The Role of the Occupational Therapist with Aging in Place Home Remodeling
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The main goal for a home modification or aging-in-place remodel must be helping your client gain or maintain independence over time. But how does a remodeler — even a Certified Aging-in-Place Specialist — know what will be best for their client now and in the future? While you know the building codes and proper specs for the renovations, an occupational therapist (OT) provides a medical perspective. They help you better understand your clients’ needs. (1)
What is an Occupational Therapist’s Role with Aging in Place?
According to the American Occupational Therapy Association (AOTA), OT (Occupational Therapy) is “a science-driven, evidence-based profession. It enables people of all ages to live life to its fullest. It helps them promote health and prevent—or live with—illness, injury or disability.” Essentially, the person who needs OT is anyone cannot do the things in life that they want or need to do. We look at a person’s occupations (work, education, leisure, play, social participation, sleep, etc.). Anything meaningful to them. And we work to maximize the person’s participation and independence with completion of these tasks.
As Occupational Therapists, we look holistically at the person. We take into consideration their strengths and limitations (including physical, sensory, and cognitive). And also how this impacts the task performed. We are also considering the environment in which the task is to be performed and also how the environment may also impact the person’s health, wellness and participation.
Activities of Daily Living
So, what is an occupational therapist’s role with Aging in Place? Part of AOTA’s 2017 Centennial Vision “is to meet society’s occupational needs.” This is done with the aging population by helping them to age in place and “live life to its fullest” (AOTA slogan). By utilizing our science-driven background, we are able to assess how a person may function in their home and participate in activities of daily living (ADLs). We gather this information and make recommendations to improve a person’s independence and safety within their home. These recommendations may include simple, or more involved environmental modifications, such as recommending rocker switches, the addition of lighting, lever handles on doors to the installation of grab bars, a curbless roll-in shower, or the adjustment of a counter to allow for wheelchair accessibility.
A Team Approach
Home modifications are a team approach. A contractor or an engineer determines structural integrity regarding the installation of an elevator, an incline wheelchair platform lift, or a stair glide. The occupational therapist would determine which of these items best meets the client’s needs for safe, independent use.
Through additional Americans with Disabilities Act Accessibility Guidelines (ADAAG), Aging in Place, and Universal Design (UD) training, appropriate recommendations are made to improve a person’s accessibility, independence, and safety within their home. We (occupational therapists, contractors, builders, remodelers, interior designers, product vendors, architects) are all pieces of the puzzle. Together we best meet the needs of the client for home accessibility evaluations. Our services are complementary. Collaboration before, during and after a job provides a marriage of the medical and the building industries. It yields home accessibility.
1. Freed, Stacey. “Able at Home: Working with an Occupational Therapist can help you serve clients’ needs now and in the future.”
– Interview with Debra Young and article with Remodeling Magazine, June 2010.
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Note from the Hosts
We would like to thank Debra Young @empowerability for contributing this piece on the active players and the thought within a build for Universal Design.
Debra Young, MEd., OTR/L, ATP, CAPS, is a RESNA and NAHB-certified clinical occupational therapist. She owns and operates EmpowerAbility®, LLC (www.empowerability.com), a consulting agency specializing in assistive technology, home safety, aging-in-place, and accessibility consultation. She can be reached at [email protected]. Thanks for reading. ~jb
Very enlightening. I think John Poole would like this article.
Thank you for your comment Alexandra. I’m very passionate about providing the greatest amount of access and independence for my clients in their homes to meet their current and potential future needs. I’m glad you enjoyed the article.
Debra,
I think you and I might’ve had a conversation on this topic once before in the past. I believe all of this universal access / aging in place design is great. My dilemma (coming from my own experience and observations) is that much aging in place design works well until possibly the very last years when a person might suddenly need total assistance, and quite frankly, suddenly lose all that independence previously afforded them by aging in place solutions. My only point here is that any viable aging in place design must also take into account that at some point, some number of adjustments might suddenly have to made to accomodate, not an older person still living an independent life, but an older person suddenly relying on caregivers. I hope that much of current aging in place design also takes this final stage of life into account. I know from first hand experience that it’s a really, really difficult problem to solve and to make retrofits for.
Thanks for the great article, though!
~John
John,
I completely agree with your concern regarding a person potentially needing full support in their home by a caregiver. When I am working with clients, I am of the mindset that a dialogue should be created with the client regarding all possible future needs (including full caregiver assistance) and possible solutions that can be integrated into the design to meet current and future needs should be recommended. One of the biggest obstacles, I find, is encountering what I liken to “the Peter Pan” syndrome whereby many people do not see themselves as aging and cannot visualize needing caregiver assistance in their own home, and subsequently not being receptive to these changes. This is a less frequent issue when working with clients who are already managing a chronic and/or progressive illness, but the design must still account for potential future changes.
One example is my own home. My husband has a C5-C6 incomplete spinal cord injury. During the design of our bathroom, he adamantly did not want a roll-in shower. His preference was to complete a lateral transfer onto a fold-down seat that is integrated into the shower stall system. However, in the future, he and I may very well need a roll-in shower with overhead lift system to safely get him in and out of the shower and age in place in our home. The shower stall was setup with blocking in the walls to accommodate the addition of grab bars later, a linen closet adjacent to the shower which can be removed to allow for a large enough shower space for both my husband and a caregiver, as well as blocking in the ceiling to allow for the addition of an overhead lift system track.
Thank you for your comments and I am glad you enjoyed the article!
-Debra
Hi Debra,
Thanks for your detailed reply. Yes, I can totally related to what you call “the Peter Pan” syndrome. My three closest relatives all exhibited it. Plus, I see aging parents of friends now also expressing denial at the need to plan for their care. It won’t happen until they’ve reached that tipping point where they can no longer carry on without help.
Also, I am sorry to hear about your husband’s situation. We likewise rely on a lateral transfer bench for showers, but things are getting more difficult now, and I am not sure how much longer use of the transfer bench can continue. So we may have to consider a roll in show at some point too.
Have a good Memorial Day weekend and thanks again for the excellent article!
~John