Occupational Therapy Home Assessment
By: Melissa Poirier, OT

Studies have shown that people function better in a familiar environment where they are comfortable and performing at their best possible level. It is up to the Occupational Therapist and other health care professionals to ensure that the patient’s environment is safe and promotes greater independence and quality of life.

It is the therapist’s goal to place the patient in situations that will encourage success. We do this by placing great value on not only teaching the patient, but teaching the caregivers and significant others in our treatment. It is crucial for the family to realize the importance of therapy and to let patients try to do as much for themselves as possible, even though it may be faster for the caregiver to do the task. It is also important to educate and motivate the patient to work with caregivers between therapy visits, in order to progress with therapy.

An OT Home Evaluation starts with interviewing the patient and any caregivers/family that assist the patient. Therapists discuss the patient and family member’s goals for therapy and assess any physical or cognitive deficits. The OT uses environmental cues to develop a sense of the patient’s level of function and may adopt these activities. For example, if functioning better in the kitchen is a goal, we would question if the patient has food in the house is able to purchase food, and just as importantly, if they can prepare it. When assessing Activities of Daily Living (ADL’S), we look at the level of function or level of assistance the individual needs to perform each activity. The individual’s habits as well as what they use to perform activities play a role in rehab. For example, if prior to a hip fracture, the patient only took sponge baths, then assessing tub/shower transfers is not necessary or applicable.

Occupational Therapy also does a physical assessment of the home. Three areas of the home that present the most problems are the entranceway, bathrooms and the kitchen.

Specific areas of concerns are as follows:

Entrance Way – Can the patient get to the entrance? Are there stairs, railings or ramps?

Can the patient unlock the door? What is the width of the door?

Are there any objects obstructing the hallway? Can the patient move from one part of the home to the other?

Bathroom – Can patient transfer from wheel chair to and from the toilet? Are tubs/showers accessible? Are there any safety bars?

Kitchen – What is the table height? Can the patient open the refrigerator and take out food? Can the patient open and close cabinets? Can they carry items from one part of the kitchen to another? Are light switches accessible?

An important question always addressed is does a patient know what to do in a case of an emergency?

The ultimate goal is to try and guide the patient in reestablishing their usual activities and make recommendations that will enable the patient to resume former activities within a safe environment. Recommendations for adaptive equipment (i.e. reacher, sock aide) or durable medical equipment (i.e. shower bench, raised toilet seat) may be made. By making necessary modifications to the home environment, educating the patient and family and implementing a treatment program, the patient will succeed in living more independently, and improve the quality of their life.