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i am in psych home health 14 years after doing inpt 7, partial hospital 2, private practice pt 14 yrs, plus adjunct teaching;;; it is remarkable. my clientel is 90 percent elderly who would not have access to psych services, 60 percent never had a psych diagnosis, but now had a traumatic physical change like sx or advanced copd, or poor sx outcome and long rehab needs. its amazing the individual an family work that can be done. i have to do basic vital signs and have gotten better in 14 years to assessing medical and psych interfacing...i have some long term depression ad bipolar and dementia pts. but everying thing is done in9 wk max intervals for medicare. i have a few more just mentally ill pts i originally started on large adolescent young adult inpt and here i am loving it. too much paper work at night. no weekends so far, no holidays, day work, but long days..1hr plus visits and traveling ...gail clark aprnc