The Home Health SLP Secret to Success: Using the Home Environment

What would you say if your patient told you that speech therapy is “boring” and “holds no value”?

I had a home health patient tell me that years ago, and his words were motivating enough for me to overhaul my entire approach to patient care. I realized that the tasks I was having my patients complete in the home had no practical relevance to safe, independent functioning, which was likely why this patient (and presumably others) felt that time spent during speech therapy was time wasted. By bringing in my paper-and-pen workbook tasks, I was not creating a treatment plan that was specific to the patient’s immediate needs.

Once I ditched the workbooks and began to consider the patient’s home as one big toolkit, I found that my patients became more engaged, motivated, and satisfied with speech therapy sessions. As an added bonus, I became more engaged and motivated as well!

Choosing Activities in the Home Environment

Whether it’s a language activity, problem solving task, or memory building activity, almost any household item in any room of the house can be utilized therapeutically for a range of different speech-language pathology tasks.

Living Room

• Expressive language and speech expression
  • Name objects and furniture in the living room.
  • Name people in photos or from photo albums.
  • Read aloud from the newspaper or magazines.
• Receptive language
  • Follow verbal instructions using common living room objects, such as the TV, lamp, newspaper, or remote control.
• Problem solving
  • Problem solve for safety and comfort in the living room area, such as arranging items in the living room for easy and safe access.
  • Problem solve how to contact important people in the event of an emergency, such as 911, the doctor’s office, or an emergency contact family member.
• Memory
  • Recall items from the newspaper or TV guide.
  • Recall names of the family members in photos or albums.
  • Recall important phone numbers with or without written cues.

Kitchen

• Expressive language and speech expression
  • Name items in the pantry.
  • Match and sort utensils.
  • Use a pill dispenser to sort and name medications.
  • Sort pantry items by content or color and type of container.
  • Create a grocery list.
• Receptive language
  • Follow verbal or written multi-step directions for simple meal prep.
  • Follow multi-step verbal directions using kitchen tools or utensils, such as, “Put the fork on the right side of the pan.”
• Problem solving
  • Problem solve for safety given different kitchen scenarios, such as, “What do you do in case of fire?” “How can you remember to turn off the stove?” “What number do you call if there is a fire?”
  • Problem solve strategies to order medication refills.
• Memory
  • Practice memory tasks using favorite recipe cards or shopping lists.
• Dysphagia
  • Follow protocols for preparing safe swallow diet protocol.

Bedroom

• Expressive language and speech expression
  • Name items in the closet and dresser.
  • Match and sort socks by color.
  • Match written labels with actual items.
  • Use family photographs for naming tasks.
• Receptive language
  • Using clothing items, follow verbal multi-step instructions for sorting and matching.
  • Follow multi-step instructions for dressing and grooming tasks.
• Problem solving
  • Problem solve to create a safer living environment through changes like improving lighting, eliminating clutter, or rearranging furniture for easier access.
  • Problem solve which clothing items match best.
  • Problem solve which clothing items would be best worn in different weather situations.
• Memory
  • Play memory games using items on top of the dresser.
  • Recall the steps to follow for dressing or grooming.
  • Recall family member names using photos.

Bathroom

• Expressive language and speech expression
  • Name items in the medicine cabinet, toiletry items, and grooming utensils.
• Receptive language
  • Follow verbal or written multi-step directions for grooming and hygiene tasks.
• Problem solving
  • Problem solve related to bathroom safety, such as, “What do you do if there is water on the floor?” “Is it safe to use the towel rack as a grab bar?”
• Memory
  • Recall items in the medicine cabinet.

As you can see, the opportunities are endless!

Using your patients’ living environment as a tool for therapy will allow you to get a realistic view about how your patients function in their homes. With this perspective, you will be able to create an endless number of tasks for your patients that will be directly related to their needs so they can function safely and independently in their home. Not only will this create a more meaningful experience for your patients, it will also increase the value of the speech-language pathologist as an important factor in keeping home health patients safe and aging in place.