Do Home Modifications Improve Function in Adults with Physical Disabilities?

Jared Hansen, OTS and Gifty Frimpong, OTS

Touro University Nevada, School of Occupational Therapy

Background

Implications for Practice

Adults want to remain independent as long as possible in their homes

People are living longer today and the need for affordable healthcare is
increasing (Mann, Ottenbacher, Fraas, Tomita, & Granger, 1999)
Limitations to functioning may develop as people age
Home modifications are adaptations to the home environment that can
increase independence and function for the individual

Methods
Inclusion Criteria
Articles published since 1999 in English
Involving physical disabilities
Peer reviewed
Intervention involving home modification
Intervention was within the scope of occupational therapy practice
Outcome focusing on function or performance
Level I, II, and III evidence (IV and V if no other evidence is found)
Exclusion Criteria
Focus on fall prevention as main outcome
Qualitative studies
Articles without a clearly defined home modification intervention
Presentations, conference proceedings, dissertations, and theses

Selected
Articles

Study Design

Systematic reviews, meta-analyses,

randomized controlled trials

II

Two groups, nonrandomized studies

III

One group, nonrandomized studies

IV
V
Other
RESEARCH POSTER PRESENTATION DESIGN 2015

www.PosterPresentations.com

Results
The review identified 47,843 articles with 10 meeting the inclusion
criteria
One article focused on lighting adaptations
One article focused on smart home technology
Eight articles focused on home modifications
Three articles included environmental modifications
Five articles included assistive technology

Conclusions

Table of Evidence
Level of
Evidence

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Descriptive studies that include analysis of

outcomes
Case reports and expert opinion, which
include narrative literature reviews and
consensus statements
Qualitative studies

0
0
0

Total:

10

Level I
Basic lighting adaptations improve activity of daily living (ADL)
performance (Brunnstrm, Srensen, Alsterstad, & Sjstrand, 2004).
Home modifications decreased the amount spent on healthcare for older
adults compared to those who did not receive any modifications (Mann,
Ottenbacher, Fraas, Tomita, & Granger, 1999).
Level II
Home modifications are effective in decreasing difficulty in activity
performance for up to six months after installation (Petersson, Kottorp,
Bergstrm, & Lilja, 2009).
Level III
Bathroom modifications are an effective method for improving
independence in ADL performance, and transferring for older adults
(Gitlin, Miller, & Boyce 1999).
Approaching home modifications with a focus on the client is beneficial in
enhancing performance for adults with disabilities (Stark, 2004; Stark,
Landsbaum, Palmer, Somerville, & Morris, 2009).

The Clinical and Community-Based Practice of Occupational Therapy

Low cost home modifications can increase functional independence and
decrease performance demands of everyday life tasks up to six months
after installation.
Program Development
Decreasing the time for identifying and installing home modifications can
assist adults in maintaining functional independence.
Societal Needs
Education of the community is needed to understand the benefits of
home modifications in reducing the amount of healthcare costs for older
adults.
Healthcare Delivery and Policy
Early identification of needs and referral for home modifications using a
client-centered approach is most beneficial for clients.
Results demonstrate the importance of a system of quality control in
service delivery and consistency of practices in home modification.
Education and Training of Occupational Therapy Students
Students should be exposed to smart home technology and educated in
making appropriate suggestions for adaptations that individuals will
utilize.
Refinement, Revision, and Advancement of Factual Knowledge or Theory
Additional studies representing the general population using objective
measures are recommended to increase the understanding of the
benefits of home modifications.

References (Partial List)

Brunnstrm, G., Srensen, S., Alsterstad, K., & Sjstrand, J. (2004). Quality of
light and quality of lifethe effect of lighting adaptation among people
with low vision. Ophthalmic and Physiological Optics, 24(4), 274-280.
doi: 10.1111/j.1475-1313.2004.00192.x
Mann, W. C., Ottenbacher, K. J., Fraas, L., Tomita, M., & Granger, C. V. (1999).
Effectiveness of assistive technology and environmental interventions in
maintaining independence and reducing home care costs for the frail
elderly: A randomized controlled trial. Archives of Family Medicine, 8(3),
210-217. http://dx.doi.org/10.1001/archfami.8.3.210

Contact Information
Jared Hansen OTS: ot16.jared.hansen@nv.touro.edu
Gifty Frimpong OTS: ot16.gifty.frimpong@nv.touro.edu