For more than two decades, Paul Miranda has been a steady, compassionate force at The Selfhelp Home, helping residents regain strength, confidence, and independence at every stage of their rehabilitation journey.
As Director of Rehabilitation and a practicing Physical Therapist, Paul brings not only deep clinical expertise, but also a genuine love for the people he serves. From his early training abroad to his 22 years at Selfhelp, his career has been shaped by a belief that progress is always possible and that meaningful, one-on-one care can transform both physical ability and quality of life.
Tell us your education and early experience…
In 1995, I earned my Bachelor of Science degree in Physical Therapy at the University of Santo Tomas in Manila, Philippines (founded in 1611, it is the very first university in Asia!). I have 30 years’ experience working as a physical therapist.
Upon graduation in 1995, I worked first as a PT in sports medicine and in an out-patient rehab clinic in the Philippines until I migrated to the U.S. in July 1997. I was in Ohio for 6 years where I worked as a PT in several skilled nursing facilities in the Dayton and Columbus areas. In 2003, I relocated to Chicago where I began working at Selfhelp Home.
What first inspired you to pursue a career in physical therapy? How has your passion grown throughout your career?
In high school, I initially thought I wanted to study psychology and then pursue a medical degree. However, during a Career Exploration/College Fair for high school students, I learned about physical therapy and the vital role it plays in helping people recover from a broad spectrum of illnesses and injuries. I also discovered that, while admission to physical therapy programs in the Philippines is highly competitive, and physical therapy programs there are known to be rigorous, most Filipino PT graduates are able to practice the profession abroad, a fact that was highly enticing to me because I dreamed of living and working abroad, even as a child.
My passion for providing physical therapy has grown steadily throughout my career, for a number of reasons.
First, since coming to the U.S., I have worked exclusively in geriatrics. When I began treating elderly Americans in 1997, I must admit trepidation, wondering how well I would be able to relate to elderly Americans, and, in turn, how well they would take therapy-related direction from a 24-year-old Filipino immigrant with an accent. To my enormous relief, I found early on that elderly Americans are really no different from my own grandparents and other elderly Filipinos: they are often filled with humor, with kindness, with appreciation for healthcare providers, with fascinating life experience, and ultimately with a wealth of wisdom. While I like to think that, through physical therapy, I have been able to contribute to the wellbeing of numerous Selfhelp Home residents, those same residents have without question enriched my life; they have made it a pleasure for me to go to work.
Second, I work hard trying to ensure that Selfhelp Home residents not only work diligently in therapy, but that they also enjoy their time with me — efforts that have paid dividends in how much progress these residents are able to make in their recovery. And because the experience is routinely so fulfilling for me, I have absolutely loved working with Selfhelp Home residents. I know without doubt that I have found my professional niche!
Finally, and most importantly, my passion grows continually from witnessing firsthand the difference that physical therapy makes in residents’ lives. It seems to me that society generally believes that with advanced age comes illness, and with illness comes the inevitable deterioration in quality of life. Nothing maintains my passion for the job more than seeing improvement, and often dramatic improvement, in each resident’s physical ability, and seeing how that ability enhances their mental outlook, and enriches their quality of life.
As just one example of the emotional highs I experience when, through therapy, a previously bed-ridden resident begins to walk, first with a lot of physical support, then with less, then with even less, and finally on their own — that, by itself, is enough to keep me inspired in this job.
How do you see physical therapy transforming the quality of life for residents here at Selfhelp? Can you share a memorable success story?
In my 22 years at Selfhelp Home, I have witnessed numerous therapy success stories. Our documentation system allows us to track resident’s functional status upon admission up to their discharge, and our data shows measurable improvement in almost 100% of the residents.
But one success story that sticks out in my mind pertains to a 107-year-old resident who was admitted to Selfhelp Home after surgery for a fractured hip. Upon admission, the resident weighed 90 lbs, was extremely fragile, and was in so much pain that she could barely get out of bed and stand, let alone walk.
Notwithstanding her condition, this centenarian resident exhibited tremendous mental and physical tenacity and determination. After several weeks of therapy, she was able to return to her home, walking independently with a walker, and she resumed an active social life with friends. She lived to be 111-years-old.
What do you value most about your rehabilitation team? How do you create a culture of compassion and excellence among them?
I am thankful to be supported by a truly amazing team of dedicated and compassionate therapists. Each therapist knows what is expected of them, and each goes above and beyond what is expected.
I try to lead by example, demonstrating therapy techniques, as well as strategies that work to keep a patient engaged and motivated. I also serve them as a clinical resource, whenever questions arise over how best to provide treatment to a given patient. And, when a therapist is having any difficulty with a particular resident, I provide guidance, along with a willingness to meet with the resident and the therapist.
What is one of the greatest challenges you face in your work, and how do you overcome it?
The greatest challenge is time management. What makes it challenging is that I have a daily deadline regarding the provision of patient care, and all associated paperwork, coupled with all of my administrative meetings and duties. Each day brings something unexpected which can make it difficult to plan ahead. What I do is complete one task at a time, instead of trying to juggle too many balls at once.
Are there any new techniques, therapies, or tools you’ve introduced or seen making a difference in physical therapy for older adults? How do you stay up-to-date?
There are frequently new techniques and changes to the delivery of service in the world of therapy because of new studies/research, new equipment/treatment modalities, and because of changes in Medicare regulations. I stay informed primarily through continuing education (PTs are required by law to undergo 48 hours of continuing education every 2 years to maintain a professional license), and secondarily, through interaction with my supervisor and with other rehab directors regarding clinical strategies.
Having said that, I still believe in hands-on, one-on-one therapy sessions that are meaningful, goal-directed, and tailor-made to each resident’s specific need and ability.
How do you work with families and the broader Selfhelp community to ensure continuity of care and support for residents’ rehabilitation goals?
I am frequently engaged with resident families. In addition to meetings with families, I endeavor to be as accessible to families as possible to address any issues they may have, to keep them apprised of progress in their loved one’s recovery, and to advise them of anything that might be done on their end to aid in that recovery.
Additionally, families are encouraged to participate in / watch therapy sessions, and I encourage family members to stop by the Rehab Department, or to call or email should they have questions and concerns. We also have discharge care plan conferences where we discuss in detail our therapy discharge plans and recommendations.
Finally, prior to discharge, residents are provided with home exercise programs so that they will maintain the gains that they have achieved, and I routinely recommend continued therapy services upon discharge whether as an out-patient or home health basis.
What keeps you motivated?
What keeps me motivated is the joy I get from interacting with and treating residents. My greatest fulfillment as a therapist comes from helping the residents and their families achieve the goals that they set forth on my initial evaluation. It also helps that I work in an environment that feels like family. Finally, taking a break/vacation helps me to recharge and avoid burn out.
What is your vision for the future of rehabilitation at Selfhelp?
More than anything else, I would love to see Selfhelp Home expand its number of beds devoted to short-term rehab. I know that this is not easy to accomplish because it would entail extensive renovation and Medicare certification. But, our short-term rehab floor is frequently at full capacity, and with expansion, we could serve even more members of the community.