Home Health OT Strategies and Insights

Monika Lukasiewicz

Is home health OT the right practice area for you? Are you already working as a home health occupational therapist, but hoping to enhance your practice? 

Below you will find an interview with home health OT, Monika Lukasievicz, about what drew her to this particular practice area and her desire to provide the best care possible to her clients.

After being in the field for several years, Monika has collected some of her hard-earned knowledge in a new ebook, Home Health OT Strategies and Insights. Monika has a keen eye, not only for the actual OT session with patients, but also the personal factors that influence our work.

Find out more about the book and some of Monika's favorite home health OTs resources at the bottom of the article.  

An interview with Monika about her work in home health OT and her new ebook

Potential: What initially drew you to home health occupational therapy?

Monika: After nearly 6 years of work as an OT in outpatient, acute, SNF and inpatient rehab, I was drawn to the opportunity to practice the skills of an OT in the truest context that the client would be living.  I was working at a SNF when I decided to make the change. Using mock bathroom measurements and scenarios was getting old. For me, these revelations (combined with an opportunity to work for a local, non-profit) meant it was time to serve as a home health OT.

What challenges did you encounter in home health that were different than the other settings you had worked in?

I have to be way more organized and willing to initiate collaboration including via phone, text, email, and in-person.  I was surprised to learn I had to make all my own phone calls to set each appointment.  (No more walking down the hall and knocking on a door.) I had to become much more flexible in terms of planning (and re-planning) my day. The documentation types were also a challenge at first. This ranged from learning documentation to send my own faxes to doctors, email with patient family members, learning OASIS and SunCoast, and using Outlook for emailing more than I was used to in previous settings.  I also relate to the team differently due to typically being with them only in the mornings. Some therapists work for companies in which home health teams see each other once a week at most. 

What made you want to invest in home health OT as your practice setting of choice?

It is this setting, of being in the home, that gives me the best sense of flow.  The challenges of building rapport with the client starting on the first phone call to carefully navigating the personal space of a home to sharing specific recommendations carefully worded. The sense of creativity that emerges from being in the actual kitchen, bedroom, or especially bathroom is unlike I've experienced in any other setting thus far.

My greatest gifts of communication, responsibility, being strategic, and being a maximizer are hugely at play in this arena. I've been able to incorporate strategies from motivational interviewing, another passion area of mine.  

I am also highly independent and trusted to make decisions like creating and carrying out a schedule within the demands of productivity.  Direct training with family and caregivers is more realistic and welcomed.  Family members and caregivers often want the training and make sure to be present for those sessions. These are the reasons I choose home health. It even inspired me to study more about flow and how it relates to my OT practice.

When applying to an home health OT job what questions do you recommend people ask about the agency?

  • What are at least 2 qualities that are important to make a team member successful in this company as a home health OT?

  • How many patients will I be expected to treat each day?

  • Approximately how much mileage will I be expected to drive each week/day?

  • What would it look like for an OT to be successful in this position? Please describe what it would look like from a management or team perspective.

  • Why did past OTs leave this company?

  • Please describe the documentation system/process for an average day (at least for an average visit and an evaluation).

  • Where would you hope to see the OT department of this company/team be in 5 years?

  • What, if any, areas of expertise are either already present on the team or are wanted on the team (i.e. lymphedema, cognition, vision, neuro, ortho, motivational interviewing)?

You mention in the book that you hope to see a revolution in home health OT. Where would you like to see OT in 10 years?

Wow. Great question. It'd be great to see OT practicing from a more evidence-based position (and therefore finding effective ways to engage with research regularly), getting reimbursement for more lifestyle management type of treatments, and interacting more with each other in fun, supportive, and accountable ways. I'd love to see the confidence in OT as a profession and in its clinicians be solid, holding it's own ground. Portland, OR hosts regular pub nights for OTs and it'd be great to begin seeing that in more cities.

It is quite the leap from thinking about writing a book to actually putting pen to paper. What made you sit down and start writing?

There was a coffee shop that proved to be the perfect "writing office"! Writing a book was a personal interest. The topic was also naturally interesting and appeared to be relevant.  Recognizing that the biggest thing that blocks the pursuit of dreams is our own behavior and/or attitude, a decision was made to begin. I felt quite convinced that it was time to reach out and attempt to provide valuable information that I wish had been available to me.  

What do you hope fellow OTs gain from your ebook?

The hope is that readers gain inspiration to engage in a process that is effective and that can decrease suffering/stress in their days. My hope is that readers are able to realistically do this as a result of the book providing simple, effective tips to improve their effectiveness as well as decrease their experiences of stress.

In addition to your book, what other resources would you recommend to OTs who are looking to maximize their home health work? 

  1. Here is a great online CEU (4 part, 6 hrs) called "Series: Defensible Documentation for the Home Health Therapist" by Diana Kornetti, PT and Cindy Kraft, PT.

  2. Occupational Therapy and Dementia Care: The home environmental skill building program for families and caregivers is a book created by an occupational therapist. The program has been heavily researched, too. (This program has been cited more than 200 times in other research literature.) I found this while searching for research about dealing with dementia in home health. Here you can find information about in-person training about the program.

  3. I've enjoyed these tricks from an experienced OT on keeping the bag light and ready to address holistic needs.

  4. I've also written for the About.com occupational therapy page: Home health is scheduled to start. Now What?

A Sneak Peek at the Table of Contents

An Excerpt from the Introduction  

Is This eBook Right for You?

Pulling out your hair due to feeling crazy, stressed, disorganized, or all the above during your life and work as an occupational therapist in home health? Looking for simple ways to allow more peace, effectiveness, and powerful value in your home health practice? Do you love being able to fulfill your calling in the field of home health? Do you wish someone would write a book of solutions for common home health stressors that was so simple you could start implementing easy strategies today? Are you getting ready to begin a career in home health and eager to know more details about this area of practice? If yes, read on!

If you are open to and believe in the value of shared experience, this book is for you.

If you are looking ONLY for research, statistics, and specific evidence-based practice information, this book is not for you....

To continue reading you can purchase Home Health Strategies and Insights here