Corey Dupont - Descript

Dr. Corey DuPont is a physical therapist who has launched his own cash-based private mobile physical therapy practice in the Boise area. He offers one-on-one sessions with clients in their homes, at work, or outdoors. He chose this path due to frustration with regulatory burdens and restrictions in the healthcare field. There are different levels of physical therapy, including outpatient clinics and home health. Insurance coverage for physical therapy depends on factors such as being homebound and having a skilled need for therapy. If insurance coverage runs out or doesn't apply, individuals have the option to continue therapy on a cash basis. Hi, I'm John. And I'm Erin. You're listening to Connect and Power, the podcast that proves age is no barrier to growth and enlightenment. Tune in each week as we break down complex subjects into bite-sized, enjoyable episodes that will leave you feeling informed, entertained, and ready to conquer the world. Welcome, Dr. Corey DuPont. You've been a practicing physical therapist since 2008 with experience in both outpatient and home health. Your expertise has been in orthopedic injury and recovery, chronic pain, and vestibular rehab. You've had extensive training in those fields. You've had many years of experience as a PT in the healthcare field, and being frustrated with the regulatory burdens and restrictions placed on physical therapy by third-party entities, you've decided to launch your own cash-based private mobile physical therapy practice in the Boise area, which allows you the freedom to dedicate full-hour sessions one-on-one with clients in their homes, at work, the gym, or even outdoors, which, by the way, is super exciting to hear. And I'm sure that means achieving outcomes in far fewer visits than seen in clinical settings, which, gosh, I'm so excited that you're here because I know you, I've worked with you, and I, for one, know you're one of the best. So thank you for being here. Thank you for having me. I'm pretty excited about this. I know you're one of the best. I don't know you personally, but we were having a discussion with somebody yesterday, and we mentioned you coming on, and they were like, oh, my gosh, that's going to be amazing. I was like, oh, yeah. We can't wait. So thank you for sharing your time with us. Yeah, hopefully I can live up to that. I'm sure you will have no problem. In healthcare, when I own my caregiving company, I remember when I'd meet with people, it didn't happen in California, but when I moved to Idaho, people were like, what's your story? I'm like, what do you mean, what's my story? How did you get in the industry? And so that's what I'm asking you. Where was the thought process? Who said, be a PT? Was it your dad, your grandpa? Did you have an experience or an injury? How did you start? Yeah, my journey was fairly methodical, really. A lot of PTs, when you talk to them, will have personal experience having had an injury as a young athlete with a physical therapist, and I really liked that. I was an athlete, but I never really got to work with a physical therapist. I really didn't know what that was, thinking about back in high school. Now, in high school, going into my senior year, I wanted to be a musician. I was wanting to get into music production and maybe create pieces for movies and shows and things like that, not a stage performer. So when I had made this decision, it did surprise most everybody in my family, in my hometown. But in high school, I was actually a volunteer firefighter. I was a junior volunteer firefighter, and so I got to be on the structure fire crew. There weren't too many fires. There were more grass fires, a few structure fires, but a lot of medical calls, a lot of car accidents that I would go on to as a first responder. And as I got into that a little bit more, I decided, you know what? I do really like helping people. I don't see myself doing the first responder thing long term. I'd like to be able to be more involved in the healthcare world. And so I did a little bit of digging and researching. John knows me from previous job that I'm a spreadsheets guy. If Excel was really a thing back then, I probably would have had an Excel because I'd looked at different jobs in the healthcare field. What does it take to get to those jobs? What does that job look like as a lifestyle? So I looked at everything from, yeah, physician, PA, audiology, music therapist, trying to blend some of that, which kind of got me into this therapy side of things. What about physical therapy? So I looked into that, and that seemed to match more of the lifestyle that I would like to live, more of an active lifestyle. I looked into that and what schools offered that and what was the path towards that, and I have a greater chance of getting into physical therapy in comparison to like medical school. And I saw what it took to get into medical school and then the cost associated with that. I think I want something that's related, but I can get there a little quicker with less debt and live an active lifestyle. I continued through the firefighting through college during the summers. I was a helitech firefighter on the BLM crew out of central Oregon, out of Prineville. And if that was actually going to be my backup plan, if I couldn't get into physical therapy school, I was going to continue on with the wildland firefighting. They had a management training program for people that were interested in that. I got into physical therapy school, and I got into a couple of them, and I chose Eastern Washington University where I was, and the rest was kind of history. Wow, what a great story. And we both have a passion for central Oregon, that area, Ben, Prineville, all that area. It's so beautiful. And it is such an active place, right, for anybody and everybody. There's just so much there. If you'll explain to the audience, because now that you've had so much experience in the industry of physical therapy, if you will explain the