By: Cody Worthington, COTA/L
After graduating from college, I found myself working in a wonderful long-term care facility in the rehab department. This setting was where I did most of my clinical fieldwork while I was a student, hence making me most comfortable in this setting. Inpatient rehab is a great stepping stone before patients transition to home. I did my best to explain to my patients exactly what occupational therapy is since there tends to be a disconnect for a lot of people. Many people are familiar with physical therapy, so I had to put a little more effort into explaining my role.
During my treatment sessions at this facility, I would assist patients with their ADLs (activities of daily living) and encourage them to do everything as independently as possible with my recommendations. We would review how to get in and out of the shower, use the rehab kitchen to practice home management and cooking, and other simulated tasks, but still I had patients saying “This isn’t what my bathroom looks like; my shower isn’t as equipped,” or “My kitchen is so different than this one, it won’t be the same at home.’” My patients would reluctantly continue to participate and practice these tasks because it was ultimately preparing them for life at home. Still, I found myself frustrated not knowing if they were fully prepared to return to their own environment.
A year and an half later I decided to try out home health. I had never worked in this setting but it very much appealed to me. Now, I’m four years into it and I’ve never been so happy with my choice to work in this setting. I learned very quickly how beneficial home health occupational therapy is. Below are some examples:
- Maximizing function in one’s environment: Simulated exercises and activities at rehab facilities can begin to help prepare someone for life at home but being able to actually work on interventions with a patient in his/her home can be greatly beneficial to making them safer, more prepared, and more confident being back home. Practicing shower transfers, getting in and out of bed, and preparing meals all in the patient’s home are just a few ways home health OT is beneficial. Being able to “age in place” is so important to keep our patients out of assisted living or long term care for as long as possible.
- Assessments for fall prevention: When the OT visits the patient’s home for therapy, he or she can immediately point out a few safety issues that could be changed or modified to help prevent falls. For example, throw rugs, cords from lamps or TV’s, and tight spaces are all just a few red flags that can pose a threat to the patient. OT’s can make recommendations like rearranging furniture, removing throw rugs, and helping to make clearer pathways for a walker or wheelchair to patients and their families to improve the safety of the home environment.
- Recommendations for home modifications: Many OT’s have references or someone they can recommend to help install grab bars or ramps to help make the home a safer place. Placing a piece of masking tape on the spots of a shower or bathroom of where the grab bar should go can help guide the family member or whoever is installing them to put them in the correct position. OT’s can also assess the shower to determine if it is recommended that patient obtain a tub bench, hand help shower, non-slip mats, and other tools to help modify the home so it is safer. They can also provide recommendations on how and where to get these items at an affordable cost.
- Medication Management: Home health OT’s can assess a patient in their home on how they manage their medications. Asking the patient to prepare or select appropriate medications they take can highlight any errors that can be corrected through training. OT’s can recommend strategies and tools to help eliminate error and establish a routine for taking daily medicines. For example, creating an alarm, writing reminders and placing them in well seen spots, the use of automatic pill dispensers or daily pill cases are all ways to make sure the patient is able to properly and safely manage their own medication.
- Caregiver/Family Training: Home health OT’s can help train family members or caregivers on ways to safely transfer someone with a disability, teach them exercises to do with the patient to maintain the patient’s strength and endurance, or educate them about dementia and what to expect when caring for a loved one. These are just a few ways Home Health OT’s can help educate the caregiver.