Library

This paper describes the design of a project evaluating the effects of using a research-based strategy for managing housing adaptations (HAs); the evaluation targets clients’ perspectives in terms of activity, participation, usability, fear of falling, fall incidence, use of mobility devices, and health-related quality of life, and determines the societal effects of HAs in terms of costs.

This article summarizes seventy-seven studies from 16 countries to examine how home modifications evidence is measured.

This 2013 document of the Department of Justice and the Department of Housing and Urban Development provides guidelines regarding the persons and structures that are covered by the accessible design and construction requirements of the Fair Housing Act.

An easy to read online book that gives tips on making a home accessible. The site also has an architecture section with more information on accessible homes and healthcare architecture.

These 2010 Standards were set for newly designed and constructed facilities that fall under the purview of the ADA to be accessible and usable by persons with disabilities.

Aging and Accessible Homes Infographic developed by the U.S. Census Bureau, American Community Survey that includes statistics on percentages of homes with certain accessibility features and percentages of older adults with difficulty completing specific activities of daily living.

This compilation of assessment tools provides examples of evaluations that can be helpful with determining home modification needs of consumers.

A fact sheet developed by the Fall Prevention Center of Excellence on the benefits of assistive devices and how to obtain them.

This Data Brief highlights key findings from the 2019 National Survey of Area Agencies on Aging on how Area Agencies on Aging (AAAs) are providing and funding home modification and repair activities. It was developed by the USC Fall Prevention Center of Excellence in partnership with the National Association of Area Agencies on Aging as part of the Administration for Community Living project, “Promoting Aging in Place by Enhancing Access to Home Modifications.”

This paper presents the rationale and design for a clinical trial of a new interdisciplinary program aimed to reduce disability among low income older adults; the outcomes included decreased disability in self-care (ADL), improvement in instrumental ADLS, strength, balance, walking speed, and health care utilization.

A fact sheet developed by the Fall Prevention Center of Excellence on Simple Steps to Prevent Falls.

A brochure in Spanish by the Centers for Disease Control identifying hazards and suggesting changes in the home to reduce the risk of falling

This Centers for Disease Control checklist, organized by area of the home, aims to help identify and eliminate fall hazards in the home.

By using a multi-phase process, this article analyzes the complex clinical process that allows occupational therapists to deliver complex interventions while delivering home modification services.

This paper determines the effect size and acceptability of a multicomponent behavior and home repair intervention for low-income disabled older adults. The results found that the Community Aging in Place Better Living for Elders (CAPABLE) intervention was acceptable to participants and feasible to provide and showed promising results.

This document from The American Journal of Occupational Therapy provides a description of complex environmental modifications and highlights the role of occupational therapy practitioners as providers of service within this area.

Comprehensive Assessment and Solution Process for Aging Residents (CASPAR).This assessment tool, developed through two Small Business Innovation Research grants by researchers at Georgia Tech and the company Extended Home Living Solutions, enables practitioners to identify a client’s aging in place needs by collecting information that can be used by building professionals and health care professionals (e.g., occupational therapists) to specify the most appropriate modifications. This assessment considers the home environment, the resident’s abilities and preferences, and the interaction between the two, combining the specific concerns of consumers, building professionals, and occupational therapists in performing home modification assessments.

This extensive list of consumer materials focused on home modifications was created by the USC Fall Prevention Center of Excellence as part of an Administration for Community Living Project.

This paper estimates the cost benefit of the modifications from construction costs and published reports of effectiveness and cost of treating falls in Hawaii. The average cost of home modifications was $800 and the average annual averted medical cost of falling was $1728.

This article outlines cost-effective fall prevention interventions.

This is the first randomized controlled trial to examine the benefits of home modification for reducing fall injury costs in the general population. The results show a convincing economic justification for undertaking relatively low-cost home repairs and installing safety features to prevent falls.

List of special grants for veterans needing home modification.

This article discussed interventions that demonstrated greater efficacy to improve occupational performance. Implications for occupational therapy practice, education, and research are also discussed.

The results of the study indicated that the rate of decline in the frail elderly can be slowed through certain in-home personnel costs, reduced through a systematic approach to providing Assistive Technology and Environmental Interventions.

A multifactorial fall prevention program with exercise intervention may reduce the risk of falls in the short-term but not necessarily in the long-term. Awareness is key to reduce falls.