difference between outpatient therapy and inpatient therapy, because I think that so many times people feel they have to go get physical therapy at a clinic or something like that. But there's some huge advantages to getting physical therapy where you live, where you reside in your life and so forth. So if you can share with the audience the difference between those. Yeah, certainly. When people think about physical therapy, they automatically think about the orthopedic clinic. There's a lot of clinics around with exercise equipment. It looks like an exercise gym with some treatment tables. That's typically what everybody thinks about or has experienced. But yeah, there are different levels of physical therapy if you want to think about that. The two basics that we have available outside of a hospital setting are the outpatient clinic or home health setting. So the big difference is being outpatient clinic, you're obviously going to the clinic where they might be. So you would set up a schedule, appointment with them at a specific time, and you would drive to that clinic and you would do physical therapy there. What's nice about that is that you do have equipment that you may not otherwise have access to. But you have to go to them. With home health, the physical therapist comes to you. When it comes to insurance and what insurance covers, because that's usually the next biggest question, is my insurance going to cover this? That was my next question. For sure. Because a lot of the population is on a fixed income and they're concerned about how much money it's going to cost. Yes, exactly. So a lot of the insurance regulations and rules are set by Medicare. And a lot of the private insurance companies follow the same Medicare basic guidelines. So when it comes to outpatient or home health and what insurance covers is they will cover home health as long as an individual is considered home bound. So that's the terminology that they use. Home bound, meaning it's a taxing effort for that individual to leave their home on a regular basis. Yes, somebody might be able to leave, but if they come back from going to the grocery store and they have to rest for an hour or two because they're so tired from just making it through that grocery experience, that's a taxing effort. But somebody like me, I can just hop in a car and go because I don't want to go to a facility for whatever reason. I can't have outpatient therapy, right? And have insurance pay for it. And have insurance pay for it. Exactly. But if you want your insurance to cover it, you need to meet those qualifications that I am home bound. I have a skilled need for therapy and I have potential for making improvements. There are some caveats on maintenance, which we can get into in a little bit. But as long as you meet those three criteria and I have a physician that's overseeing my care, that's another Medicare regulation. If you're a Medicare beneficiary, you have to have a physician that is overseeing it and signing off on the therapy plan of care. Same for the outpatient realm. You have to have a referral to go see a physical therapist from a physician for Medicare beneficiaries. Private insurances, depending on the state, don't necessarily need a physician's referral. Like in Idaho, we have what's called direct access to physical therapy. So an individual that's not a Medicare beneficiary or other federally funded third party insurance payer can go see a physical therapist themselves. That was my next question, too, into that is, if I only get a certain amount of PT time and I wanted to do more and then I'm not qualified for whatever reason, how do I continue that? Because I see the benefit of it myself. Right. How does that work? What do I do? So people do have options. So if for some reason you've run out of your benefit, because there are plans that have a limited number of visits that say it's 10, just an arbitrary number, and you made it to 10, but there's still a need, you can continue on a cash basis at that point. Thinking about Medicare, if you don't meet the criteria, but you would like to continue working with that physical therapist, either you're not homebound anymore or your potential for rehab, you've achieved those outcomes, but you would like to work more. You can pay cash for that. And there's certain paperwork that shows that, hey, Medicare or your insurance is no longer going to cover this. And you understand that. And you are agreeing to pay the cash rate at that. So there are options. That's good to know, because sometimes people don't know that I only get this money and I'm going to space it out. It's so much time to maximize how I can. or some people that may have the resources, right, if maybe they're going to an outpatient clinic and they like that setting, but maybe they want some additional support at home and they want to continue getting back to normal, but to get that physical therapy, they're willing to hire somebody like you, Corey, to come into their home, evaluate the setting, and make sure they're really set up with success in their normal life setting, their home or out in their garden or getting back on the trails, riding a mountain bike. I'm super excited to learn more about this as we're talking about this. Can you explain the concept of active aging and how physical therapy can support aging adults and staying active and engaged in their life? Because obviously you and I both are and Erin are all on the same page that, gosh, we want to continue doing all the things we're passionate about as we age, right? We don't want to get to a certain point where it's, okay, gosh, we can't even leave the house now. I'm going to stop you right there. As John is an active hiker, he can hike and hike and hike. So I'm okay with not getting therapy to be able to hike 50, 60, 70 miles in a day. Sorry, just throwing that in there. Okay. All right. So can you explain about active aging and how some of that physical therapy can continue to support people as they