More and more people are remodeling or modifying their home as they age or take care of a loved one. You may want to have an accessible home to stay home longer, as well as to save money. Also, taking care of family, whether they are children, adults with disabilities or aging parents, is often easier if they are in familiar surroundings. If done properly, home modifications can improve the safety of the home, are easier to maintain, improve appearance and are an asset for home resale.

Most home modifications do not cost tremendous amounts of money. However, the costs can become enormous in terms of safety, money and stress if you do not know the person's physical/mental limitations or what type of equipment is available, do not have a reliable vendor or have an installation that is not correct.

Often people try to do it themselves or get a friend to install equipment. However, when retrofitting in a home there are often "surprises" when remodeling. For example, there are often poor or inadequate studs to support a grab bar. If installed improperly it can be worthless or dangerous! The walk-in bathtubs look "cool," but maybe a roll-in shower would be safer for the long term and more cost effective. To help you decide what is needed, several factors need to be considered.

A physical or occupational therapist can help you look at physical limitations such as abnormal gait or balance issues. Dizziness resulting from inner ear issues or medications can contribute to falls and need for grab bars. Residents may have difficulty moving easily from lying down to sitting to standing. Also, if residents use braces, canes, walker or wheelchairs, floors and doorways may need changes. Difficulty reaching, twisting or bending will determine what modifications may be needed. Mental issues such as dementia, poor judgement, impulsivity and fatigue also play a part. Consultation for existing problems and possibly therapy can resolve or minimize these issues. A trained therapist can provide recommendations and help develop a plan that can help you in the short term as well as the long term.

To look at the environmental factors it is helpful to assess your home (and yard too!) Do a "walk through" as if you were looking at your home for the first time. Often we are so used to how things already are, we no longer see them. Look critically for any potential danger areas such as the following.

Common areas for falls are uneven ground, stairs, curbs, bathroom and kitchen. Other dangerous areas are where there may be spills on the floor or transitions from floor to carpet or where throw rugs are used. Check to see that exits and entries are clear of obstacles and that there are sturdy rails on stairs.

Outside assess need for a ramp instead of stairs, as well as uneven surfaces and obstacles such as hoses in the yard. Have a clear path. Getting in and out of the car, or reaching in and out of trunk or back seat can also be difficult. Indoors or out be aware of your animals - they love to get in your path and around your feet.

Changes can be simple and in expensive. Put items where you need them - for example place commonly used items low, lighter objects up higher and seldom used on top shelves. Simple items to help you such as a swivel seat in the car, a commode next to the bed at night or a reacher can give that little boost. Your therapist can help you make sure you are using ambulation devices (cane, walker, wheelchair) appropriately which can also help avoid injury to caregivers. Equipment should be maintained and checked frequently.

Two of the biggest issues as we develop physical limitations are fear of falling and overwhelmed care providers. Your security and peace of mind are critical issues. If you need help to assess your status, resources for equipment or installation, we can refer you to local resources to make sure the modifications are right for you, installed and maintained correctly and provide you a safe and attractive "home sweet home"

Virginia Taft, OTR/L, ATP, is an Occupational Therapist and Assistive Technology Practitioner with more than 25 years experience. Her clinic, Coeur d'Alene Hand Therapy & Healing Center provides occupational and physical therapy services with a hands-on, whole body and lifestyle approach to health. Call for a free consultation 664-2901 or check us out on the Web cdahandtherapy.com.