What is Home Health Occupational Therapy Like?
When you graduate from occupational therapy school, one of the biggest questions on your mind is most likely, “Where am I going to work?”
Because of the nature of OT school, with a diverse group of educators and fieldwork placements, you have most likely had exposure to a number of different occupational therapy settings.
However, even with a broad range of experience to draw on, you may still have some unanswered questions about one specific field:
Home Health Occupational Therapy.
You might have found that many of your professors and fieldwork educators don’t recommend that new graduates or inexperienced therapists work as a home health OT. While that is a helpful thought, you still want your questions answered, whether you’re a new grad or a seasoned practitioner thinking about this setting.
Below are some of the most common questions people have about home health therapy, and as a home health OT practitioner, I’m happy to answer:
What is it like working in a patient’s home?
As you began to implement treatment plans in a real world setting, you probably noticed that occupational therapy is pretty similar across the board, regardless of the actual treatment setting.
Working with kids on a swing, having a recent stroke survivor sit unsupported on a mat, or walking with someone with a new prosthetic limb can all use many of the same skills.
This is true for home health as well. The main difference in working in home health is the frequency and location of treatment. Obviously, the therapy will be in their own home.
This is going to be hugely helpful for developing occupational independence. Instead of practicing transferring in and out of a hospital bed, you will practice on their real bed. Instead of working with a shower specially designed for people with disabilities, you will use a normal shower. This can take a lot of problem solving.
What are home health OT treatments like?
The treatments themselves should be very occupation-based, as all of our treatments should be. As there will only be a few visits a week for a few weeks, these treatments will need to get right to the occupational needs of the patient.
Thankfully, this will be pretty easy to do. Everything around you will be occupation-based.
Are they having trouble showering? Have them shower for their treatment. Do they need to work on cooking skills in the kitchen? Put them in the kitchen and have them cook, all while providing helpful tips and safety strategies.
It’s important to be ready for whatever may come. In a traditional treatment clinic, you will have all kinds of equipment available for use. In home health therapy, there is no gym full of tools. You’ll have to bring what you need and be adaptable to meet your needs.
There are some basic things that you should have on hand. This includes a stethoscope, blood pressure cuff, hand sanitizer, and more. For more ideas, check out our article “10 Must-Haves for Home Health Occupational Therapy.”
How to build trust with your patients
When you’re in a hospital or other rehab facility, you automatically have a level of rapport with your client the moment you walk into their room. When you enter their home, though, you will have to prove to them that you know what you are doing and that it is valuable for their lives.
The majority of people who receive home health occupational therapy are going to be open and excited to engage in therapy.
Family training will be a large part of the therapy process in this setting as well. You will be in a prime position to give the family specific instructions for how best to take care of their family member.
Is there mentorship for home health OT?
Even though you know what it takes to pass the national certification exam, an honest and modest therapist recognizes the fact that they don’t know everything. Mentorship is a very valuable tool to help you improve your practice and provide your patients the highest quality therapy possible. It is highly recommended to have a mentor if home health is one of our first jobs out of OT school.
Mentorship can come in many forms. The most common and obvious type of mentorship is that of having a direct supervisor or confidant in your workplace. Throughout the day, you can ask them specific treatment questions, for ethical advice, or just how to improve a treatment.
It’s important to realize that this is not the only kind of mentorship available. Online OT forums, live workshops and conferences, and educational experiences can help you find a potential mentor to help guide you. It will be important to be self motivated in finding a mentor for your OT practice.
While working in home health, you’ll need to be independent. Most likely, you’ll be the only person in this patient’s home directing their medical care.
If something happens, you will need to know the right steps to take to ensure the safety of yourself and your patients. You will also have to be competent. Basic skills, such as taking vital signs, grading therapeutic activities, and accurately documenting treatments is essential to working in any setting.
Even more so, when you are on your own for a treatment you will need to be able to do these routine things while still helping your patient engage meaningfully in their occupations.
How do you manage your schedule in home health?
Wherever you have worked or had field work in the past, your schedule was likely created for you. Maybe a manager scheduled every hour of your day. Or maybe you were just given a list of names and you were responsible for finding and treating those people in your day.
The exact method of scheduling for home health varies from company to company. Some take a more hands on approach, scheduling each and every treatment. Others may simply give you the names and contact information for your patients and you will have to figure out a schedule on your own.
Regardless of how it’s done, it is important that you are organized and flexible. Unlike an inpatient setting, these patients are leading their regular daily lives. Things come up, so they may have to cancel or reschedule their treatment.
Flexibility will be important in finding the time to treat everyone. On the other hand, keeping your schedule as organized as possible will make it easy and enjoyable for your patients while keeping your mind free for coming up with treatment solutions.
What is the compensation like for home health?
Payment for home health occupational therapists is going to vary greatly depending on experience, the state you’re working in, and any specialized certifications you might have.
According to the U.S. Bureau of Labor Statistics, the current average hourly rate for an OTR working in home health is around $50 an hour, and for a COTA it is an average of $36. This translates to an average salary of around $105,000 or $75,000 per year for an OTR and COTA respectively.
Compensation in home health is typically a little higher than working as a full-time employee in a skilled nursing facility or inpatient rehab unit (although it is comparable to working as a PRN OT in a skilled nursing facility).
Remember to take benefits into the financial equation of your decision. You will need to talk with your potential employer at length about what you expect from your pay and benefits.
Working in home health might not be for everyone. However, it can be one of the most fulfilling and client-centered fields to work in and there is a great need for quality home health occupational therapy practitioners.
Do you think that home health occupational therapy is a good fit for you? Have you worked in home health? Please share your thoughts and experiences in the comments below!
Additional Home Health Occupational Therapy Resources
This post was originally published on May 10, 2019 and updated on June 23, 2023.