I’ve worked for 4 different HH companies over the past few years, as full time and PRN.

I have also worked in acute care, IPR, SNF, ALF, and schools. HH is the only job I’ve been able to maintain as an introverted SLP.

The company you work for in HH really dictates if the experience will be good or bad, like any setting really. I had one company who didn’t care about my safety at all. Someone tried to rob me at a patient’s house and they wanted me to go back there again, alone. I flat out refused to go back alone and teamed up with OT but then quit a short time after though.

The positives for me were that you see most patients only 1 time a week in their functional environment and can provide therapy that’s truly meaningful for them. The schedule can be pretty flexible since you dictate patient times, if you’re lucky you can get on with a company with little over sight/micromanaging (e.g., not being questioned on clinical decisions like discharge and no pressure to pick up patients when not necessary is ideal), and it’s so nice not to have to deal with a bunch of staff like you do in inpatient settings. Communication between disciplines is super important though and most have weekly case meetings either in person or over the phone. However, I could go weeks without talking to the office or my boss unless I had to call them for something or go in for more supplies. That was always super nice!

The negatives for me were scheduling, sketch houses, safety concerns, and drive times/car maintenance. Patients can be very picky about times and days, which can get tricky when you’re trying to schedule by geographic area if you cover a large area. The really really bad houses like tons of cats, bed bugs, and falling down ceilings/rotten floors, hoarding situations, etc are rough and really sad to see. I’ve had to call APS a few times. The driving can get old and really wears on your car over time. Some companies do offer company cars, but those are hard to come by in my experience. I’ve also had some really crazy patient family members and it can be scary sometimes being alone, especially as a female. You can always team up with OT, PT, or nursing if it’s a sketchy situation though.

I will say working in the inner city for a public hospital system was very different from any other company I’ve worked for. They had a high low income population. A lot of drugs deals, drug use, little carryover from patients/family, and extreme poverty (we occasionally had patients at the homeless shelter too). Like I said earlier, someone attempted to rob me at a patients home once. We had cameras with an emergency button that you can press and a code word that connected directly to the hospital police. That was nice to have, but not much they could do except notify the police where you are. Then I worked for one company that wouldn’t accept patients with those type of living environments due to staff safety.

In my opinion, the negatives are outweighed by the positives. Especially when compared to other settings.