age? Certainly. As the name implies, as you are aging, it is important to remain active. A rolling stone gathers no moss, right? As we continue to age, we all experience changes in our physical body. What I found is that most people in their mind still reference themselves as being a younger self. I still think I'm 25, and my body says something completely different. I'm not able to do what I used to be able to do. My run times are considerably slower than it used to be, but I'm okay with that. But as time marches on, the collagen fibers in your body begin to change, your joints begin to change. And that doesn't mean that we should just get into that, because that's actually probably the worst thing you could do, is not continue to do. So you may have to modify what you're doing, how you're doing it, how often you're doing it, but continue to remain active as you continue to season over time. Active aging, we've talked about that, and what do you mean being active? If I'm listening to this, I'm like, well, I get up and go to the bathroom, I do the laundry, I do the dishes. I'm active. What does that mean? And so that's where a lot of healthcare practitioners kind of fail, is they say, yeah, stay active, or diet and exercise is going to help you out. And then you leave, and you go, well, what does that mean? And it does mean different things for different people, and I think this is where a physical therapist really can step in, is helping you identify for you as to what active means. Because staying active for you is going to look different than staying active for John, because John's going to go do a 20-mile hike up in the mountains. And I'm like, three or five things. Exactly. So it will, and it ought to look different for individuals based on their scenario, because as we also age, there are certain conditions that seem to show up. Everything from diabetes to Parkinson's, ALS, dementia, so on and so forth. These are things that aren't necessarily normal. We don't expect these things. We all expect to just continue to get older, but we're still capable. And so you want to be able to work within that. And a physical therapist can really help, especially if you have specific conditions, to identify what's safe, what's appropriate, how much to stay active. What I tell people is probably the best thing you can continue to do as you're aging, especially getting into those later years, 70s, 80s, even in the 90s and 100s, is walk. It's one of the best things you could possibly do. We are designed, we are meant to walk. And people get into trouble when they stop doing that. And that's one of the simplest things you could possibly do. What are the most common physical challenges in aging, and what can we do about it, or what can our listeners do about it? We can't get younger. We can try. We haven't figured that out. But what we have figured out is how quickly you age. You have the ability to slow down the aging process or speed it up. I have worked with some individuals where I swore they were in their 60s, but they are actually 40. And then I have to double check their date of birth. I'm sorry, what did you say your date of birth was? And I say, yeah, born in 1976. Okay, you've been through some things that have sped this process along. And then you'll meet individuals who are like, oh, he's got to be in his 50s. And you learn that he's 82. Yeah. Yeah. I hope that's me down the road, right? So everybody ages differently. But what I find is that the people who have made choices to remain active, to generally eat and stay well, so eating more natural type of foods, thinking generalities, staying well hydrated with water versus somebody who may, what I had somebody describe once upon a time, a rough back alley life, alcohol, drugs, that will speed up the process. Or inactivity speeds along the process, especially even thinking about arthritis. Inactivity, we are meant to move. Some of the people that have some of the worst low back, hip and knee arthritis are truck drivers. Yeah. Because what are they doing all day? You won't meet a truck driver who's going to stop every hour, get out of the truck and walk around because time is money. And so they're going to be trucking along. They've got their cooler, got their big gulp. They got their peak cup because they're not going to stop for that either. And they're going to just continue to move. And they have some of the worst arthritis. On the flip side, other individuals who have some of the worst conditions of arthritis are people who have been overly active, almost abusive, if you will, to the body, very hard on their body. So that's there's a way to be smart about it. Thinking about some of my farmers, my older farmers, construction workers, police, firefighters, because they've been generally their career was rough. So active. It was rough. So we want to live somewhere in the between. Yep. In between. We don't want to be still, but we don't want to cause unnecessary roughness, if you want to call it that. I tell John, it's the 80-20 rule, 80 active, 20 percent, I can do whatever I want. Right. And, you know, life is meant to be enjoyed. I've met some individuals, they feel like they have to be doing something all the time and some people qualify that for that. And it's OK to take a break. It's OK to sit and enjoy a show. It's OK to let your body rest because you have inflammation and it needs to heal. It needs to do its stuff. You can keep going. We just get into trouble where we might be sitting on the couch and three seasons later, we do decide we should... That's a 20 percent rule on a weekend, on a rainy, snowy day. But we do see more issues, especially with the kind of work that we're doing now with computers. A lot of us end up spending time sitting in front of a computer. It's nice to see now these days that we have standing desks or even little treadmill things underneath the desk. We've talked about that. Yeah. And a lot of places are recognizing that and making adjustments to help people