The Role of Therapists in Assessment of Home Safety

By: Nicole M Boyko, MSPTSept 22, 2003

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

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

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. 

Components of a Home Safety Assessment• Inventory of Physical Health

• Cognition/Behavior

• Physical Exam

• Activities of Daily Living

• Support Systems

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?

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

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

Activities of Daily Living

• Dressing• Bathing• Functional txfrs• Toileting• Meal Prep• Feeding• Shopping

• Money management• Problem solving

skills• Driving• Household

management

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?

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

Resources/Discussion

• Sample Interdisciplinary home safety eval by BlueCross/ BlueShield

• Sample home safety packet that could be distributed at NWH

Questions