Home And Community, Occupational Therapy
Occupational Therapy Home Visits: Why They’re More Important Than Ever in 2025
The Evolving Importance of Occupational Therapy Home Visits
Occupational Therapy Home Visits have long been a cornerstone of client-centred practice across Australia. While the core goal remains to empower clients to live as independently and safely as possible, the landscape has evolved significantly. Growing client complexity, funding reforms, the NDIS, technological advancement, and increasing service demands continue to shape how and why OTs deliver community-based care.
What does the latest evidence reveal about the value of Occupational Therapy Home Visits? How are clinicians balancing the resource intensity of these assessments with clear client benefits? And what do emerging models, like telehealth and digital assessment, mean for the future of practice?
The Core Value of Occupational Therapy Home Visits
A Holistic, Contextualised Assessment
Occupational Therapy Home Visits allow clinicians to assess and intervene in the real-life environments where clients perform their daily activities. This is far more than convenience, it is fundamental to occupational performance and participation. By observing clients in their home environment, therapists can:
• Identify barriers to function across self-care, domestic, and community participation tasks
• Provide practical recommendations for assistive technology, equipment, and home modifications
• Understand unique routines and environmental factors, such as distances between objects, heights, stairs, and lighting
Research consistently demonstrates that home-based assessments capture risks and opportunities for intervention that are simply not visible in a clinic or hospital setting – supporting more tailored, effective, and sustainable outcomes for clients.
Client-Centred Goal Setting and Engagement
Home visits are uniquely positioned to empower clients and families. Client-centred care is fundamentally about shared decision-making and meaningful goal setting. This is best achieved when the client feels safe, understood, and can demonstrate priorities in context. For children, the elderly, adults with chronic illness, and those with disabilities, the home is a foundation for independence, dignity, and agency.
The Evidence: Outcomes and Effectiveness
Enhanced Functional Independence and Safety
A recent Australian randomised controlled trial with patients recovering from hip fracture found that those who participated in a pre-discharge Occupational Therapy Home Visit experienced improved outcomes (Lockwood, Harding and Taylor, 2020):
• Increased Adherence: Home visits improved patient adherence to OT recommendations (e.g., assistive devices and environmental modifications), leading to enhanced daily function and reduced hospital readmissions.
• Reduced Falls and Injury: Patients receiving pre-discharge home visits showed lower rates of falls after returning home—particularly when interventions addressed real-world environmental hazards.
• Quality of Life and Participation: Programs delivering both pre- and post-discharge home visits, such as the HOME trial, reported better participation, self-efficacy, and confidence in transition after acute events like stroke.
Hospital Flow, Readmission, and Cost Efficiency
The role of Occupational Therapy Home Visits in supporting safe discharge planning is well-recognised. Studies show that these interventions can:
• Prevent unplanned readmissions, particularly within the first 30 days post-discharge
• Enable earlier but safer hospital discharge by bridging hospital-to-home transitions
• Produce cost savings for health systems when appropriately targeted, although indiscriminate use for all patients may not be justified by available evidence
Challenges: Resource Intensity and System Pressures
The Time and Labour Investment
Traditional Occupational Therapy Home Visits can take several hours, factoring in travel, preparation, assessment, reporting, and multidisciplinary communication. This reduces therapist availability for other patients and is a well-recognised challenge within inpatient and community teams.
Unfunded travel, such as driving to and from a client’s house without adequate reimbursement, significantly constrains an OT’s ability to offer home-based services. A 2025 Occupational Therapy Australia survey found that 98% of OTs consider travel reimbursement essential for service viability, with over half describing it as critical for enabling home and community-based assessments.
The consequences of inadequate funding are clear: financial strain, longer waitlists, and reduced service reach—particularly across rural and regional areas—limiting access to truly client-centred, context-driven care.
