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The Role of Therapists in Assessment of Home Safety
By: Nicole M Boyko, MSPTSept 22, 2003
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Objectives
• To identify the components of a home safety evaluation
• To come up with a resource booklet for patients and families regarding:– Identification of potential safety threats
within the elder individual’s home– Tips for home modifications
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Key Terms
• Home Safety Evaluation: An interdisciplinary assessment of the elder individual and his/her primary residence to gauge how well the client is able to perform activities of daily living (ADLs) within the home environment
• Completed with input from the patient, family members/caregivers, Occupational and Physical Therapy, Nursing, and the pt’s physician
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Key Terms cont’
• Home modifications- refers to adaptations to the home environment to increase ease of use, safety, comfort, security and independence
• Home Safety Training: techniques taught to pt/caregiver that promote safe activities, conserve energy, and enhance quality of life for both the caregiver and receiver.
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Components of a Home Safety Assessment• Inventory of Physical Health
• Cognition/Behavior
• Physical Exam
• Activities of Daily Living
• Support Systems
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Inventory of Physical Health• Past Medical History
– Chronic diseases? – Orthopedic issues?– Incontinence?– History of falls or
balance issues?
• Medications– Taken as directed?– Knows how to avoid
interactions?
• Appearance & Hygiene– Appropriate dress?– Clean clothing?– Does the pt routinely
brush teeth, trim nails, wash and comb hair?
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Cognition/Behavior
• Alert and Oriented?• Memory
– Hx of Alzheimers or age-related dementia?• Pyschological Issues
– Depression, anxiety, psychosis• Mood• Ability to follow commands• Safety awareness in home and community
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Physical Exam
• Musculoskeletal– Strength– ROM– Posture/Alignment
• Vision• Hearing• Speech• Prior Level of Fxn
• Neurological– Sensation– Proprioception– Balance– Coordination
• Functional Mobility– Supine to Sit– Sit to Stand– Ambulation/Stairs
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Activities of Daily Living
• Dressing• Bathing• Functional txfrs• Toileting• Meal Prep• Feeding• Shopping
• Money management• Problem solving
skills• Driving• Household
management
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Support Systems
• Living situation?• Friends or family nearby?• Home Services received?• Does the pt have readily available the contact
information for:– Emergency contacts– Caregivers
• Community organizations/ church groups?
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Role of Acute Care Therapist• Determine need for placement/home services
– Can recommend a home safety evaluation by home PT/OT upon D/C from hospital
• Provide patient with appropriate adaptive equipment/assistive devices
• Education regarding safe fxnl mobility, ADLs and energy conservation within home environment
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Resources/Discussion
• Sample Interdisciplinary home safety eval by BlueCross/ BlueShield
• Sample home safety packet that could be distributed at NWH
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Questions