45 - Home Modification

Abstract

This chapter coalescences the beginning of an evidence base for effective home modification interventions with a person-centred approach and examines how occupational therapists can employ it to produce improved outcomes within the home of the person to whom they are providing an occupational therapy service. Rapid technological advances increase levels of specialisation, and this is no different with home modification, where the connected home of the future and the Internet of things will be the next frontier opening new possibilities and challenges. Person-centeredness, akin to the client-centeredness movement in medicine, has a long history in occupational therapy but can be difficult to implement as health care and rehabilitation practices have become more technical and are increasingly driven by impersonal standards, protocols and guidelines. In the home space the individual and the individual’s preferred activities, rhythms and routines and support system are central, and personal preferences are critical to good outcomes. There is an increasing body of evidence that home modification and changes in the structural design and fabric of the dwelling can reduce care burden, improve quality of life and afford greater autonomy and independence across the lifespan. Ensuring a safe, accessible, affordable and secure home base enables people with an illness, injury or impairment to build on their abilities while maintaining function longer with greater dignity in a place of their choosing and with a degree of control over their daily activities and social participation.