Home Assessment and Modifications for Older Adults in OSOT 1250

This assignment is a home assessment project for an Occupational Therapy Assistant (OTA) program, focusing on the home safety of an aging adult. The student, acting as an OT, assessed a client's home using a modified checklist, identifying potential hazards in various areas such as the entrance, hallway, living room, kitchen, bedroom, bathroom, staircases, and laundry room. For each hazard, the student provided detailed solutions, modifications, and recommendations to improve the client's safety and quality of life, including suggestions for railings, lighting, flooring, and accessibility. The assignment also includes a reflection paper where the student discusses the process of the assessment, the client's initial reactions to the recommendations, the resources recommended, and the insights gained from the experience. The student emphasizes the importance of considering the client's health background, family support, and daily activities when making recommendations, and the need to address the client's concerns and preferences to ensure the acceptance and implementation of the suggested changes. The student highlights the challenges in convincing older adults to change their long-established habits and the importance of focusing on practical solutions to improve their living conditions and prevent falls. The assignment demonstrates the student's ability to apply occupational therapy principles in a real-world setting, providing a comprehensive evaluation of the client's home environment and suggesting practical solutions to enhance their safety and independence.

Running head: OCCUPATIONAL THERAPY
OCCUPATIONAL THERAPY
Name of the Student:
Name of the University:
Author Note:

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Name: Mr. Robert Henderson
Entrance to Front Door and Front Yard
 Lack of railings or unstable railing
Unsafe steps (too steep/cracked)
Unmarked or raised threshold
Lack of lighting at night
Lack of a ramp for a wheelchair
Uneven/cracked pavement
Ice or snow on driveway/walkway
Lack of an outdoor grab bar
Other:
Solutions/Modifications/Recommendations:
Presence of unstable railing provides no support to the client whereas it should be present to
provide support while getting down the stairs present at the front door of the house. Lack of
support might result accidents such as falls. A wooden railing or any such provision should be
present in the front yard of the house.
Entrance to Back/Side Door
Lack of railings or unstable railing
Unsafe steps (too steep/cracked/chipped)
Unmarked or raised threshold
Lack of lighting at night
 Lack of a ramp for a wheelchair
Uneven/cracked pavement
Ice or snow on walkway
Lack of an outdoor grab bar
Other:
Solutions/Modifications/Recommendations:

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With ageing there is always an uncertainty of health. Situations may arise where the client might
need a wheelchair for provision of proper healthcare. If such situations arise, presence of a ramp
will be required for convenient movement of the wheelchair.
Hallway or Foyer
 Uneven or slippery flooring
Cluttered area
Dark or poor lighting
Lack of access to ceiling light
Other:
Solutions/Modifications/Recommendations:
As already mentioned, old age often takes a toll on the strength of the muscle of the individuals.
This reduces their capability to stay steady during walking or any other activity, therefore uneven
or slippery flooring might increase the client’s difficulty to stay steady and might face an
accident like fall.
Living Room
Presence of throw or scatter rug
Presence of clutter
Presence of electric cords across the floor
Poor lighting
Presence of unstable furniture
Presence of unstable chair
 Difficult to access light switches
Not enough space to move around
Other:
Solutions/Modifications/Recommendations:

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With growing age there is impairment mobility along with vision. Therefore if the switches of
the light are available at an easily accessible location it would be quite beneficial to the client as
well as his family.
Kitchen
Cabinet too high or low
Not enough counter space
 Using a stool or a chair to reach things
Not enough room to maneuver
Presence of throw/scatter rug
Slippery floor
Poor lighting
Presence of a pet underfoot when preparing meals
Other:
Solutions/Modifications/Recommendations:
Use of stools is not a good option during old age as it there is always a risk of fall. Such
situations can be avoided if the shelves are located at more convenient heights.
Bedroom
Presence of clutter
Presence of electric cords across the floor
Unsafe carpet (uneven, torn, curled up)
Presence of throw/scatter rug
 Height of bed (too low/high_
Lack of a telephone near the bed
Lack of nightlight
Arrangement that causes difficulty to reach items (TV remote, lamp)
Lack of device to get in/out of bed
Other:
Solutions/Modifications/Recommendations:
Height of the bed might provide inconvenience to the client because getting up on the bed
regularly which are high enough becomes difficult. Low beds are much more convenient since

