Home Safety Assessment

• Prepare for a loved one to come home from the hospital or a rehabilitation facility. Those who have had emergency or elective surgery, suffered a sudden illness or change in health, may need to make changes to their home. Often, they cannot return home until an occupational or physical therapist does a home visit to make sure home is safe.
• Prepare for future limitations you or a loved one will experience as you age. You may find that you can’t climb stairs as well as you once did or that you have difficulty bathing because getting in and out is challenging and standing is tiring. Updating your home now ensures that you will avoid unnecessary risks to your independence.
• Take steps to feel more confident and comfortable after receiving medical directives like using a cane/walker.

A home safety assessment reduces anxiety by identifying and providing solutions to dangerous situations that unaddressed could result in moving to a care facility. Taking prudent measures now means a fall will not force you to move later. You may, sometime, decide to move into an assisted living community or a care center, but it will be your decision. We are here to guide you through making your home safe and comfortable for you, your loved ones, and anyone who visits.

How we assess

First, we sit down and ask questions to develop a clear understanding of your situation, and to allow you to ask us questions. Second, we walk through your home focusing on areas of concern. We may ask you to demonstrate how you function in them. We may ask to see other areas that could present challenges that you have not thought about. Typically, it takes an hour.

When we finish our walk-through, we sit down and go over everything we’ve noticed. Your home may have some of good features, or you may have already planned on adding them. We review our recommendations. You can ask questions and our answers will be informed by the unique knowledge base we have acquired about what works.

If, at the end of the assessment, you need something simple such as a few grab bars, we can give you a price. Upon receiving a deposit, we will order the grab bars and schedule their installation. If you need design and construction, for example for a temporary or permanent ramp in your garage or for a walk-in, curbless shower, we may recommend that you hire us to measure, create drawings, write specifications, and present them in a follow-up meeting. Once we have worked with you to finalize the design and select products, we can create an estimate of how much it would cost for us to build it.

• You may do your own preliminary research by using a checklist offered by the AARP: https://assets.aarp.org/external_sites/caregiving/checklists/checklist_homeSafety.html
• You may also search for local organizations that offer Home Safety Assessments. IUHealth’s “Home Safe Home” program, a local alternative, describes their home assessment process:

A comprehensive evaluation is 60 minutes and, using medical judgement, determines an individual’s functional ability with their home environment. The participant will receive a written report as well as recommendations for home modifications, resources, equipment needs and adaptive techniques to promote improved independence in the home. .

• We can arrange an IUHealth’s “Home Safe Home” evaluation for you. If you have Medicare and a prescription from your doctor, Medicare will pay for it.

When do you need a Home Safety Assessment?

Whether you have lived in your home for decades or just a few years because you moved to be close to family, you may not be ready to give it up just yet, and you shouldn’t have to.

Families who call us either acknowledge their vulnerability or are in a crisis. Doctors recognize that we reach an age when a home safety assessment and making modifications is more urgent that getting a mammogram or our cholesterol checked, because falling is a greater threat to our health. Doctors tell us they recommend them, but their patients rarely follow through. Unfortunately, many people resist because they believe modifications will make their homes look institutional.

We focus on what you can do now to make your home safer and keep it attractive. Often our projects are designed with one family member’s needs foremost, however, the changes benefit other family members too. For example, we spent a few weeks making many small modifications for one of our first clients with mobility issues. When we finished, she was thrilled to regain important independence. A few weeks later her husband fell and broke his hip on a walk. When occupational therapists made a home visit they were pleased to report that no additional modifications were necessary and he could return home promptly.

We guide families through the often-sudden challenges of preparing for the homecoming of a loved one after a hospitalization or stay in rehabilitation. Therapists typically schedule a home visit with patients to assess their functional abilities, risks, and make recommendations for assistive devices. Often the home visit is thwarted because the patient cannot enter the home.  We design and modify entries, either temporarily or permanently, in a timely manner, so the home visit and return home can happen when patients and their caregivers are ready. We encounter many families made anxious by not knowing how to accomplish what needs to be done by their loved one’s release date. We explain the pros and cons of various options and create a plan with recommendations that they can follow. We can also make the arrangements, install the assistive devices, modify, or remodel their living spaces as needed.

Denial is common when it comes to facing our aging and frailty. Denial means avoiding factual realities because facing them is too uncomfortable. Hope means moving forward with a clear grasp of realities that is augmented by faith.

Falling is a fact of life. It’s frequent and natural in childhood. It’s infrequent and usually just embarrassing in adulthood. It becomes frequent again and dangerous as we grow frail. Because we fear it, we don’t want to admit that it could happen to us and we resist making changes to our homes.

A study measured the needs and intentions of elderly and disabled Indiana residents to repair and modify their homes. Those in good health reported the least need whereas those in poor health reported the most need. This suggests a correlation between the state of one’s health and one’s recognition of the need for home modifications. Those who were confident about aging in their homes likely:

• had already modified them,
• acknowledged needing modifications just not yet,
• were denying the necessity.

The statistics are dreary: One out of three adults aged 65 and older falls each year. Adults aged 75 and older who fall are five times more likely to be admitted to a long-term care facility for a year or longer. Adults 85 and older are four times more likely to fall and injure themselves than adults 65 to 74.

Delay and denial drive up the costs of falls among adults. According to the Center for Disease Control and Prevention fall injuries cost $50 billion annually: $29 billion is paid by Medicare, $12 billion is paid by private or out-of-pocket payers, and $9 billion is paid by Medicaid.

If we accept that we are at risk and act proactively we dramatically lessen our risk of injury. If a loved one is in denial about his or her risk for falling, here are some suggestions from the Mayo Clinic.

• Be patient. Some people need more time to face realities.
• Make sure the person understands the factual realities and encourage conversations with experts or with others in similar circumstances.
• Without using a judgmental tone, calmly present the facts that led you to your conclusions.
• When someone in denial criticizes your position, don’t take it personally.
• Encourage talk, by posing gentle, probing questions about the very things being avoided.
• Don’t give up hope.