Occupational therapy plays significant role in improving safety and independence

By Sara Kennedy, OTR

Who would have thought that "home sweet home" could be such a dangerous place? The home environment can be a significant factor in limiting our independence later in life. For example, more than half of falls by the well-elderly come as a result of tripping over something, with an estimated thirty percent of those over 64 falling at least one time a year.

As our physical abilities change, safety in the home can be increased by adapting the environment to meet our unique needs. An occupational therapist can play a significant role in home assessment and adaptations for people desiring to improve safety and increase independence.

What happens in a home evaluation? The occupational therapist (OT) works with the consumer to develop a "strengths and problems" list related to the daily routine at home. Perhaps there are no concerns about getting around the home by day, but getting up at night is difficult. The OT would help the consumer get to the root of the problem; whether that may be lack of proper lighting, obstacles such as throw rugs, or even a medication that may be interfering with alertness or balance.

Many people are concerned about bathroom safety, and rightly so, for more than half of the falls in the home happen in the bathroom. (After all, we all have to visit bathrooms regularly and the bathroom is often a slippery place.) Non-slip surfaces are one obvious solution. Narrow doorways that were not problem when we were fifty can be hazardous when we must navigate sideways to accommodate a cane or walker.

Besides addressing environmental barriers, the OT may also recommend a short course of therapy to improve functioning in daily living skills. If overhead reach has become a problem, therapeutic exercise and stretching can be beneficial. For people with memory difficulties, systems can be set up to enhance memory through written or other visual cues.

In this day and age, most of us need some sort of calendar to keep track of our schedule - the same principle can be used to remember medication, cooking safety measures, and to manage bill paying. In any case, the consumer and the OT collaborate to reach the best outcome.

Often, the therapist takes an active role in educating the family or other caregivers to improve safety, ease and efficiency of care. Common topics include conserving energy, easier methods for lifting, use of assistive devices for care, and simplifying tasks and routines.

Opening up one's home to an assessment of this nature can be an uncomfortable notion. Many people fear that letting a health professional know that there are "problems at home" will spell an end to independent living. Certainly there are times when the benefits of living at home outweigh the risks of injury. However, those people who have successfully remained at home have made timely accommodations to their changing abilities. Safety first!