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The value of an in-home evaluation

Last Modified: 9/11/2019

When a caregiver recommends an in-home evaluation for older patients, the thought can elicit some fears for those who treasure their independence. This shouldn’t be the case, according to Jennifer Ferguson, MOT, OTR/L, occupational therapist, Parkview Fall Prevention Clinic, who has an executive certificate in home modification. Here, she outlines the benefits of having a fresh set of eyes explore your environment for possible risks and improvements. 

The upside of coming on site

We constantly modify our home as we grow. We do it for young children, and throughout our entire lives. This is just another stage. And truly, education is power.  A lot of times people just don’t know what’s possible or out there for adapting or putting equipment in their homes to make things easier.

As occupational therapists, we’re trained to do activity analysis. We take activities that seem super simple and break them down into parts. We ask things like, what does the body need to perform the task? What role does the environment play? And so on. We take timing, culture, and other variables into consideration, as well. Everyone has a different, unique way of doing things, and if I’m in your home, I can really customize modifications to fit the way you live and want to live.

Even if you aren’t currently experiencing falls in your home, it’s important to have someone come take a look from a prevention standpoint. There’s a quote we use a lot: “You don’t think you have a problem until your OT finds one.” So often, we can your day-to-day so much easier.

Risks, statistically speaking

There are three main areas to focus on, where falls are statistically happening most often: the bathroom, the entry/exit to your home, and the stairs.  These are areas of fall risk for adults of all ages. And remember, even one fall is too many. It only takes one fall to get serious injuries, which can lead to your health spiraling and complications.

Simple adaptations

It’s not just about picking up the rugs. There are so many options for improving your home environment.

  • Let there be light!  Lighting is a great example that impacts tasks and the overall environment. I look at things like the glares from natural light and different types of bulbs that can improve visibility.
  • Guests welcome.  A lot of people don’t think about making their home visitor-friendly. I can give ideas to plan for the future, including how to accommodate walkers or wheelchairs, in and out of the house.
  • Convenient cupboards.  I help people arrange items in their kitchen cabinets or other storage areas so it’s easier to reach. This minimizes the risk of losing their balance.
  • Practical powder room.  The No. 1 place people fall is the bathroom, so I’m big on permanent grab bars. I can recommend locations where bars would help them, too, because everyone reaches in a different place. I make sure they have nightlights or that it’s easy to turn the light on. I’ll also look at the toilet and possibly recommend using something to help center themselves on the seat.
  • Carry with caution.  When carrying items, try to carry with one hand and keep one hand free to use a railing or an outdoor grab bar by doorway so it’s easier to step up into the home.
  • Green thumb.  I can help provide adaptations for gardening and different hobbies. This might include raised beds or different tools.  
  • Pet-friendly functionality.  I help a lot with caring for pets. It can be helpful to modify for where the food bowls are located, where food is stored and having large bags of food delivered rather than trying to handle them.
  • Room organization.  Furniture is something a lot of people struggle with, especially getting in and out of chairs and couches. I can give options for furniture risers, lift chairs, etc. There are simple solutions like putting a folded up bath towel under a cushion to give them a few more inches of height or putting a board under a rocking recliner to make it more stable. Sometimes it’s placement. I might suggest moving the bed to another wall so they have a more direct route to the bathroom.
Stay or go?

While some fear we’ll recommend they relocate, out of the home, that is not my decision or intention. My goal is to help them be as independent and safe as possible. I want patients to stay in the environment they’re comfortable in for as long as they possibly can. I can give them all the ideas and recommendations I have, and in the end, it depends on how much effort and resources they’d like to put into modifications. But again, I just provide information. It’s the individual’s responsibility to pick and choose what they think will help them.

Schedule a visit

In-home evaluations are offered to everyone who comes through the Fall Prevention Clinic. This multidisciplinary team is a great place to start if you’re experiencing health issues that require a big picture exploration. The service is also provided to patients who utilize Parkview’s outpatient occupational therapy services or have received a physician referral. If you are concerned about fall risks and would like to receive an in-home evaluation, please speak with your primary care physician.


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