A Week As a Home Health SLP Part 1

driving

There have been a lot of blog posts recently looking at a day in the life of an SLP in a variety of settings.

I took a job as a Home Health SLP 1 year and 2 months ago.   In 2013, I was completely burnt out on the medical field and decided to take a job in the school system.  For a change.  I found that I missed the medical side.  I continued in the hospital on a PRN basis and continued medical-based continuing education.  In 2016, I decided to go back to the medical field because I really missed working with adults.

Here’s a look at my previous week in home health which will be written in 5 parts over 5 days:

Monday:

I always start out my day by looking at my tablet.  We use a small Samsung tablet for all paperwork and communication.  I also look at my calendar to see who I have scheduled and where they are.  I need to plan when to leave my house to reach the first home on time.

Today, I need to leave my house at 9:20.  My first patient is a new eval that lives 40 minutes away and would not be seen before 10.

I arrive at my first home and the patient’s son answers the door.   This is a person that had some signs of dementia, had a stroke and is now unable to be left alone.  During this evaluation, the patient was asleep for most of the time, but would awaken to complete some tasks.  I’m going to pick this person up every other week for family teaching and strategies to modify the home environment.

My next patient lives about 5 minutes away from my first patient.  This is also another evaluation.   This patient has a long medical history dating back to the early 1990’s.  Throughout the evaluation this patient smoked 3 cigarettes.  I was so happy that there were multiple windows open as I am not a smoker!  Throughout the evaluation there was difficulty with memory and swallowing, so I will be picking this patient up also.  I also have to call the hospital to obtain the MBSS report.  Fingers crossed I’ll get it as that is a 50/50 shot.

I have a 30 minute drive to my next house so I book it in my car and drive to arrive at the next house.  I typically eat my lunch in the car so that I can just keep moving and seeing patients.  I also always give each patient a ranged time because it’s impossible to plan for traffic, weather or needs that keep me in a house longer than 45 minutes.

I arrive at the next home, a patient post stroke with significant facial droop and dysarthria.  I knock on the door multiple times and try to call twice with no answer.  I leave a note on the door to call me as I couldn’t leave a message on the answering machine and go back to my car to log the missed visit.  I always have to put in a missed visit so that the miles don’t count against my personal miles.  I drive a company car and have 1000 personal miles a month.  I don’t want to use up those miles when I don’t have to!  I also want to make sure that it’s logged that I arrived at the home and nobody was home.

Since my last person wasn’t home I have a few extra minutes so I find a clean gas station and use the restroom.  I always keep a large bottle of water in the car, but try not to guzzle too much so that I don’t have as many bathroom stops.

I arrive at my next home, which is probably about 15 minutes from the previous home.  I pull up to the house and see the garage door is closed, which is not a good sign.  I ring the doorbell a few times with no answer to the door.   I call the patient’s daughter and leave a message since she is at work.  Again, I have to log my missed visit on my tablet.

My next patient lives in a different county and is about 45-55 minutes away so I start heading that way.

I get bored in the car just listening to the radio and fortunately I have a brand new company car so I have my personal phone synced by blue tooth.  I typically listen to my Amazon music, podcasts or Audible books.  I like to switch it up because I spend a LOT of time in the car.

I arrive at my next patient’s home.  This person lives in an assisted living facility and has difficulty with memory.  The memory deficit is affecting medication management so I was called in.  This person has a great med box that holds a month’s worth of medicine and each individual pill box goes by date.  We work on keeping the medication updated and by date so that when the patient forgets pills one day, we know when it happens.  This date, there were several missed doses over the past week.   We set up a new system of a daily check-off sheet for morning and evening (when pills are taken) along with several brightly colored post-it notes to aid in memory.  We’ll see how this works.

My last patient of the day lives about 15 minutes away.  I have to knock really loud because this person is very hard of hearing and does not typically wear their hearing aids.  This is another patient with memory difficulty affecting medication management.  We work on memory through a calendar and post-it notes to aid in memory.  This patient often feels that memory is not the issue as much as laziness, however we are working to see that there are definitely memory issues there.

Now, I’ve been doing this job for over a year, so I’m getting really good with notes.  I don’t want to work any at home if at all possible, so while the patient and I are working, I’m typing my notes.  All of my notes are done, so as I sit in my car outside the last patient’s home, I go ahead and put my time in and out on our timesheet system.

Now I’m done, so I can head home to take care of my children, cook dinner, do laundry and find time to create slides for an upcoming online course.

Watch tomorrow for day 2 of my week!

 

2 thoughts on “A Week As a Home Health SLP Part 1

  1. Hi, I’m so interested to read your series of posts about home health because I started in home health almost 3 years and I’m always looking for tips to handle time management. I am amazed that you were able to complete 2 evaluation reports during the session. What EMR does your company use? My company is currently using McKesson, and it takes me a solid hour at home to write up a new eval.

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