save off from that. Going back to the back pain you talked about, I did not realize how important our core is because my back pain really was my core and my PT said, your core, you have a baby. Your doctors don't teach you that you need to retighten it. Things don't just automatically go back. And so if we can learn some of those practices now, really your core is huge. Yes. It can save us a lot of things in the future as we age. Am I wrong? No, you're exactly right. They call it the core for a reason. It's the center of your body's being. It's your foundation. To build a house on a weak foundation, on a sandy foundation, the house is not going to be able to withstand life. And so you have to have that stable foundation to be able to function off of, to be strong, to be able to perform. It can lead to injuries down the road, even though I feel like I'm generally healthy. I look like I'm active, but I've got a pretty weak core. Maybe some muscles have been inhibited for women after pregnancy. Things are stretched out because that baby was in there for quite a while. Like I said, things just don't snap right back. It's not a rubber band. Maybe it came out in some fashion. Things were stretched out that way too. We do want to make sure your core is strong and it doesn't matter how old you are. Your muscles still function. You can still be older and strengthen up muscles, strengthen up your core. If I'm listening to this point, I've had this back pain. I think it's from when I gave childbirth, now listening to this, is there something I can do or how do I tighten it or what do I do and can I go to a doctor and request help? Certainly. There's still hope. There is always hope. Part of what I also help people understand too is about pain, what pain means and what it's trying to get at. I do have that certification as a therapeutic pain specialist. Somebody who's been dealing with pain for a long time and continues to have back issues and they keep going to the doctor, the x-rays look fine, MRI shows there's a couple of bulging discs but it really doesn't explain why I'm having back pain. Just take this drug. You'll be alright. Yeah. Right. It feels dismissive really but I still hurt and you're telling me everything looks what's going on and so helping people understand why you continue to hurt, just that knowledge itself actually starts to calm down the pain itself because when you understand something, it becomes less scary. When something's less scary, it's less painful. The analogy I give people is like if you approach a door and you're going to open the door but you hear something growling on the other side of the door, are you likely to open it? I'm a very curious person so I might want to peek. You might want to peek. Yeah. Most of us be like, oh my gosh, there's something on the other side of this door. What is it? I'm going to barricade it. I hear it growling. I'm putting chairs, fridge. But how do you know it's not a million dollars on the other side and it's just a machine making that noise? You would want to barricade the door because in your mind, what's on the other side? Something about to eat you. That's a protective response. We're wired to do that. That's a protective response and that's like how pain works is when it doesn't understand this noise that's coming, it assumes worst case scenario. I have a bulging disc, next it's going to slip right on out and I'm going to be paralyzed. I had a neighbor whose cousin's dog had a slipped disc and had to be in a little dogged wheelchair for the rest of his life. That's what the brain does. It goes down a rabbit hole. It does. I love that you're talking about that because so many times we'll go to our primary physician because we do have that back pain that you're talking about. However, sometimes they'll just give us a pharmaceutical and they'll say, take this, right? Take that and you can take all these other medications and it will alleviate some of those symptoms. However, it's best to go to some expert like yourself to really dive in, ask questions, understand and then teach them better practices to say strengthen those muscles or do different movements to loosen that area up or strengthen that area. And so it's super exciting that you're here with us and we're talking about that because I, for one, know that there's some great pharmaceuticals out there. However, a lot of them have side effects and so it's better to get to the core of what's happening with our muscles and our back and our joints and everything to have a better understanding to alleviate those long term so we don't have to deal with the side effects of taking these pharmaceuticals that can affect us in other areas. So like we talk about advocating for yourself and the doctor is telling you, oh, we don't want anything. We don't do it. Here's some drugs that's going. No, something's wrong. I am requesting you to write me to go see a PT. Something's wrong. That's how I also educate physicians as well as if soon as you hear somebody complaining of pain, maybe one of the first things you think about is let's try physical therapy because a physical therapist is going to be able to help you understand what's on the other side of that door to be able to help you open the door and realize that was a puppy playing with his toy. It wasn't it wasn't a Rottweiler wanting to get you. It's still there, that noise, that pain is still there. But now I can actually function. And as the body recognizes that the threat is no longer there and I'm now becoming more active, the pain naturally starts to subside. It's just through that understanding. Survival mode. Right. Just surviving that whatever is coming, that noise. We are designed to survive. Without that survival mechanism of assuming worst case scenario, we're not going to survive. We wouldn't survive as a species. You've heard of the Darwin Awards, right? People who don't have that filter of this could harm me, maybe. I think that people should really evaluate what is best