Occupational Therapist's Guide to Home Modification Practice, Second Edition

Older people and people with disabilities have a right to be included in all aspects of home and community life, yet environmental barriers continue to exist in the built environment. There are concerns about how well homes can support older people and people with disabilities over time as their needs change.

Occupational therapists are well-suited to determining the most appropriate home modification solutions to address environmental barriers. They possess the knowledge and skills necessary to evaluate people’s current and future needs in the context of the nature and use of the environment and can work collaboratively with design and construction professionals to develop solutions.

To be comprehensive and effective in their approach, occupational therapists need to understand not only the individual’s requirements, but also the ethical and legal contexts for practice, technical aspects of the built environment, relevance and intent of access standards and design approaches, and application of a range of products and finishes.

An Occupational Therapist’s Guide to Home Modification Practice, Second Edition by Elizabeth Ainsworth and Desleigh de Jonge and their team of expert contributors provides comprehensive information to inform occupational therapists about current practice and research. This includes the authors using a transactional approach to examine the person-occupation-environment interaction and providing occupational therapists with a detailed understanding of the various dimensions of the home environment that can impact clients’ home modification decisions.

New material has been provided relating to research and practice issues, such as an overview of the latest home modification outcome research findings as documented in literature; an update on outcome evaluation; new research information about the dimensions of the home impacting decision making; additional information on grab rail and ramp prescription; and the inclusion of new case studies illustrating minor and major modification solutions for clients who present with diverse needs.

In the Second Edition, you’ll find:

• A detailed understanding of aspects of the home environment that impact home modification decisions
• A review of legislative environment and funding systems that facilitate service delivery
• An overview of home modification services as well as future trends
• A range of comprehensive case studies illustrated by photographs
• Additional theory to inform knowledge and skill development that can be used in home modification practice worldwide

Instructors in educational settings can visit www.efacultylounge.com for additional education material to be used for teaching in the classroom.

An Occupational Therapist’s Guide to Home Modification Practice, Second Edition provides a range of resources and tools, and it can be used as a teaching aid to support students, interns, and novice therapists or as a manual for reflection and practice for more experienced home modification practitioners.

Dedication

Acknowledgments

About the Authors

Contributing Authors

Preface

Foreword by Carolyn Baum, PhD, OTR/L, FAOTA

Chapter 1              The Home Environment

Tammy Aplin, PhD, BOccThy (Hons) and
Bronwyn Tanner, BOccThy, Grad Cert Occ Thy, Grad Cert Soc Planning, MPhil

Chapter 2              Approaches to Service Delivery

Bronwyn Tanner, BOccThy, Grad Cert Occ Thy, Grad Cert Soc Planning, MPhil;
Desleigh de Jonge, MPhil (OccThy), Grad Cert Soc Sci; Andrew Jones, BA, MSW, GCE;
Rhonda Phillips, MPhil, BA, Grad Dip; and Jon Pynoos, MCP, PhD

Chapter 3              Models of Occupational Therapy

Desleigh de Jonge, MPhil (OccThy), Grad Cert Soc Sci
and Merrill Turpin, PhD, Grad Dip Counsel, BOccThy

Chapter 4              Legislation, Regulations, Codes, and Standards Influencing
                                Home Modification Practice

Elizabeth Ainsworth, MOccThy, Grad Cert Health Sci;
Desleigh de Jonge, MPhil (OccThy), Grad Cert Soc Sci; and Jon Sanford, MArch, BS

Chapter 5              The Home Modification Process

Elizabeth Ainsworth, MOccThy, Grad Cert Health Sci
and Desleigh de Jonge, MPhil (OccThy), Grad Cert Soc Sci

Chapter 6              Evaluating Clients’ Home Modification Needs and Priorities

Desleigh de Jonge, MPhil (OccThy), Grad Cert Soc Sci
and Melanie Hoyle, BSc (Psych), MOccThySt, Grad Dip Health Sci, Post Grad Dip Psych

Chapter 7              Measuring the Person and the Home Environment

Elizabeth Ainsworth, MOccThy, Grad Cert Health Sci
and Desleigh de Jonge, MPhil (OccThy), Grad Cert Soc Sci

Chapter 8              Drawing the Built Environment

Elizabeth Ainsworth, MOccThy, Grad Cert Health Sci
and Desleigh de Jonge, MPhil (OccThy), Grad Cert Soc Sci

Chapter 9              Developing and Tailoring Interventions

Desleigh de Jonge, MPhil (OccThy), Grad Cert Soc Sci;
Melanie Hoyle, BSc (Psych), MOccThySt, Grad Dip Health Sci, Post Grad Dip Psych;
and Elizabeth Ainsworth, MOccThy, Grad Cert Health Sci

