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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#ref5">5 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.5
Therapeutic intervention that includes home modifications may prevent premature long-term care by supporting aging in the home,2 as well as improve the patient’s functional performance and reduce the risk of falls and physical demands on caregivers.5 Additionally, home adaptations may reduce costs while older adults age in the home.4
When considering home modifications, the patient’s physical functionality is one of the main factors for the therapist to keep in mind.4 The therapist must also take into consideration the patient’s perception of the home modifications, readiness to change the environment, and cost.3 The therapist must work with the patient or caregiver (or both) and have the patient’s consent before making any changes in the home.
The assessment of flooring includes its type and condition. The therapist must consider how well the patient can negotiate through the home and if the patient uses a walker, cane, or wheelchair. Additionally, determining if the patient’s home has sufficient lighting for safe movement through the home and for tasks such as reading or food preparation is an important component of the assessment. The therapist must take into consideration any visual deficits the patient has that will have implications for home modification recommendations.
Take note of preexisting conditions such as visual or hearing impairment, neuromuscular dysfunction, fatigue or reduced energy, or postural hypotension.
Rationale: Throw rugs are a tripping hazard.
Rationale: A contrasting color increases the visibility of each step.
Rationale: Toggle switches are easier to turn on and off.
Rationale: LED bulbs create less glare than other lighting sources.
Rationale: Dimmer switches allow the patient to adjust lighting for specific activities (e.g., task lighting) versus having a specific wattage and then turning the lights off.
*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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