Home modification (HM) refers to converting or adapting the environment in order to make performing tasks easier, reduce accidents and support independent living. HM attempts to reestablish an equilibrium between a person whose capabilities have declined and the demands of the environment.20 Sometimes the environment itself may change over time as a home becomes older and the resident does not have the resources to fix problems such as steps in poor repair. On the other hand, changes in a person’s capability in climbing stairs may require additional features such as handrails on stairs.
HM, ranging from low-cost to more expensive adaptations, includes removing hazards (e.g., clutter, throw rugs), adding special features or assistive devices (e.g., grab bars, ramps), moving furnishings, changing where activities occur (e.g., sleeping on the first instead of second floor) and renovations (e.g., installing a roll-in shower). In some cases, modifying the home may also require repairs such as improved wiring to eliminate the need for extension cords or fixing loose stair treads. HM involves a willingness of the resident to alter the home environment and often changes the way activities are carried out.
There is considerable evidence that HM has an important role to play in fall prevention. A number of studies have indicated the efficacy of HM in improving independence, safety, caregiving and functioning. For example, a study of older persons in a controlled intervention with assessment by an occupational therapist found that home care services and HM significantly reduced home health costs and delayed institutionalization of those in the treatment group.21 The Community and Home Injury