Understanding home modification outcomes from the perspective of older people and people with a disability: informing home modification evaluation

Abstract

Purpose There is limited evidence to guide therapists in home modification outcome evaluation. Involving consumers in evaluating home modifications is critical to progressing practice. This study investigated the home modification experience and outcomes most valued by older adults and individuals with a disability in Australia. Materials and methods An interpretive description approach was used. Twenty participants aged 24–93 who had received major home modifications were interviewed and transcripts were analysed thematically. Results Two major themes emerged: life before and during modifications – “it was all hard,” and life after modifications – “to have a life.” People’s prior experience of home, the circumstance of and time to plan modifications, the perceived value of the modifications, and the home modification process and funding influenced perceptions of outcomes. Valued home modification outcomes included those that enable people to experience emotional and physical health, and safety; do what they want; maintain the image of the home; and plan for the future. Experiences and perceptions of modifications ranged from supportive to disruptive. Conclusions These findings point to the need for therapists to deeply understand and evaluate their clients’ experiences of home and life as an initial and critical step in the home modification process. Implications for rehabilitation Major home modifications result in broad and meaningful outcomes of importance to clients. Occupational therapists need to partner with clients to understand their life before and during modifications to achieve positive outcomes. Evaluation of major home modifications needs to be integrated and prioritised in daily practice.