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there body movement required is less as compared to that of getting up on high beds. Excessive
body movements often becomes difficult at old age therefore such should be avoided.
Bathroom
Presence of unsafe bath rugs
 Lack of grab bars in the tub
Lack of grab bars in the shower area
Lack of grab bars near the toilet
Toilet is too high or low
Slippery tub (lack of bath mat, etc.)
Claw foot/tub that is too high to get into
Lack of bath chair in the shower area
Clutter
Incorrect placement of grab bars
Other:
Solutions/Modifications/Recommendations:
While getting out of the tub individuals often face difficulties since the water makes the spot
slipper. Therefore provision of grab bars would be helpful for the client.
Staircases
Lack of or poor lighting
Lack of railings
Clutter
Steps too steep
 Slippery steps without tread/carpet
Other:
Solutions/Modifications/Recommendations:
With growing age there is a tendency to show mobility impairment since the muscles become
weak. Therefore in such situation, to reduce the risk of falls, slippery steps should be avoided at
any cost. Carpeting provides friction which reduces the slippery nature and hence enhances the
grip of the foot on the floor, thereby preventing the chances of fall.

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Laundry Room/Basement
 Poor or lack of lighting
Lack of railings
Clutter
Steps too steep
Slippery steps without carpet/luminous light
Presence of cords across the floor
Same colored floor at bottom of stairs
Other:
Solutions/Modifications/Recommendations:
Proper lightning like use of high voltage bulbs is especially required in the basements as there is
no provision of natural light to come in.
1. For recommending suggestions for the respective client, it is important to identify mainly
the health background. The individual is an older adult therefore chances of suffering from
any disorder related to old age or any chronic disorder is high (Pergolotti et al., 2015).
Once health conditions are recognized it would become easier for me to analyze the
situations around the individuals and suggest ways in relation to the existing situation.
Apart from the health issues, factors like family members or availability of caregivers and
the quality of care that the individual has been receiving is also required. Moreover it is
also important to aware of the daily activities of the individual so that it can be kept in
mind before suggesting recommendations to improve his conditions or betterment of the
conditions around him.
2. At first the client was not sure of the recommendation that were suggested to him since he
has been living in the existing situation or with the resources for the past 40 years.
Therefore all of a sudden the need for change was not that convincing for the patient.
However later when the client went through the checklist in details, and was made to

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understand the need for the changes, it appeared to be more or less convincing and he
agreed to implement the changes for the betterment of his lifestyle in the later years of his
life.
3. As already mentioned the changes that were recommended to the client did not appear to
be quite convincing initially. Therefore the client continuously questioned regarding the
usefulness of the suggested changes in his home. According to the checklist I had
recommended that it was not a wise choice for the switch boards to be located at such odd
places or the shelves were too high in the kitchen due to which there was a need for using
stools (Liu et al., 2013). The client questioned this because he has been using these
resources for many years now and have yet not realized the disadvantages of the current
situation.
4. The resources that were recommended to him were all related to his home like installing
proper lighting wherever possible. It is an established fact that with growing age there is a
tendency to have impaired vision and in conditions proper lighting becomes necessary.
Absence of this can increase the risk of falls. Additionally I recommended change in the
location of the switch boards especially in the living room. With growing age there is
impairment mobility along with vision (Giné-Garriga et al., 2014). Therefore if the
switches of the light are available at an easily accessible location it would be quite
beneficial to the client as well as his family. Similarly use of stools is not a good option
during old age as it there is always a risk of fall. Such situations can be avoided if the
shelves are located at more convenient heights.
5. The assignment has given me an insight to the problems that the older adults generally
face in their day to day lives. The assignment also helped me to understand the client’s

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mentality regarding their home and their resources and how they are attached to such
things. The study also reflected the fact that the individuals who are in the latter stages of
their life are more tend to show more rigidity in their thought process hence are more
difficult to convince. They are less bothered regarding the quality of their life or care and
focus more the health outcomes (Golisz, 2014).

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References
Giné-Garriga, M., Roqué-Fíguls, M., Coll-Planas, L., Sitjà-Rabert, M., & Salvà, A. (2014).
Physical exercise interventions for improving performance-based measures of physical
function in community-dwelling, frail older adults: a systematic review and meta-
analysis. Archives of physical medicine and rehabilitation, 95(4), 753-769.
Golisz, K. (2014). Occupational therapy interventions to improve driving performance in older
adults: A systematic review. American journal of occupational therapy, 68(6), 662-669.
Liu, C. J., Brost, M. A., Horton, V. E., Kenyon, S. B., & Mears, K. E. (2013). Occupational
therapy interventions to improve performance of daily activities at home for older adults
with low vision: A systematic review. American Journal of Occupational Therapy, 67(3),
279-287
Pergolotti, M., Deal, A. M., Lavery, J., Reeve, B. B., & Muss, H. B. (2015). The prevalence of
potentially modifiable functional deficits and the subsequent use of occupational and
physical therapy by older adults with cancer. Journal of geriatric oncology, 6(3), 194-
201.