As we are invited into someone’s home to look at modifications, renovations, or improvements that can be made to assist them in living more safely and comfortably in their homes as they continue to remain there, we need to consider two important details.
We start with the “what” to determine what is going on in the home that is creating mobility or sensory issues, what products or solutions we can use to help alleviate those situations, and how the members of the household are able to use their space. Then, we add in the “why” to examine why a situation exists that demands our attention or why it is it important that we address it. Both the “what” and the “why” matter, but they are quite different aspects of how we approach the renovations we might suggest.
To begin our focus on what can or needs to be done or what project should be undertaken, we conduct a home assessment or evaluation. Sometimes, it’s called a home audit also.
The purpose of the assessment – done by someone such as a contractor, occupational therapist (OT), physical therapist (PT), other health care professional, designer, consultant, assistive technology professional (ATP), social worker, or case manager – is to look at the home and determine deficiencies it might have that can be corrected easily or to spot functional areas the client is having trouble within their home.
This can be defined as the “what” – learning about what is present or what the issues are. We look at the physical features of the home and its characteristics. Nothing is overlooked when gaining an initial impression of what exists. We don’t know yet how what we observe impacts the residents or how it will factor into a suggested or recommended renovation or solution. That will come separately.
We start at the front door – actually outside, to include the area leading up to the door – and look at passageways, doorways, door hardware, light switches, the amount and type of light available, windows (location, size, and ease of operation), flooring, cabinetry, door hardware, countertops, appliances, bath fixtures, electrical outlets, closets, each room in the home, laundry facilities, ventilation, and similar features.
This gives us a good picture of the what exists in the home and its relative condition and general age.
Then, we look at how people operate in a space. We want to see if they have any issues using their living space. Do we see them struggling with using controls, outlets, knobs, or handles? Do we detect any issues with retrieving items from cabinets, furniture, or closets? Are there mobility issues in terms of getting around in their space? Balance or other issues?
This still is part of the “what” picture – examining what is going on in the living environment. We must know this important part before we can recommend any course of action. However, this is only part of the assessment. The second part is determining the “why.”
Once we have a good idea of the basic condition of the home and what is going on as far as how the occupants are using their home, we are concerned with how accessible, safe, comfortable, and convenient various aspects of the home are to the people living there.
It’s one thing to know about what is present. It’s quite another to understand why it affects people in certain ways and impacts their ability to function well in their space.
Just knowing that people are having issues or difficulties in using the faucet, turning on the light switch, using the toilet, opening the door, walking across the room (on their own or with some type of assistance), using a kitchen appliance, getting in or out of bed, or any of the many other tasks they perform or need to do inside their home is the starting point for determining why those issues exist and then creating solutions to eliminate or minimize as many of them as possible – subject to what the clients will consent to having done, the severity or complexity of the needed improvements, and the ability to pay for the improvements deemed necessary.
Whether it’s their stature, vision, mobility, balance, stamina, range of motion, reach, physical strength, gripping ability, coordination or other issues that affect their ability to use their space as well as they should, we take the “why” things are not effective and suggest modifications to the “what” to make things better.