Fieldwork I: Home Health

I had my first taste of occupational therapy this past semester during my fieldwork I rotation with home health. I actually very much enjoyed it and I look forward to sharing my experiences with you!

I enjoyed learning about the work/life balance and flexibility required for this setting and learned that it helps to be open, empathetic, and good-natured as you are literally going into people’s homes to assist them. This means establishing a positive and comfortable relationship in order to be successful and for them to continue to want you to visit.

Pros:
* Autonomy! It was awesome being able to set your own agenda, as long as you meet your designated clients for the day.
* You are actually helping clients in their home environment. Unlike the perfectly set-up hospital kitchens and bathrooms with grab bars and modifications, you get to see how the client interacts in their own space and provide the most appropriate recommendations.
* You can help bridge the gap between being discharged from the hospital and going home. Clients have said that having therapy there to assist can alleviate a lot of that anxiety.

Cons:
* Detailed reports are imperative and you spend a lot of your time with documentation. Side note: all of my peers commented that documentation is a huge part of every setting. You might spend 45 minutes with a client and 30 minutes on documentation and that is not unusual. Reports are especially important in home health because you do not see the other members of your team very often so make sure they can read what you’ve done and get a clear idea of where to pick up.
* There can be a lot of car time so it would be beneficial to enjoy driving or being by yourself.
* You may not do what you plan for the day. Multiple times we showed up at the client’s home and they said they were not feeling up to therapy that day or had a different agenda.
* Compliance is key to recovery, and that means clients might not progress unless they stick to the program so home health is very dependent on the client.

My experiences with home health have been informational and realistic to the setting. For example, last Wednesday we had two clients who were not in capacity to have services that day and that kind of threw off The occupational therapist’s schedule but she explained this was very common for the clients to have “off” days and to reschedule and/or work with the capabilities they have that day. Oftentimes, she had a goal before going in to work with the client and the client would have something else that was more pertinent for that day, so although having a set plan sounds ideal, it is not always realistic. Interactions with caregivers were professional and educational and my mentor was very good at answering all questions that were pertaining to safe and effective care for the client. I feel that working in home health requires confidence and curiosity to continue to learn and grow, especially if you are in the agency as the only occupational therapist. I feel very comfortable working with adults with disabilities or limitations, I have been a CNA for 3 years in long-term care. I think that my experience with older adults has benefited me in that I understand the importance of educating family and caregivers on proper care because I have observed situations in which this education has not happened and it ended up being detrimental to the client.

Our adult disability rotation was only with one setting and I choose home health because I have an interest in it after I graduate. What fieldwork did you most enjoy?

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