long term. Right. And it's best to dive into what's truly happening to our body. And is there an alternate way to strengthen that area or fix that area so that we don't have to take all these pharmaceuticals? Because if you don't strengthen that area, you will have to subject yourself to taking more and more pharmaceuticals to take care of that pain. So I think that's super excellent. And physical therapists such as yourself can really teach us about mobility and flexibility as we age. So when you meet with clients and your different people that you've worked with meet with clients, they teach you all kinds of things from exercises to stretches and what you recommend to take care of themselves physically, correct? Certainly. Kind of circling back a little bit to the issues that older folks tend to deal with, the loss of mobility. So staying active is going to help out with that. I'm going to touch a little bit on arthritis a little bit, too. The other thing is balance. I was going to add falls. Like how do we prevent falls? Yes. That is one of the leading reasons and causes of hospitalizations is having had a fall in the home. And once you've had a fall, it becomes easier and easier and easier to fall again and again and again. So there's some multiple factors that go into play. Strength is certainly a factor in that. Your strength, your reaction speed, but what I also find is that your sense of balance also changes over time. And that's where people get into trouble, especially thinking about how we continue to age. Looking at my children, I've got children, a seven-year-old and a five-year-old. One of the things that they love doing is spinning, spinning, spinning, spinning and bumping into things and rolling around. If I spin around two times, I'm done for the day. I got a headache. I just, I can't do it. But kids have really good balance because they're always utilizing their systems. They're always challenging their balance system. So we have three basic systems for balance. One is our sensation. We can feel where we are in space. Number two, actually, I should probably flip this around. Number one is your vision. Your eyes, being so close to your brain, are constantly scanning everything in your environment. It knows that these windows, that the floor are horizontal or they should be horizontal or vertical. And so always telling you if you're off kilter or not. And your eyes can tell you immediately that, hey, you're starting to lose your balance. It's the reason why a lot of falls happen at night. You can't see your environment so well. That's why it also feels weird to be in one of those funny houses where the whole house is tilted. You feel dizzy because your eyes are saying, whoa, this is straight, but your inner ears, your vestibular system is saying no, but gravity is this way. And you get an interruption of two different signals saying two different things at the same time. And that can trigger a sense of dizziness or disequilibrium. So the third sense of balance is in your inner ears, your vestibular system, your gyroscopes that tell you where you are in relation to gravity, especially your head. Are you leaning one way or not? That system in particular becomes less and less used over time because we don't see adults spinning around. We see gymnasts that do that, and they have amazing balance. But as we get older, as generally speaking, we just stop actually using that system. And the body follows the use it or lose it principle. So if we're not stimulating that vestibular system, those gyroscopes, it becomes weakened just like muscles. If you don't use them, the body's going to reappropriate that energy somewhere else. And so what I see with a lot of older folks is what we call vestibular hypofunction, meaning it's under-functioning. It's having a hard time telling you if you're off kilter or not. So when you go to move, these guys aren't saying that you're moving, but your other systems say you're moving. So you might get mixed signals and you can end up with vertigo or just a loss of balance because I can't feel myself falling. I'm already falling, but I can't feel it. Now it's too late. So are you saying that John and I need to dance circles in the living room every night? Yes. No, that's not what he's saying. But he is. He just said yes. Dance party. We're circling around. Yes. You're actually hitting it right on the head there is stimulating that system on purpose. And so what I teach older individuals, keep it simple and start off safe and sitting in a chair, you move your head left, right, left, right, tick, tock, tick, tock, just like a little clock left and right. Like you're saying no. And then up and down, down, down, up, down. So you're getting that stimulation, that input into that part of your nervous system, wakes up those nerves, helps your overall balance. Yeah. Yeah. That's amazing how just the simplicity of what you just said, there's so many people that are unaware of that, right? They're so unaware of that. I had no clue. I might have flown. Yeah. I'm sitting here going, oh, you mean all I have to do is turn my head back and forth or up and down. Whoa, whoa, whoa, whoa. Can you do that one more time? Yeah. I like the little head bobbing. The little like attitude, you know. But that's such a great tool, right? That some of us can start practicing to help strengthen those areas and help us with balance and stuff. Because one of the most frightening things as we age is losing our independence, right? And all these little tips and tricks that obviously, you know, and we don't. And there's a lot of people that are going to learn from this podcast once it gets out there. Simple things like that can really change the course of their life and their future. And so I'm definitely, Erin, if you see me in the living room one night and I'm, you know, doing that with my head back and forth or up and down, please don't make a video of it. Don't make fun of me or anything. But you know what I'm doing. I'm quite