A fact sheet from the Albuquerque area southwest tribal Epidemiology Center

This resource is a copy righted document and its content, specifically the photographic portrait images belong to the AASTEC Tribal Injury Prevention Program.

This article investigated the role of environmental and behavioral factors surrounding fall incidents in a senior living community. Falls occurring in the bathroom can cause severe damage; three types of activities and five behavioral factors related to falls are identified.

This paper assesses the effectiveness of an environmental falls prevention intervention delivered by qualified occupational therapists or unqualified trained assessors. The study found that an environmental assessment prescribed by an occupational therapist significantly reduced the number of falls in high-risk individuals whereas that prescribed by a trained assessor did not.

Evaluation Basics for Fall Prevention Coalitions and Programs, Gretchen Alkema, PhD & Phoebe Liebig, PhD

This article aims to provide reliable and consistent practice guidelines to help prevent secondary falls in elderly adults. The guidelines include home and institutional assessment guidelines as well as recommended interventions.

A one-page companion piece to the Home Modification Checklist, developed by the National Home Safety and Home Modification Work Group.

As part of the Administration for Community Living-funded project, Promoting Aging in Place by Enhancing Access to Home Modifications, the University of Southern California Leonard Davis School of Gerontology and ADvancing States created this Technical Assistance Brief. The Brief outlines various funding sources State Units on Aging and other state agencies might consider in implementing policies and programs. The goal is to increase access to and the availability of home modifications and repairs.

Home Modification and Repairs for Older Adults

As the aging population in the United States increases, the number of older adults living in HUD-assisted housing also continues to grow rapidly. Both property owners and residents benefit from supportive home environments. For instance, residents typically want to live independently for as long as possible and stable tenure reduces management costs. Even so, as older adults capability’s change, configuration of their homes can present many challenges to living safely and independently. Adaptations of the living environment, called home modifications, help improve the comfort and safety of older persons, allowing them to flourish in independent housing and age-in-place.

Home FAST is a home assessment tool designed to identify older people at risk of falling because of hazards within their home environment. The tool consists of 25 items that include a range of indoor and outdoor environmental and functional concerns. A dichotomous assessment, the user marks whether or not a hazard is present. A higher score indicates a higher risk of falling.

A brief introduction to home modification, a list of everyday situations that pose risks for falls.

Includes a review of types and costs of the most prevalent of home modifications, funding streams at the federal and state levels, and an Appendix listing recommended home modifications for specified conditions related to military service.

This August 2021 Data Brief shares the results of a survey by USC and n4a of 276 Title VI programs serving Native American elders across the United States. It identifies the home modification needs of this diverse population, the challenges of the housing stock, and strategies used by local providers to ensure supportive home environments.

This report by the USC Fall Prevention Center of Excellence and ADvancing States reports on a national survey of home modification and repair efforts of State Units on Aging

A list created by the National Multiple Sclerosis Society of state programs and tax credits that help finance accessibility improvements to homes.

Hosted by the University of Buffalo, this site features archives of monthly online discussion on various aspects of home modifications.

Now, more than ever, it is important to consider the safety and support of homes. We are “safer at home” when it comes to the new Coronavirus, but our homes can have fall hazards such as throw rugs or poor lighting that could make it difficult or even dangerous for residents and guests of various ages to move about. We created a fact sheet “Home Modification Service Delivery During COVID-19” that contains tips for professionals and consumers to consider when making changes to the home during these challenging times.

This inventory of state tax credits that include home modifications was created by the University of Southern California Leonard Davis School of Gerontology as part of the Administration for Community Living project, “Promoting Aging in Place by Enhancing Access to Home Modifications.”

A  fact sheet by the USC Leonard Davis School of Gerontology with recommendations on how to make the home safer and more supportive, many of which are low or no cost.

This study tested the safety benefits of home modifications such as handrails, grab rails, outside lighting, edging and more. The findings suggest that low-cost home modifications and repairs can be a means to reduce injury in the general population.

This 2008 report from the US Department of Health and Human Services outlines the use of home modifications by older adults.

This article determines the health gain, cost-utility and health equity impacts from home safety assessment and modification (HSAM) for reducing falls in older people. Findings include: the provision of a HSAM intervention produces considerable health gain, is highly cost-effective, and provides a promising initial approach among older people.