The Good and Bad of Home Health
Written by Denae Asel-Templin MS, OTR/L, Published on March 20, 2018
So you’ve passed the NBCOT and can officially claim your “OTR” title. Now you are faced with the challenge of deciding upon a setting to work in — a task that can be overwhelming in and of itself. As a new grad, I thought I was going to work in the outpatient or acute care setting because that’s primarily where my experience was.
It wasn’t until I started doing home health as coverage for additional income that I realized how valuable occupational therapists (OTs) are in the home health setting.
HIGHLIGHT: Working in a client’s familiar environment
As an OT, this setting is a gold mine! You’ll be working in a patient’s living space and will no longer need to simulate a patient’s bathroom setup or practice gathering objects out of a hospital closet. Additionally, a majority of the time the patient’s family and/or caregivers will be present. This provides a great opportunity for education and carryover.
HIGHLIGHT: It pays well
As a recent grad, getting that statement in the mail saying it’s time to begin paying back your loans can seem daunting. According to the Bureau of Labor Statistics, the annual median wage for a home health OT was $94,160, which is the highest of all occupational therapy settings. Most companies will also reimburse for mileage and/or gas.
Home health is flexible in scheduling. Need an hour off in the afternoon to go to the dentist? Don’t like seeing patients after 5 o’clock? For most companies, you have free will over your schedule, so long as your clients are seen in the frequency required and their needs are met. As a bonus, most home health companies do not require OTs to work weekends or holidays (unless you were unable to see a patient during the week.). This provides the opportunity to pick up hours on the weekends at a local hospital or skilled nursing facility (SNF) if desired.
HIGHLIGHT: Opportunities for specialization
While OTs can specialize within any setting they work in, there are certain specializations that may be more pertinent to the home health setting. Some agencies will reimburse part or all of the cost of getting certified in a specialty area. These include but are not limited to:
- Certified Aging in Place Specialist (CAPS)
- Seating and Mobility Specialist (SMS)
- Certified Lymphedema Therapist (CLT)
- Certified Diabetes Educator (CDE)
- Certified Autism Specialist (CAS)
Now you can learn more about the OT alphabet soup and all the credentials and letters available to you!
HIGHLIGHT: Building relationships
Seeing a patient in their home provides the therapist an opportunity to build a strong relationship. The patient establishes a level of trust with you different than any other healthcare setting. It is common for therapists who have worked in the home health setting for many years to have a “following” of patients because of that established relationship.
You will put a lot of miles on your car. Companies have different ways of dividing up their designated areas. Some days you may spend more time in the car than with patients. To offset this, most companies will pay you some sort of mileage/gas compensation, and some may even pay for regular maintenance for your vehicle.
CHALLENGE: Paperwork/Scheduling/Phone Calls
The paperwork will pile up if you save it all for the end of your day. Most companies require paperwork be submitted within a certain amount of time such as 48 hours from the time of visit or by the end of the week. On top of the paperwork you’re managing your own schedule (which can be a pro or con), and making phone calls to clients, co-workers, physicians, etc. It can be tough to manage initially. It’s important to find a rhythm that works best for you.
CHALLENGE: You’re on your own
In this setting, you really have to be self-directed. If you have a stressful session or need clarification on an issue you are not able to turn to the therapist sitting next to you and get their advice. Oftentimes the only time you may see your co-workers is at a weekly conference meeting. Many times there will be experienced therapists at your company that you can deem as your go-to person as you get started.
In addition to the point made above, therapists can and do experience burnout in this setting. Seeing 5-7 patients per day for 45 minutes to 1 hour each doesn't seem very overwhelming, but tack on 3-4 hours of drive time plus extra documentation time and that can really add up. It’s important to have an outlet for stress to avoid burnout.
Ways to meet the challenges:
Find a mentor! Whether it is another therapist within your company, state association, or AOTA – having someone to collaborate with and bounce questions off of will ease your adjustment into the home health setting.
Utilize blogs, continuing education, networking. Seniors Flourish, AOTA, Medbridge, Facebook pages, and social gatherings specifically for OTs are just a few resources to assist in expanding your industry knowledge.
Find your work-life balance. Make sure you spend part of your week doing something unrelated to OT, whether it be exercising, reading, or watching your favorite Netflix show to avoid burnout.