a bit older than you and I'm just training myself so that I can do it. I think we should all do that. Yeah. Maybe we can do it together. We can all make a video reel and do it. But yeah. Wake it up. Stimulate it so that it can serve a function for you. Yeah. You know, we're always talking about falls and injuries and making sure that we prevent those. Because like you said, you know, one fall eventually leads to another fall. And sometimes what happens is somebody falls and then they go to their primary physician and their primary physician says, oh, you're in pain from that fall. You don't have anything broken. You don't have anything torn. So take this medication and I'll deal with the pain. However, with your expertise, you can come in and you can evaluate their surroundings, have a better understanding on how that fall happened, right? Maybe it's throw rugs. Maybe it's just the struggles of getting around things. And you can help evaluate that and create better solutions in their environment so that they don't have those repetitive falls. Because as we know, the more falls you have, the more you're going to have and eventually you'll lose your independence. And hiring somebody like an expert such as yourself and being able to do that is something that they're not necessarily going to get in an outpatient clinic. They may get to use certain gym equipment and tools and stuff to strengthen certain areas. But it's even more of a bonus to have somebody like you come in and evaluate and assess and create almost like a plan of care based on their environment. Am I right on that? Yeah. You're hitting it spot on. As therapists, we will do a multipoint assessment of your environment. How do you have things set up? Like you said, are there things that are a tripping hazard, rugs or wires, or is it too narrow and it doesn't give you a lot of wiggle room? Thinking about where a lot of falls happen between the wall and the bed, between the toilet and the tub or the wall, kind of tricky places. Are they happening at night? Is it a lighting issue? What kind of light should we put in there? Nightlights. Super important. Most people don't want to turn on the room light because that will also wake you up. But I also advocate for red light. So red nightlights because it doesn't stimulate the nervous system and wake you up as much. The military knows this. They use red light at night because the wavelength isn't going out so far so the enemy can see it. But your eyes attenuate to it and you can still see in the dark and it's not having that waking effect. Then we would do a physical assessment. How are your different balance systems working? Is it your vestibular system not working? Is it your sensation? A good example, little cues we can look at. Somebody's kind of shuffling their feet. Why do people shuffle their feet? That's because oftentimes they don't have very good sensation. So when they can shuffle their feet, they're getting more information put into the system of where the ground is. I'm always trying to figure out where the ground is. Do you have another question? I do actually. Because I know I do this and I'm sure some of our aging adults do. When you go to PT, you go and you go and you're like, okay, I don't know why I keep coming. I'm not seeing the benefit within the first three, four, five. Why am I doing this? I still feel like this. A couple things there. When I'm working with people, I always tell them it is going to take some visits to start noticing some changes. You want to give it three or four, especially if it's been around for a long time, to feel like, oh, yeah. You might get those glimpses in the beginning, like, oh, wow, that does feel different than what it was, whether it's pain or I can actually do something that I wasn't able to do. But also don't be afraid to tell your therapist that, hey, we're five visits into this and I don't feel like it's making changes. As a physical therapist, I want to know that because if I don't know that things aren't changing, it's tough for me to make a change to what we're doing because we might need to pivot. We're trying this, okay, maybe I'm missing something and so I'll dive in and look a little deeper at something else. Oh, my goodness, it really was this. Let's start working on that and what do you know, things start falling into place. So it's okay not to be making progress, but I think you need to communicate that is happening so we can make a pivot. How important is the homework we're given? Yeah. Yeah. I'm glad you asked that. Yes. So a physical therapist will always be able to tell if you're doing your home program or not. So it is in your best interest to do the home program because we put that out there on purpose, working on something once a week really isn't going to get somewhere, even twice a week. It's what you do in between that's actually going to make the big difference. Yeah. I'd like to think that I'm the magic. You don't need anything but me. I just touch you, walk. Yeah. I haven't figured that quite out yet. I'm working on it. When you do, share it with us. I feel like my power as a PT is helping you understand what the issue is. And part B, this is what you do about it. And I use my words on part, this is what you do about it. I can help move things along, but it really does depend on every day, what are you doing to fix the issue? And sometimes it's a mental thing too for them, right? If I do the work or if I don't do the work, I'll still progress or I won't progress. Or sometimes people are like, maybe you're my only interaction I have for the week. So they hold themselves back. And so it's getting them to get over that for their benefit. Right. And occasionally you do see that because as a physical therapist, we get to spend time with these individuals. We get to know them, especially in home health. Maybe we're working with somebody, like you said, who doesn't get a lot of social interaction and therapy has a social aspect to it. It can become a challenge