Home modifications are "adaptations to living
environments intended to increase usage, safety, security,
and independence for the user. Home modifications are used in
conjunction with assistive devices and home repairs" (American
Occupational Therapy Association [AOTA], 2005, p. 28). As part of
the home modification process, services include assessing needs,
identifying solutions, implementing solutions, training in the use of
solutions, and evaluating outcomes that contribute to the home modification
product (AOTA, 2005; as adapted from Sanford, 2004).
The results of this process may be recommendations for alterations,
adjustments, or additions to the home environment, through the use
of specialized, customized, off-the-shelf, or universally designed
technologies, equipment, products, hardware controls and cues,
finishes, furnishings, and other features that affect the layout and
structure of the home (Sanford, 2004).
Occupational therapy practitioners are experts at identifying
the cause of difficulties in performance of activities of daily living
(ADL) and instrumental activities of daily living (IADL).
Occupational therapy practitioners evaluate the client, their environment,
and their occupational performance in that environment, as
well as make recommendations for products to improve the fit
between the client, place, and activity. Occupational therapists can
evaluate both the skills of the client and the environmental features
that support or limit the performance of meaningful or necessary
activities, thereby enhancing health, safety, and well-being. Based
on this assessment, they recommend modification and intervention
strategies that improve the fit between the person and his or her
environment.
As the population of older adults continues to grow dramatically,
home modifications are a key factor in enabling individuals to "age
in place." Aging in place refers to the ability to remain in the home
even if the client's abilities have declined. An AARP study found
that more than 80% of people older than age 50 want to age in their
own homes as they grow older (Bayer & Harper, 2000). Others who
can benefit from home modifications include clients of all ages with
health conditions, sensory or movement impairments, or cognitive
disorders that have an impact on their occupational performance,
safety, and well-being. Home modifications may also provide the
opportunity for someone to move from a more institutional setting
(e.g., a skilled nursing facility) to the community, if he or she
desires.
Home modifications recommended by an occupational therapy practitioner
can reduce the challenges posed by the environment, thereby
supporting an individual's capabilities. One example is installing a
chair lift if the client cannot climb the stairs to the second floor of
the home. Another example is adding railings and grab bars to bathroom
or other walls to provide support during functional mobility
and self-care activities. Occupational therapy practitioners can provide
unique and valuable services in home modifications, both
directly and indirectly to promote safety and function, so that individuals
can participate in their daily occupations and activities of
choice.
