The Art and Science of Home Modifications: A Guide for Occupational Therapists

Key Takeaways:

• Home modifications for occupational therapists go beyond grab bars and widened doorways—holistic solutions support mobility, safety, and dignity.
• It can be easy to overlook key environmental details such as lighting, flooring, and emergency access.
• The bathroom and kitchen are high-risk areas that require thoughtful, functional modifications to maintain independence.
• Emergency preparedness and fall prevention should be part of every aging in place home assessment.
• Collaboration with clients, caregivers, and contractors is key to successful and sustainable modifications.

As occupational therapists, we know that the home environment plays a crucial role in an individual’s ability to remain independent. But are we truly looking beyond the obvious when making home modifications?

It’s easy to recommend a grab bar or a threshold ramp, but real success happens when we create a fully functional, safe, and livable home that accommodates mobility challenges while maintaining dignity and comfort. Even experienced OTs can miss small, critical details that make all the difference.

This guide breaks down key home modifications for occupational therapists, providing practical strategies, overlooked details, and solutions to enhance independence for aging in place.

1. Looking Beyond the Obvious in Home Assessments

Common Oversights That Impact Safety

Aging in place home assessments should include more than just mobility aids. Don't forget to look at lighting, flooring, and clutter to address everything that can affect performance.

• Lighting Matters: We all experience vision changes as we age. That makes glare and shadows a risk. Ensure layered (overhead and task) lighting in hallways, staircases, and task areas to improve visibility.
  
• Flooring Risks: Slips and trips are common. Recommend non-slip flooring, and if a client insists on keeping a rug, suggest using rug tape to secure it.
• Managing Clutter Without Resistance: Instead of pushing for complete decluttering, offer creative storage solutions to maintain safety without overwhelming the client.

💡Pro Tip: I've had so many people reject home modifications if they appear tooclinical, even if that means they're less safe. So, blend function with aesthetics by recommending well-designed grab bars or a raised toilet seat that resembles a standard seat.

2. Bathroom Modifications: Thinking Beyond the Basics

Key Enhancements for Safety and Independence

Bathrooms are high-risk areas for falls, and while grab bars can help, there’s more to consider when improving safety.

• Strategic Showerhead Placement: Install a secondary showerhead holder near a seated area so clients can easily reach it while using a shower chair.
• Color-Contrasted Grab Bars: These make grab bars more visually distinct, increasing the likelihood of proper use.
• Adaptive Toileting Aids: Long-handled wiping tools and bidets can enhance hygiene while reducing strain.
• Towel & Toilet Paper Accessibility: Ensure these essentials are within easy reach to prevent overreaching and falls.

💡Pro Tip: Don't forget about motion-activated lighting for nighttime bathroom use. A small investment in automatic lighting can significantly reduce fall risks.

3. Kitchen Accessibility: Creating a Functional Space

Preventing Fatigue and Encouraging Healthy Eating

The kitchen is often overlooked in discharge planning, but a downward health cycle can start when we resort to more processed foods if it's too hard to prepare meals.

• Seated Meal Prep Areas: A small table or pull-out cutting board allows clients to prepare food while sitting, reducing fatigue.
• Smart Storage Solutions: Use Lazy Susans, pull-out shelves, and lower cabinet storage to minimize reaching and bending.
• Lighting Under Cabinets: Bright task lighting ensures safe meal prep without shadows.

💡Pro Tip: If standing for long periods is a challenge, recommend anti-fatigue mats for added support near prep areas.

4. Planning for Emergencies & Fall Prevention

Ensuring Easy Access to Help

Many OTs focus on fall prevention but forget emergency preparedness. Clients need a clear plan for getting help in case of a fall, fire, or power outage.

• Wearable Alert Systems: Encourage Apple Watches, fall alert pendants, or phones with lanyards so clients always have access to emergency calls.
• Motion-Sensor Lighting Outside: Prevent falls at night with automatic lights near entryways, stairs, and outdoor pathways.
• Exit Strategy: Make sure to review the most accessible exit in case of emergency.

💡Pro Tip: Making an emergency plan is often not top of mind for clients. Reframe the conversation by emphasizing how these solutions maintain their independence rather than signaling frailty.

5. Using Technology to Improve Home Modifications

Smart Solutions for Aging in Place

Technology can improve home safety, but many older adults hesitate to adopt it. Start with familiar devices to increase acceptance.

• Voice-Controlled Assistants: Alexa or Google Home can remind clients to take medication, call for help, or control lights without moving.
• Smart Doorbells & Security Systems: Video doorbells allow clients to see who is at the door without getting up, increasing safety and confidence.
• Automated Medication Dispensers: These reduce missed doses and medication errors.

💡Pro Tip: If a client uses Facebook or texts family members, they can learn how to use other smart devices—encourage them to start with one simple tool.

6. Collaborating with Clients, Caregivers, and Contractors

Teamwork is Essential for Successful Modifications

Even the best modifications fail if the client refuses to use them. Collaboration ensures that solutions are practical, sustainable, and well-maintained over time.

• Client Buy-In is Key: Explain how modifications maintain independence rather than focusing on limitations.
• Work with Caregivers & Family Members: Teach them how to adjust and maintain modifications as needs change.
• Coordinate with Contractors: Ensure modifications meet ADA guidelines while maintaining home aesthetics.

💡Pro Tip: When possible, show modifications in use to help clients visualize the benefits before they commit.

Checklist: OT’s Guide to Holistic Home Modifications

✅ Lighting Improvements: Use layered lighting to prevent glare and improve visibility.
✅ Bathroom Adjustments: Install color-contrasted grab bars and a secondary showerhead holder.
✅ Kitchen Modifications: Create seated meal prep areas and optimize storage.
✅ Emergency Planning: Set up wearable alert systems and ensure safe exits.
✅ Tech Integration: Introduce voice assistants, motion-sensor lighting, and smart security tools.
✅ Collaboration: Work with clients, caregivers, and contractors for lasting home safety.

Conclusion

Occupational therapy-led home changes go beyond grab bars and ramps. You might be the only OT someone ever sees, so create a safe, useful space that helps people feel secure, independent, and respected. By addressing overlooked details, such as lighting, clutter management, and emergency preparedness, OTs can enhance a client’s ability to age in place safely. Every thoughtful modification we make improves the quality of life and supports long-term independence. For more resources to pull into your home assessments, visit AskSAMIE today!