for physical therapists to establish boundaries and expectations of what physical therapy can do and has a finite amount of time because it's not in the patient's best interest or the third party's best interest to continue to pay for or utilize resources for something that's not achieving results. And so I'm a big advocate of utilizing your resources wisely. You said in the beginning, you want to be able to do this. Okay. How are we going to get there? A lot of times I'm going to take you to 80 or 90% of that and the rest is going to be on your own because I know you're going to succeed that last little bit. A good physical therapist is going to be able to exit at the right time with you succeeding on your own. That's super great. And I think that if we can touch base on your support system. So physical therapy in a home setting or even an outpatient clinic and stuff is quite different with or without a support system because even us now, you know, it's important to have somebody that helps keep you accountable, right? So if you're an aging adult and you've moved into your children's home, sometimes it's nice if the children maybe come in one or two sessions of that physical therapy just to see the homework that's being left behind where they can encourage mom or their dad or brother or sister, even their children, right? Or help them remember because that's sometimes part of the thing. I know I have that issue. I'm like, wait, what am I supposed to do again? Right? Yeah. So it's important, right, to be part of some of those sessions, to have a better understanding, to support, to help encourage them and to reach their goals. Because I love that you said it's not a smart thing just to pay a physical therapist on a continued basis just for that social interaction. They come in, they work with you for an hour or two, and then you leave. You don't do anything. You don't really see any results. So you continue to pay them forever, right? You have a goal to hopefully get to, and that physical therapist wants you to reach that goal, and they want to help do that. And I think that communication works really well. You can go in, and if you notice that they're living with their children, you can say, hey, listen, would you mind coming in so I can show you some of the things that I'm working with your father or mother? And sometimes that becomes challenging because they're saying, mom, Cory said you need to do this. And she goes, yeah, I don't want to do that. I'm sore. I'm uncomfortable. I don't want to do that right now. But it's still important to help support that physical therapist to reach those goals. With compassion. Yeah. With compassion. Yeah. Is it compassion or nagging? And you're exactly right. Having a support system in place is going to help the accountability. When it comes to assigning home program or exercises or homework for one of my patients, I never go beyond three things to work on. It's usually one, two, maybe three, because myself, if it's beyond three, I have a hard time remembering. If I go to the store with four things to get, I will get three. There might be a fourth, but it won't be what was actually supposed to be. Or five might be as often times the case. So keeping it simple to here's the most important thing to do. Every day working this one thing. Sometimes the power also with a physical therapist is being able to say, hey, I'm the expert. This is what you need to do. And oftentimes with the family present, oftentimes what I hear is, I've been telling mom to do that for years. And for some reason, having it said externally, that's not within the family realm. It sticks better. I got a little story, actually, of a patient I had worked with at an assisted living facility. She was, gosh, what was she, 83 years old. And she couldn't walk. She couldn't even get out of bed by herself. She had to have assistance to get up out of bed, assistance to be transferred into a wheelchair, wheeled to the bathroom, helped onto the toilet, wheeled to the dining, all that stuff. She was dependent upon caregivers for everything. And I asked her, what do you want to work on? What do you want to be able to do? I want to be able to walk. I'm thinking, okay, that's a tall ask. When was the last time you walked? Probably 10 years ago. Wow. Okay. Here's what we got to do. We got to get your strength first. That's the one thing we're going to work on. And we're going to do that with a squat. And she looked at me, she goes, a squat? No, that's not happening. I haven't done a squat. And I was like, well, let's start this. Let's sit you at the edge of the bed. And we're going to work on standing up. You're going to stand up. And I had to do a lot of the work for her because she just literally didn't have the strength. But we got her up standing for a moment and then right back down. I said, you just did a squat. In reverse, it is a squat. And she went up and then back down rather than down and then back up. Same muscle groups, so on and so forth. And the light went off in her head. This is what we're going to work on. And so I worked with her for a couple of weeks, being able to do those stand up and downs. And she got to the point where, okay, she could actually handle doing it on her own. So I gave her the homework. You have to do one of those every day. And she worked on that. She did one every day for a week. And then the next week, she did two every day for a week and then three and then four. And she progressed. And I got to the point where I didn't actually need to be providing therapy anymore. Her caregivers were helping out with the exercises and she knew what to do. And I checked in on her some months later. She worked her way up to doing a hundred of them a day, a hundred of them a day. Not all at once, but it was 10 or 20 here and there. And she was able to get out of bed, stand up and walk all throughout the facility without a device. Wow. And that had been 10 years since she'd done that. Yeah. She was in her 80s. I love