Decision-Making Tools and Prioritisation
Given the resource intensity, Australian research has focused on frameworks to help OTs decide when Occupational Therapy Home Visits are warranted. Decision-support tools have been shown to:
• Improve the appropriateness of referrals and support less experienced OTs with clinical reasoning
• Prioritise home visits for high-complexity clients while identifying alternative assessment methods for others
Innovations in Practice: Telehealth and Digital Assessment
The Digital Age of Occupational Therapy Home Visits
Since COVID-19, OTs have increasingly embraced technology to safeguard clients and clinicians. New models include:
• Telehealth Home Visits: Using video, phone, and digital photography to assess the home, guide clients or families through measurements, and provide real-time recommendations
• Hybrid Models: Some clinics now conduct preliminary questionnaires or request photos/videos to triage which clients truly need face-to-face assessment
Emerging research shows that mHealth interventions and digital discharge planning have significantly increased the number and timeliness of Occupational Therapy Home Visits, improving access for clients in remote or underserved regions.
However, remote or virtual visits have limitations, such as difficulty testing equipment in situ and reduced opportunities for non-verbal communication. Careful clinical reasoning is essential to determine the right model for each case.
Best Practice Guidelines
• Client-Centred, Contextualised Assessment: Whether in-person or via telehealth, focus remains on meaningful goals in real-world environments.
• Collaborative Planning: Involve the client and family throughout assessment, planning, and follow-up.
• Prioritisation Tools: Use evidence-based frameworks to determine which clients will benefit most.
• Integration with Multidisciplinary Care: Effective Occupational Therapy Home Visits involve collaboration with physiotherapists, nurses, social workers, case managers, and community supports.
Special Considerations Across Practice Areas
Occupational Therapy Home Visits remain vital across diverse settings:
• Aged Care: Supporting frail older adults to remain at home, prevent falls, and avoid hospital readmissions.
• Disability and NDIS: Identifying participation barriers, environmental modifications, and funding supports.
• Paediatrics: Working with children and families “where life happens”—at home, in schools, and the community.
• Chronic Illness and Rehabilitation: Supporting safe mobility, sustainable independence, and community access.
Conclusion
Occupational Therapy Home Visits continue to be a cornerstone of safe, meaningful, and independent living for clients across Australia. The profession’s evolution – blending traditional practice with telehealth and evidence-based tools, positions OTs to deliver high-quality, accessible care despite growing pressures on time and funding.
The future of Occupational Therapy Home Visits lies in staying evidence-driven, client-centred, and adaptable to new technology, ensuring that clients can thrive wherever they call home.
References
- Aplin T, Godfrey M, De Michele L, Hoffman A, Palmer C, McCormack C, Halin C, King M, Nix J, Eldridge A, Eames S. Supporting Occupational Therapists in Predischarge Home Visit Decision-Making: Development and Evaluation of a Decision-Making Support Tool. Occup Ther Int. 2025 Feb 26;2025:2296340.
- Lockwood K, Harding K, Boyd J, Taylor N. Home visits by occupational therapists improve adherence to recommendations: Process evaluation of a randomised controlled trial. Aust Occup Ther J. 2020;67(4):267-275.
- Nix J, Comans T. Home Quick – Occupational Therapy Home Visits Using mHealth, to Facilitate Safe Hospital Discharge: A Process Evaluation. Int J Telerehabil. 2017;9(1):9-20.
- Fukumoto M, et al. Home visits by occupational therapists in acute hospital care: A systematic review. Disabil Rehabil. 2019;41(20):2390-2397.
- Hoffmann T, Russell T, Thompson L, Vincent A, Nelson M. Pre-admission orthopaedic occupational therapy home visits conducted using the internet. J Telemed Telecare. 2008;14(5):231-234.
- Brown T, Williams B, McKenna K, et al. Effect of occupational therapy home visit discharge planning on participation after stroke. BMJ Open. 2021;11:e040841.
- Lannin NA, Clemson L, Drummond A, et al. Effect of occupational therapy home visit discharge planning on participation after stroke: protocol for the HOME Rehab trial. BMJ Open. 2021 Jul 5;11(7):e044573.
- OTA: “OTA’s survey of OTs shows dire consequences of NDIS pricing decision”. Accessed September 2025. https://www.otaus.com.au/news/otas-survey-of-ots-shows-dire-consequences-of-ndis-pricing-decision