Chapter 10           Sourcing and Evaluating Products and Designs

Desleigh de Jonge, MPhil (OccThy), Grad Cert Soc Sci
and Melanie Hoyle, BSc (Psych), MOccThySt, Grad Dip Health Sci, Post Grad Dip Psych

Chapter 11           Access Standards and Their Role in Guiding Interventions

Elizabeth Ainsworth, MOccThy, Grad Cert Health Sci;
Desleigh de Jonge, MPhil (OccThy), Grad Cert Soc Sci;
and Bronwyn Tanner, BOccThy, Grad Cert Occ Thy, Grad Cert Soc Planning, MPhil

Chapter 12           Ethical, Legal, and Reporting Variables: Pathways to Best Practice

Elizabeth Ainsworth, MOccThy, Grad Cert Health Sci
and Barbara Kornblau, JD, OTR/L, FAOTA, FNAP, DASPE, CDMS, CCM, CPE

Chapter 13           Evaluating Outcomes

Desleigh de Jonge, MPhil (OccThy), Grad Cert Soc Sci
and Melanie Hoyle, BSc (Psych), MOccThySt, Grad Dip Health Sci, Post Grad Dip Psych

Chapter 14           Literature Review: Home Modification Outcomes for Older Adults and
                                Adults With Disabilities

Elizabeth Ainsworth, MOccThy, Grad Cert Health Sci; Tammy Aplin, PhD, BOccThy (Hons);
Louise Gustafsson, PhD, BOccThy (Hons); and Desleigh de Jonge, MPhil (OccThy), Grad Cert Soc Sci

Chapter 15           Case Studies

Elizabeth Ainsworth, MOccThy, Grad Cert Health Sci; Kathleen Baigent, Dip COT, Dip Health Prom;
Ruth Cordiner, Dip COT, Grad Cert Occ Thy; Shirley Darlison, BOccThy; and May Eade, BOccThy

Appendix A           Minor Modifications: It’s Not as Simple as “Do It Yourself” (DIY)

Appendix B           Outline of Shapes and Occupied Wheelchairs

Appendix C           Fundamental Types of Compact Turns

Appendix D           Ramp Installation Considerations

Appendix E           Home Modification Practice Resources

Appendix F           Access Standards Resources

Appendix G           Home Visit Checklist

Appendix H           Home Modification Report Template

Appendix I            Example of an Occupational Therapy Report

Financial Disclosures

Index

Elizabeth Ainsworth, MOccThy, Grad Cert Health Sci graduated in 1989 with a bachelor of occupational therapy (honors) degree and completed a master’s in occupational therapy (contemporary clinical practice at the University of Queensland) and a graduate certificate in health science (environmental modifications at the University of Sydney) in 2000. She is a private practice occupational therapist, accredited and qualified access consultant, and PhD candidate at The University of Queensland.

Elizabeth has had over 20 years’ experience aiding older people and people with disabilities who require home modifications or alternative housing. She has a history of working in government and non-government agencies that assist people living in a range of housing tenures such as private and social housing and private rental accommodation. Elizabeth provides consultancy services to clients and their families, and to organizations, about housing and home modification solutions. She also completes medico legal work, providing information to the courts in Australia and overseas about the housing and home modification needs of people who have had complex or catastrophic injuries. She provides home modification and universal design education and training to occupational therapy university undergraduate and postgraduate students and to occupational therapy clinicians working in a range of settings in the community, both in Australia and overseas. She is a member of the Australian Network for Universal Housing Design (ANUHD), Universal Design Australia, the Australian Access Consultants Association (ACAA), the Australian Rehabilitation and Assistive Technology Association (ARATA), and Values in Action.

Desleigh de Jonge, MPhil (OccThy), Grad Cert Soc Sci graduated in 1978 with a bachelor of occupational therapy from The University of Queensland, completed a master’s in philosophy in 2001, and is currently completing a PhD at this university. She has over 35 years’ clinical experience as an occupational therapist and 12 years teaching and research at the School of Health and Rehabilitation Sciences at The University of Queensland, where she currently holds an honorary research title. Her teaching and research is focused on interventions and outcome measures that recognize client goals and priorities. Desleigh’s national and international reputation in client-oriented analysis of assistive technologies, environmental design, and home modifications has earned her invitations to present at international conferences on assistive technology and home modification services and outcomes in the United States and Australia, and she has been published extensively in national and international journals. Desleigh was on the editorial board of Disability and Rehabilitation: Assistive Technology from 2006 to 2012 and regularly reviews articles for national and international journals.

Elizabeth and Desleigh have worked together for at least 18 years to provide training to occupational therapy students and practitioners. They have presented at national and international conferences on home modifications and universal design to a broad range of people from various backgrounds. The second edition of this book is testament to their dedication to equipping occupational therapists to achieve quality home modification outcomes for older people and people with disabilities internationally.