regards,

Mike Billings, President, Infinity Rehab

Clinical Internships: The Benefits of Mentoring a Student Therapist

Our country’s health care industry is dependent on an increasing workforce. Health sector employment is projected to grow from over 14 million jobs in 2010 to nearly 18.3 million jobs in 2020, an increase of 30%. This compares to only 13% growth for jobs in all other employment sectors. Students of allied health professions provide a critical source of new health care employees. A successful clinical internship program can expedite the learning process for students becoming professional practitioners..

The goal of a clinical internship program is to provide students with an excellent learning experience while leveraging the clinical focus and resources of a company. At Infinity Rehab, we strive to offer as many clinical internships as possible to students seeking opportunities to work with older adults.

Over the past three years, Infinity has placed over 300 students in clinical rotations across three rehab disciplines in seven states. This commitment requires a significant investment of time and resources to coordinate and provide the supervision of these students. Clinicians practicing in the field must commit extensive time and attention to give students a fulfilling experience during a clinical rotation. Being involved in a student intern program sounds like a great idea, but is it worth the energy?

“Will you take a student?”

What a loaded question. For many seasoned therapists, those words invoke a first reaction of stress, self-doubt and maybe even personal insecurity. For a few, excitement and intrigue may come to mind.  Either way, it feels like added work. And added work is never good if it’s not worth the sacrifice.

Consider what the question implies:

  • It is a one-way road.  The question suggests a power imbalance. “I, Experienced Clinician, give to you, Young Novice, my knowledge. Now go be wise.”
  • It is a burden.  To some degree, there is an imposition on your day as a therapist.
  • It is your duty.  This is a commitment that you owe someone else. You were a student once – now it’s your turn.

The science of decision making says you are a more effective person when you can make a choice rather than be forced into a decision. A favorite practice of mine is to “reframe” a situation when I face a significant decision that lacks a clear benefit.

Reframing is a great tool and helps you be a stronger professional. The facts stay the same; it’s the view that changes. No person ever gets things exactly as they want. Successful people make the circumstances they are dealt work for them. We help our patients do this all day – “This hard work gets you back home” – but health care professionals are often unpracticed at reframing our own challenges.

In my last blog post, we discussed what it means to be a “professional” in today’s health care environment. If we reframe the idea of mentoring students, will a clearer view emerge?

Therapist Mentorship

Today’s professional is open, appealing, collaborative, and humble. It is an attractive worldview if you aspire to be a greater version of yourself. Mentoring students is a natural fit for professional growth.

The perspective of a professional: Mentoring a student is a win-win deal.

Students bring energy, new knowledge, and fresh perspective to the field – sometimes from their own university research experience. Time spent orienting and training students is not always a sunk cost either; reviewing the basics is often a needed refresher for a professional. And possibly most exciting, professional networks begin to expand quickly – among companies, universities and clinicians alike.

Infinity Rehab is committed to mentoring and teaching future professionals. Our business is stronger because of it, and our industry depends on it. Thank you, current professionals, for considering how students fit into your own professional growth. Our health care industry depends on you.


Derek FenwDerekF-Infinity_Rehabick, PT, MBA, GCS is a physical therapist and board-certified geriatric clinical specialist.  He develops leaders in healthcare as the Director of Professional Development at Infinity Rehab.  Find him on LinkedIn and on Twitter @DerekFenwickPT.

Invest in our people. The rest will follow.

Hello, I’m Derek Fenwick, PT, MBA, GCS. I served as an Area Rehab Director for Infinity Rehab for the past 2.5 years. Now, I’m both excited and proud to say I’ll take on the role of Director of Professional Development

My mission in this new position is to begin the task of cultivating the ideas, feelings, and innovative visions of our professional staff to help turn those deep notions into tangible, forward-moving realities.

It’s no secret, the health care industry is highly dynamic and ever-evolving. Luckily, we already have a proactive strategy at Infinity Rehab, aimed squarely at taking on this challenge:

            Invest in our people.  The rest will follow.

That sounds great, right? But what does it mean?  And – more importantly – what does that philosophy mean for our therapists; especially in today’s health care world?

The renowned researcher and writer Allison Fine, contributed a great article to Harvard Business Review summarizing where Infinity stands on the question: “What does it mean to be a ‘professional’ today?”

Flow Chart                                                      Source: Harvard Business Review (

Infinity Rehab recognizes that we are nothing without our people. We believe it is important to develop our managers and clinicians to be the best at every level of service to our company.

Subscribe for future updates to the Infinity Blog about my adventures in Professional Development. It’s going to be a fun and eye-opening journey over the coming months and years. Here is what you can expect to find in my For Your Growth section:

  • Tips on leadership and management, boiled down and ready for immediate use in your job
  • News on Infinity’s initiatives and upcoming opportunities for you and your top colleagues
  • Stories about our employees, and the amazing work you do to lead our industry forward everyday


DerekF-Infinity_RehabDerek Fenwick, PT, MBA, GCS is a physical therapist and board-certified geriatric clinical specialist.  He develops leaders in healthcare as the Director of Professional Development at Infinity Rehab.  Find him on LinkedIn and on Twitter @DerekFenwickPT.