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Provide special consideration to patients who are at an increased risk for falls due to impaired cognition or vision or to decreased strength or balance.
The Occupational Therapy Practice Guidelines for Home Modifications defines home modifications as adaptations to environments that are intended to increase use, safety, security, and independence.undefined#ref6">6 Modifications may include, but are not limited to, the use of medical equipment or universally designed products; architectural modifications or major home renovations; and education of the patient regarding new strategies to use in the home environment.6
Therapeutic intervention that includes home modifications may prevent premature long-term care by supporting aging in the home,3 as well as improve the patient’s functional performance and reduce the risk of falls and physical demands on caregivers.6 Additionally, home adaptations may reduce costs while older adults age in the home.5
When considering home modifications, the patient’s physical function is one of the main factors for the therapist to keep in mind.5 The therapist must also take into consideration the patient’s perception of the home modifications, readiness to change the environment, and costs.2 The therapist must work with the patient or caregiver (or both) and have the patient’s consent before making any changes in the home.
Entrances are an important area for the therapist to focus on during a home safety assessment. Barriers at a home entrance can prevent out-of-home mobility for patients4 and may contribute to falls and injuries.2 The therapist should also address entrances inside the home, as well as outside.
Take note of preexisting conditions such as visual or hearing impairment, neuromuscular dysfunction, fatigue or reduced energy, or postural hypotension.
Ramps with a rise of more than 15 cm (6 inches) should have handrails.
Keall, M.D. and others. (2017). Cost-benefit analysis of fall injuries prevented by a programme of home modifications: A cluster randomised controlled trial. Injury Prevention, 23(1), 22-26. doi:10.1136/injuryprev-2015-041947
*In these skills, a “classic” reference is a widely cited, standard work of established excellence that significantly affects current practice and may also represent the foundational research for practice.
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