Assessment Forms & Checklists
For Aging In Place Evaluations

Steve Hoffacker, CAPS, CEAC, SHSS, talks about home assessments, evaluations, checklists, and home audits in the CAPS courses that he teaches. Conducting the physical audit and assessment is a collaborative process that can be conducted by the contractor for non-medically based improvements, by the occupational or physical therapist for mobility or sensory needs, and by interior designers and others - sometimes with input from the client on what they think is going on in their home - to examine the issues in the home and then suggest solutions. Often, it is a joint effort where various perspectives are combined into a single approach for the client.

The concerns in the home that are noted, chronicled, and documented in the assessment process with a checklist. sketches, and photos, can focus on (1) the physical aspects of the homes (such as the design, layout, floor plan, physical features, technology items, wiring, plumbing, access points, construction materials, finishes, doors, windows, lighting, flooring, cabinetry, bath fixtures, kitchens, switches, and controls) as well as (2) the physical and emotional needs of the occupants of the home (mobility, sensory, or cognitive concerns or issues, if any). Taken together, the professional has a outline of how to structure a program for dealing with the most pressing issues.

There are many types of assessment forms that you can use. Some are presented or referenced here. You may want to create your own based on the types of services you are providing and the types of clients you serve.
  • Here is a 2-page "Home Audit" form that was included in the previous edition of the CAPS II workbook on pages 4/30 and 4/31. It allows you to note and check items that need attention but does not provide space for elaboration or comments about what type of prescriptive action is needed or recommended. It does not differentiate among members of the household of focus on any specific limitations they may have.
  • When you are looking for a more extensive and comprehensive form "CASPAR," by Extended Home Living Services, Inc., is a 26-page document that includes many features and measurements. Some people choose to use this as a way of creating their own form.
  • An "Assessment & Evaluation Form" that allows you to note your observations about the home and your clients, and then to review on a room-by-room basis many of the physical issues that might be present, by the level of their severity is provided free-of-charge by Steve Hoffacker. This is a Word document that you may modify as you see fit.
  • The AARP "Home Fit" Guide offers a simple checklist for consumers to use to ease them into the idea that their home may need some improvements. This focuses on a best practices approach rather than identifying any weaknesses or deficiencies in the design.
  • Here is an InterNACHI Checklist used by Home Inspectors with many options for noting improvements that might be desired and published on the International Association of Home Inspectors (InterNACHI) website.
  • This is a well-done checklist by Easy Living that pinpoints ares inside and out that require our focus to make a determination of how they allow individuals to function in their home, irrespective of their specific needs
  • This checklist from Rebuilding Together provides a nicely organized list of items to be mindful of that pertain to the physical and safety features of a home.

OTs should develop a safety assessment form that works for them that they can use to provide an initial service for aging-in-place clients - whether any additional work is done or not. A professional functional assessment that an OT or PT performs for a client will factor into an overall strategy for home improvements but may be more specific than a spatial study to identify mobility and other concerns.

There are additional apps and resources for locating and using home assessment forms. Just be sure to find one that works for you and your clients. Feel free to create your own. If you want a turnkey package with instructions and coaching, Age Safe America ((Age-Safe-America.html)) offers such a program. Just be sure to mention that you learned about it here.
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