Sunday, January 28, 2018

A Typical Day of a Homecare Occupational Therapist

Currently, I work as fulltime homecare pediatric OT.  With that being said, a few of my clients aren’t pediatric clients.  This is due to company regulations where some patients can stay on the program even after they’ve reached adulthood.   

I only service one borough in NYC.  However, the main office is in a different bough.  Therefore, I only go to the office approximately once a month for face to face staff meetings.  Most of my communication occurs via email, phone or via a secure text application.  

It is really hard for me to describe “a typical day.”  There are many varying factors that can occur throughout the day that can affect my schedule.  For example, cancellations, patients being sick or hospitalized, emergency case conferences, school days versus holidays, traffic etc.  However, I will try to give you an example of a “typical day of a homecare OT, so here we go:

Wake up, perform my personal morning routine and get ready for work.

Administrative work: Read and send emails, text or call to confirm visits for the day, sync notes in Meditech (documenting system).  Leave for the first visit.

The first visit is usually to the patient closest to my home.  (This is because I do not get mileage reimbursement from my home to my first visit.)  I will provide treatment to a 9-month-old infant diagnosed with Bronchopulmonary Dysplasia and Developmental Delay.  The session typically focuses on upper extremity and core strengthening using different toys and games.  For example, I will pull him up to sit and have him reach for various toys.  The end of the session I will talk to mom about the session and give her activities she can do with the child at home to improve carry over.  Occasionally, I end up staying at this home longer than 30 minutes.  Patient has 4 other siblings, therefore, I try to include all the kids into games, so they don’t feel left out. 

Drive to the second visit and grab something to snack on.

Provide treatment to a 24-year-old diagnosed with the Unspecified disorder if psychological development.  The patient is highly functioning, however, requires moderate to maximum verbal prompts and redirection to complete a task.  The session is broken into three 10-minute segments.  The first 10 minutes include working on an ADL such as shoe tying or upper body dressing.  The next 10 minutes is a therapeutic exercise.  Last week we worked on dynamic sitting and dynamic standing balance.  The last 10 minutes the patient chooses one activity of leisure she wants to do such as playing a game on the phone, a puzzle or an arts & craft project.

Provide treatment for a 2-year-old child diagnosed with unspecified congenital malformations of the spinal cord.  The family is non-English speaking (Bengali).  Initially, I used a translator over the phone.  Now I use the Google translator app on my phone for any imperative information I need to get across.  Most of the time I use visual gestures.  The child wears a clubfoot brace.  Treatment includes performing upper extremity activities in supported standing.  I will pull the child to stand up at a table.  As I support her at the waist, she completes a puzzle at the table.  The child also receives PT and on some occasions, I co-treat with the PT.

Provide treatment to a 7-month-old infant diagnosed with Bronchopulmonary Dysplasia, feeding difficulties and Developmental Delay.  The session involves sensory integration and visually tracking tasks.  Parent and siblings are present throughout the entire session.  Parent education is provided at end of the session.

During this time, I will take a break.  If I packed my own lunch I will eat it in the car or a park.  If not, I will go to a restaurant and buy something.  I will also reply to any texts or missed phone calls I received while I was in a session or driving to a session.

Provide treatment to a 12-year-old diagnosed with epilepsy & chorionic respiratory failure.  The patient is severely low functioning and bed bound.  The session involves passive range of motion for upper and lower extremity & positioning to avoid skin break down.

This is usually rush hour.  During this time I commute to my last visit which takes me approximately 45 minutes to an hour depending on weather and traffic condition.

Provide treatment to an 8-year-old diagnosed with Tetralogy of Fallot (TOF).  Child attends school, therefore I must see him in the late afternoon and this is the only time slot that is feasible. Currently, treatment focuses on fine motor coordination and sequencing.  We usually start with a preparatory task such pulling beads out of putty.  Then we will work on an ADL task such as buttoning a shirt or practicing using a knife and fork.  

I’m not going to lie, I struggle to do my notes once I get home.  However, on my BEST day I will do administrative work for about an hour when I get home.  This includes synching my computer, answering emails, completing manage care summaries, discharge summaries and/or session notes for the day.

Again, I just want to reiterate that this is a condensed “typical day” just to give you an idea of what I do daily.  Sometimes I see more than 6 patients a day sometimes I see less and do more paperwork.  Just remember it’s important to be flexible, patient and extremely independent. 

Thank you so much for reading, Dionne


  1. Wow! Your cases include conditions I can’t even remember studying! Sounds challenging but fun! I’m curious about co-treating during home care? For billing I thought this was a hard no? All in all sounds so interesting! I’d love to be a fly on the wall on your sessions. Lol.

    1. We had 2 different TX goals and also work for two different NYC programs


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