Home Modifications Program Karen Smith OTL CAPS Occupational

Home Modifications Program Karen Smith OT/L, CAPS Occupational Therapist ksmith@aota. org

OCCUPATIONAL THERAPISTS • Work in a variety of settings. • Work with clients across the lifespan. • Have knowledge and expertise in aging and disability issues. • Help clients do the things they need and want to do. • Are great partners in home modifications projects.

OTs Assess the Fit Between Individuals and Their Environment

HOME MODIFICATION Adaptation to the living environment intended to increase of use, safety, security and independence.

Safe at Home • One of RTMC’s primary goals is to address home repair and maintenance issues that potentially present a safety risk or limit the access to or within the home. • Strategy is driven by RTMC’s vision of a Safe and Healthy Home for everyone.

Safe at Home • Safety and Prevention are grouped into three categories: – Falls Prevention – Fire Safety and Prevention – General Safety • Home modifications enhance safety and prevent falls

HOME SAFETY ASSESSMENTS • RTMC is committed to addressing the home modification needs of homeowners to help them remain safely in their homes. • A team of OTs have volunteered to assist with home safety assessments and recommendations to house captains. • We may assign OTs to some houses and encourage house captains to request an OT safety assessment for homeowners who are elderly or have a disability.

RECOGNIZING THE NEED For Home Modifications Familiar Sights: @ no access to outside world for wheelchair users @ exposed pipes/wires @ excessive clutter @ unsteady stairways @ inaccessible bathtubs, cabinets, storage areas @ poor lighting @ multi-level homes without handrails @ abundant use of throw and area rugs @ sitting surfaces too low @ faulty doorknobs/locks/peepholes/doorsteps

Home Modifications Include: • Handrails on both sides of steps • Lever door handles and faucets • Widened door ways or swing away hinges • D ring handles on cabinet doors and drawers for easy grip • Smoke detectors • Walk-in or no step shower • Grab bars in the shower, toilet, and tub • Hand-held, flexible shower head • Removing clutter • Repairing walking surfaces • Ramps for accessible entry and exit

RUGS CAN BE TRIPPING HAZARDS • Secure area rugs with nonslip matting or double faced tape • . • Remove scatter rugs that are not firmly secured. • Secure area rugs with non-slip matting or dbl -faced carpet tape

LEVER STYLE FAUCETS AND HANDLES • Lever handles - no need to grip or twist • Great Grips – low cost knob cover that makes gripping and turning easier.

VISION PROBLEMS • Add additional lighting fixtures • Increase wattage – high efficiency bulbs • Provide color changes to distinguish surfaces • Reduce glare – Low gloss floor surfaces – Window coverings

IMPROVED LIGHTING www. tasklighting. com • Easy on/off rocker switch mounded 42 -48” above floor • Non-glare task lighting for specific work areas

COMMON BATHROOM MODIFICATIONS • Horizontal and vertical grab bars • Bath seat • Hand held shower with slide bar or lower clip mount • Shower curtain rather than door • Raised toilet insert with arms • Non-slip mat or strips

BATHROOM MODIFICATIONS

HIGHER HEIGHT TOILET www. kohler. com Comfort height toilet adds 2 ½” to the seat height for easier on and off Toilevator Toilet riser raises toilet 3 ½”

GRAB BARS & HAND GRIPS

GRAB BARS • • • Come in various lengths 1½” or 1¼” diameter Space between bar and wall no more than 1½” OT can help advise placement Must be properly installed – Wingits or Moen Secure. Mount Anchors – Studs – Wood blocking between studs

PROPER INSTALLATION • In Studs or • Wood blocking between studs • Using Wingits • Moen Secure. Mount Anchors

INDIVIDUALIZE MODIFICATIONS • Make sure the modifications fit the needs of the homeowner or others in the home. • Work with the OT to ensure safe use of grab bars or other safety modifications.

STAIRWAY SAFETY Hand prints on walls indicate need for additional railing for support.

SIDEWALKS AND STEPS • Ensure at least one sturdy railing on all steps. • Repair uneven, broken, or badly chipped sidewalks to prevent tripping.

Level floors and smooth surfaces

Raise the height of chairs, beds, and sofas with Easy Risers or other devices to make getting on and off surfaces easier.

ORGANIZE FOR EASY USE Move items used most often to easy to reach surfaces

MODIFICATIONS THAT IMPACT SAFETY • • Removing clutter Removing or securing scatter rugs Adding smoke and carbon monoxide detectors Moving wires out of pathways Installing doorbells Large house numbers-for emergency situations Portable phones Sturdy door pull (Stanley 6½”) or 10 -12” grab bar for one step entrances to assist with balance

RAMPS CAN PROVIDE FREEDOM AND ACCESS This woman had difficulty leaving her home. A lowincline ramp will allow her the opportunity to come and go as she pleases. (easy grip hand rail needs to be added. )

TO RAMP OR NOT TO RAMP • Consider if a ramp is the best solution. – Is the person wheelchair bound or would railings on both sides of steps or shorter step rise work? – Can signal disability and vulnerability – May affect resale of the house – Family may not think it looks good – Must be done right (slope no more than 1: 12, curbs, nonslip, etc) • Check resources on RTMC website for design and construction • Contact staff and OT for input and approval

HOME MODIFICATIONS links to resources • National Resource Center on Supportive Housing and Home Modifications http: //www. homemods. org/index. shtml • Center for Universal Design www. design. ncsu. edu/cud/ • Wood Ramp Design: How to Add a Ramp that Looks Good and Works Too http: //www. design. ncsu. edu/cud/pubs_p/docs/rampbooklet 296 final. pdf • AOTA RT Collaboration http: //www. promoteot. org/AI_Rebuilding. Together. html