that story because it showed that it doesn't matter how old you are. And the research has proven it. You can be a hundred plus years old. You have the capacity to improve. Muscles can regenerate. Brain matter can actually regenerate and get better. Not as like it was when you were 20, but it can get better when you have the buy-in and the desire and you have the tenacity to do it every day. Yeah. I love that story. I know you have an amazing company that you have. You've got a course for people that they can follow along and learn, educate themselves, empower themselves, which is what we want as part of our company. And then anything else you can share? Yeah, certainly. So I got a couple of things that I'm working on. I just launched DuPont Wellness. I'm just a couple of weeks into it. Two things I'm working on with that in particular is I'm providing one-on-one physical therapy visits at home, at work, at gym, outdoors, like you said. I'm a mobile physical therapist. It is a cash-based practice that affords a few things. It allows me to provide patients a full hour dedicated one-on-one time. And I get to come to you. So you're eliminating the drive time to go to a clinic. If it's during the day, which most clinic hours are, that's time out of work to go do that. That's longer than a lunch hour. So I can come to you. So at a clinic, oftentimes, you're going to spend 20, 30 minutes with a physical therapist. And the rest of the time, you're either working with an aide or a tech doing exercises or even doing exercises on your own while the physical therapist is working with somebody else. Yes, the physical therapist is on site, but the attention is not fully on you. And so I get to spend that one-on-one time really diving into what is the issue here. And by doing that, it's far fewer visits. Oh, that's awesome. Far fewer. The national average is about 12 visits for physical therapy at a clinic. I'm averaging less than five. Yep. You get that concierge service. Exactly, that concierge service. And for me, I'm no longer bound by rules and regulations that third parties can place onto it, the limitations on what can be done, how much can be done, how often it can be done, or where it can even be done. And so it allows me that freedom, and I get to spend my time with you on that. So that's a big part of what I'm doing. Huge. Super important. Second thing I'm working on is a program, an online course program that I'm designing. I hope to have it launched here, trying to set a timeline on that. But it's designed to help people overcome chronic pain. And I intend to call it that, Overcoming Chronic Pain, where it goes through five, what I call pillars of being able to overcome chronic pain, going from understanding what it is or isn't, to your sleep, to your psychosocial well-being, your physical well-being, and your nutritional well-being as it relates to chronic pain is a whole other conversation that we can have. Huge. Huge. But yeah, look for that sometime to be available online for people to purchase and engage on their own time. I already know of three or four people. I can almost guarantee that we'll take that course, including my father, that would really be great for him. And to find you, your website, phone number or email, what's the best way for someone to get ahold of you? Social media? Yes. So dupontwellness.com. I was going to say, just like it sounds, like the company, Dupont, D-U-P-O-N-T, wellness.com. I am on Facebook. So it's at Dupont Wellness. And my email address is cdupont at dupontwellness.com. And that's the letter C, not S-E-E, the letter C. Yeah, letter C for Corey. Yes. Dupont at dupontwellness.com. All my contact information is there. If people want to ask and inquire, they can ask and I'd be glad to talk to people. Awesome. I'm so excited to encourage people to support your business because I know just your story about the lady and the benefits that she received. I know you and I know you well and I know how amazing you are and how caring you are as an individual. So I'm excited to help you grow. And again, it's your life and your choice and what better way than to have a physical therapist spend that one-on-one quality time to improve your life. You're worth it. Oh, for sure. Don't sit at home going, I can't do this. I give up. I give up. Don't. Get back outdoors. Do the things that you love in life. And Corey has got a million stories I'm sure he could share with you and yeah, get up. Let's do it. Well, Corey, I'm honored to have you here. I love what you've already taught us. I'm going to be doing a lot of different things now as I continue to age and I know our listeners will too. So thank you for that. We look forward to your courses. We're so grateful. Thank you. And all of you just provided today, it just, it will help many for sure. Thank you for tuning in to another episode of Connect Empower. We want to express our gratitude to you for being part of our community and we hope today's episode has provided you with valuable insights and inspiration to enhance your life and that of a loved one. We are more than just a podcast. We are a community dedicated to enhancing the lives of our aging adults and their support system. We encourage you to visit our website now at www.connect-empower.com, explore more information about our guests from today's episode and to access our free resources. Our mission doesn't end at the conclusion of this episode. We invite you to take action now by sharing the knowledge you've gained today with someone who may benefit from it, whether it's a family member, friend, or colleague. Your influence can spark positive change. Remember, subscribing to our podcast ensures you never miss an episode and we have more incredible guests and resources in store for you. So hit that subscribe button and stay connected with us. Your commitment is the driving force behind our mission and together we can create a movement for a brighter future as we age. I'm John. I'm Erin. Until next Wednesday.