My job: Physio says her car is her office

Julie Rope says she often uses basic household items in providing therapy. Photo / Graeme Sedal

Name: Julie Rope.
Age: 34.
Role: Home-visiting neurological physiotherapist for Rope Neuro Rehabilitation.
Working hours: Seven days, usually 9 to 5, but sometimes evening, early morning to fit in around people's work schedules.
Average salary: $60,000 to $70,000.
Qualifications: Bachelor of Physiotherapy from Otago University.

What do you do?

We provide physiotherapy to people in their own homes, rest homes or private hospital settings. About 60 per cent of our clients self-fund; the other 40 per cent are ACC clients.

We have a special interest in neurological rehabilitation which means helping people with strokes, multiple sclerosis, head injuries, Parkinson's and spinal and neurosurgical rehabilitation.

We also provide education on manual handling to carers and staff in residential homes and in private agencies that provide carers into homes. This is to protect carers and clients from further injuries.

Our car is our office. We can bring most types of therapy equipment with us, but we also use things in people's homes.

Your background?

I graduated as a physiotherapist in 1997 and did my junior rotations at Auckland Hospital before specialising in neuro-physiotherapy.

Then I went to England and Wales for six to seven years and worked in hospitals and community settings. When I worked as a community mobile therapist, I visited clients on a push-bike.

That experience really helped me learn to be lateral and flexible - you can't carry too much equipment on a bike! Both roles were priceless experiences for what I do now.

Why set up a mobile service?

When I returned to New Zealand in 2006, I worked on contract for Auckland Hospital and noticed the lengthy time clients had to wait to get therapy after leaving hospital because of the heavy demand on the Ministry of Health-funded community health services.

I saw a gap for a business providing physiotherapy for people who could afford to pay while waiting at home for community services, or wanted further therapy after their community services funding ceased.

I researched carefully, talked to GPs, neurologists, neuro-surgeons and support societies, and decided to go for it. That was three years ago.

Once I was under way I also began doing one-off assessments for agencies who'd pay on behalf of the client and then got into ACC referrals.

I now also employ two other physios but there isn't much room to grow any further because there are only so many people who can afford to pay privately for home visits.

What kind of clients do you have?

Our clients range from 16 to 103 years old. I love older people; they are wonderful to be around.

How do you do physiotherapy in the home?

We carry a lot of basic equipment in the car but we also need to think laterally about what we can use. For example, recently I saw a stroke client who had a stiff and weak arm from disuse.

I used the kitchen to develop a therapy programme, utilising scissors, tea towels, penne pasta and other kitchen equipment.

You try and think of functions that are important to the person, such as practising bringing a cup of water or a water bottle to their mouth without spilling.

Useful training and experience?

After graduating it is important to get experience in a hospital, including acute and rehabilitation experience, and neuro experience.

What skills or qualities do you need?

You need to be good at communicating because you have to be able to explain your treatment so people understand what you're trying to achieve and how you're going to get them there.

You need to be confident, flexible and a lateral thinker. You need to be confident about your clinical skills and able to work independently.

You need to be extremely organised with good time management. You must be very mindful of the confidentiality of your clients, particularly when entering their homes.

Best part of the job?

I love people and am passionate about helping and it's an honour to be involved with people during a difficult time in their lives.

I also love the flexibility my business offers around my own life, even if I do work weekends.

Most challenging aspects?

The space within a home can be a challenge. The financial limitations are frustrating! It is a moral challenge that non-ACC patients have to be self-funding. Occasionally we've felt a bit unsafe in a home but we have systems to deal with that.

Special moment?

One client with Parkinson's had diminished ability with his writing and speech.

His therapy was to write about his life so he wrote between visits and then read out loud to me.

The exercise improved his writing and speech functions, delighted him and gave me an objective measure of his physical ability to write and speak. And he had such a wonderful story.

Where would you like to be in five years?

My dream would be to find a way to be a fully fundable service.