Guide: The Difference Between Home Physical Therapy and Home Occupational Therapy

Since the pandemic, home-based therapies have become a popular alternative for older folks who need rehab services but don’t feel comfortable going to an outpatient clinic. And in truth, in many cases, home based rehab services are actually more appropriate because clinicians can assess how seniors function in their home and can offer suggestions for safe aging in place.

There are generally two common types of home-based therapies that doctors will generally send out. 1. home physical therapy (PT), and 2. home occupational therapy(OT). When I am talking to a lot of my patients and I mention “occupational therapy”, my patients typically say something like “Isn’t that what YOU do?” and I have to tell them, “No, I am the physical therapist. The occupational therapist will look at other things…” So, in this article, I want to point out some of the differences between the two in this article.

So, What is Home Physical Therapy?

I usually put it this way, “home physical therapy is interested in, and works on how you move”. It’s true that both disciplines are both referred to as rehabilitation services and both need a license to practice. But, PT focuses more on a person’s strength and flexibility, their mobility, and their overall physical function.

Common reasons a doctor may prescribe (or you or family may request) home physical therapy include:

1. Recovering from surgery, such as hip/knee joint replacements, cardiac or spine surgery
2. Managing chronic pain, such as, carpal tunnel, back pain or arthritis
3. Rehabilitation after having had a stroke or other neurological condition like Parkinson’s
4. Treating sports injuries or other “musculoskeletal” disorders like strains and sprains.

What is Home Occupational Therapy?

Home occupational therapy, on the other hand, although it’s a type of rehabilitation service, the focus is on helping folks be independent doing their daily activities. Daily activities could include bathing, dressing, cooking, key turning to enter the home or drive the car, and other upper extremity fine motor activities down throughout the day. Common reasons for seeking home occupational therapy include:

1. Recovering after having had a stroke or other neurological condition
2. Functioning and managing chronic conditions, such as Parkinson’s disease or multiple sclerosis
3. Adapting to physical or cognitive limitations due to aging by developing strategies to help with daily activities
4. Educating and instructing in the use of adaptive equipment to improve daily function in the home

Key Differences Between Home Physical Therapy and Home Occupational Therapy

While the overall goal of both home physical therapy and home occupational therapy is to improve the quality of life for the individual in their home, they focus on very different aspects of recovery and rehabilitation. Here are some key differences between the two therapies:

1. Goals: Home physical therapy focuses on you getting around in your home safely, while home occupational therapy aims to make sure you can do everything you need to do in the home to be independent and safe.
2. Scope: Home PT primarily addresses issues that are related to mobility, whereas the home OT actually covers a broader range of concerns, even getting into a person’s cognitive and emotional well-being.
3. Interventions: Home PT typically involves exercises and sometimes manual therapies to improve strength, flexibility, and balance, while home OT uses adaptive equipment, environmental modifications, and checks a person for the strategies that they use to overcome challenges in the daily routines.
4. Duration: Each clinician will develop their own plan of care based on the individual goals, needs, and rehab potential. This may range from 1-2 visits to 16-20 visits. It really depends on the need.

How to Choose the Right Therapy for You

If you’re an individual or family caregiver who thinks home health rehab services can help, it’s really important to understand a couple of things. Number 1, home PT or OT are temporary services and not open ended. Although a person may qualify for home PT or home health services, these services are only for a short period and if more care is needed, the patient or family would need to seek out home care rather than home health services. The second thing to consider is that there needs to be an actual medical need and opportunity for functional improvement. If there is little to no rehab potential, then home health services are not warranted and typically will not be covered by health insurance.

With that said, it’s also essential to consider the specific needs and goals you may have. Some people need to learn to climb stairs again or develop strategies to get between floors in a home. Or, a person who may have a broken arm will need to learn how to bathe or prepare a meal while using 1 arm instead of 2. Another goal may be to teach a family or hired caregiver how to progress an elder or senior through an exercise program safely. All of these are appropriate goals.

Here are some factors to consider:

1. Identify your primary concern: If your primary goal is to improve your physical function and mobility, home physical therapy may be the best choice. If you’re looking to regain independence in daily activities, home occupational therapy may be more appropriate.
2. Consider your medical history: Your medical history and any underlying conditions may help determine which type of therapy is best suited for your needs. Consult with your healthcare provider to discuss the most appropriate course of action.
3. Evaluate your home environment: The setting in which you will receive therapy may influence your decision. Consider whether your home environment is conducive to physical exercises or if modifications are needed to support daily activities.
4. Talk to a professional: Reach out to a licensed physical therapist or occupational therapist to discuss your situation and receive expert guidance on which type of therapy is best for you.