During OT school, I had zero experience with home health and what it entailed, other than general knowledge imparted to me via textbooks/lectures. After completing a travel assignment in home health, I can say that I’m glad to have experienced it and glad to leave it behind for now. Not that it’s completely awful, but it’s kind of a niche and it takes a certain getting used to.
+Pros of home health:
- Set your own schedule. This was probably my favorite aspect of home health. Most people want to be seen between 9am-6pm, Monday-Friday.
- See people in their own element. Treating clients in their homes is very therapeutic, client-centered, and can be so much more occupation-based.
- Autonomy. In general, being an OT is pretty autonomous. But in home health, it’s even more so. No one to keep tabs on you, other than the occasional reminder if you’re not meeting productivity
- Easy documentation. My previous employer gave all employees tablets and the documentation system was pretty easy to use. I didn’t really have to worry about billing; just had to keep track of my time (most insurance companies require at least a 30-minute visit for reimbursement.)
- Variety. No two visits are alike. Being out on the field alone forces you to be resourceful and to assess/think/plan quickly. It definitely keeps you on your toes. I think this is a great asset to being a skilled practitioner.
-Cons of home health:
- Actually setting your own schedule. My previous company didn’t provide a cell phone, so I had to use my own phone to call patients. For the most part, clients/families were nice, but you get the occasional, “Who ARE you?”, “Why are you calling me?”, etc.
- A lot of driving. During my busiest weeks I was seeing 6-7 patients each day and drove over 2000 miles each week. (I had a 100-mile round-trip radius.)
- Tip: download google maps offline, know where the good gas stations and bathrooms are, invest in AAA or some other roadside service, and be sure to have comprehensive car insurance
- Potentially bad or unsafe homes/environments and/or clients. I would say >50% of the homes I went to were dirty, unkempt, unpleasantly odorous, and/or cluttered. Most people also keep their pet(s) inside all day as well. I only had a handful of clients whose homes were super clean/neat/tidy. There were also a few homes in some run-down neighborhoods as well as clients/family members that were creepy or sketchy.
- Lack of resources. It was really difficult for me to do home health in a new city with little to no resources. However, this can be affected by the training you receive (I had very minimal training). This was especially apparent when I had to secure DME for clients. There are places that offer low cost or free equipment; you just have to do a bit of research and possibly ask around.
Other things to consider:
– Cancellations. This can be good or bad. Good if you’ve had a long day or if a personal situation comes up. Bad if you’re paid by the visit and you’re relying on the paycheck.
–You’re on your own. It can get pretty lonely. Prior to home health, I was working at a large hospital with a large rehab team of 25-30 PTs/OTs/SLPs on any given day.
–You will use google maps a lot. Make sure you have a decent phone, good coverage, battery back up, etc. And even then, some folks live in tiny or unincorporated areas, so their address may not even show up on google maps.
–Good time management. Give yourself time to accommodate traffic, bathroom breaks, and whatever else you may need.
–Mandated reporter. You never know what can happen. Make sure you know where/how/who to contact if a situation occurs where you need to contact APS.
–You will live out of your car. Keep snacks, water, medications, etc handy.
–Therapy equipment. When I was per-diem for one agency, I had to purchase everything that I needed. During my full-time assignment, I was provided with all the basics (BP, pulse ox, thermometer, gloves, tablet for documentation , theraband, therafoam.)