I still receive emails from people asking about COTA jobs and schools. I had one just recently asking about entering the field into pediatrics. As much as I hated to steer someone away from entering the profession, I had to make them aware of the few opportunities available in peds for a COTA.
With 86% of all COTAs employed in Long Term Care (LTC), that is where most find employment. A few will continue their education to specialize in one area of Occupational Therapy, not necessarily to advance their degree but to gain the skills and knowledge needed for their selected niche.
So where do COTAs work? Here's some information from my experience:
Nursing Homes or Long Term Care (LTC). Most facilities provide therapy to their residents under Medicare or other insurance. In this setting a COTA would be responsible for patient education on dressing, bathing, transfers, strengthening, adaptive equipment training and more as the OTR determines. Basically the COTA addresses dressing and bathing of the person while educating them on adaptive techniques and equipment in an effort to achieve more independence with these daily tasks.
Hospitals are another place a COTA can find employment. In this setting the routine will be similar as a nursing home. The big differences are that the patient's may be more complicated (illness wise) and their length of stay will be shorter. As they become more stable they will probably be moved to a LTC facility. Depending on the hospital you work at you might have patients who are on oxygen, feeding tubes, IV's and other similar live sustaining devices. In my experience I find the pace in a hospital to be fast, usually having just 30 minutes to complete a treatment and move to the next patient.
Outpatient Clinics. Although my experience tells me that very few COTA's work in outpatient clinics due to insurance and/or Medicare regulations, the patients seen here tend to be higher functioning. Most are typically recovering from a surgery, fracture, or other sort of non-life threatening injury or illness. The pace is more relaxed, and treatments are scheduled for a specific duration depending on the therapy needed.
Home Health is an area that has expanded recently, meaning more jobs for COTA's. Insurances prefer to have the person at home to save money rather than leaving them in LTC. Be prepared to almost live in your car though, because you will be traveling from house to house. One drawback that I note with Home Health is that any needed equipment has to travel with you. In my days of Home Health my car(s) looked like a rolling office with bags of equipment, paperwork files, and splinting materials. I also mentioned cars, as in multiple vehicles. Think about this before you leap into this area. The price of gas, car maintenance, and insurance costs can put a dent in your earnings. A major breakdown of your vehicle can mean no work as well as a big repair bill or needing a new car.
Schools. In this setting the assessments typically focus on the specific skills the child needs to succeed in the school environment, such as seating posture, grasp and control of classroom tools, self‐regulation, and the development of sensory motor skills. Employment in this area will demand some experience and additional education.
Mental Health Settings can range from a facility similar to a nursing home, a group home, or a hospital-like facility where people with mental handicaps reside or attend on a regular basis. This is the area where OT began years ago, doing crafts with the mentally handicapped to teach them job skills. Additional education beyond the required degree would be beneficial in this setting.
Education only--a small percentage of COTA's work as educators or teach at a college. As AOTA changes requirements for educators I see this area being closed to COTAs who do not hold a Bachelor's degree.
My final thought today regarding COTA employment is that almost anyone who has a compassionate heart will find their niche in OT. Some areas will definitely entail more physical work while other areas will require more mental exertion. If you want to work as a COTA the two year program is not that difficult to complete, and there are many types of settings to find a job you are happy with.
Until next time, hope all your "Thoughts" are Good-