Home modifications

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Home modifications are defined as environmental interventions aiming to support activity performance in the home. [1] More specifically, home modifications often are changes made to the home environment to help people with functional disability or impairment to be more independent and safe in their own homes and reduce any risk of injury to themselves or their caregivers. [2] [3] Examples of home modifications include installing ramps and rails, altering kitchen and bathroom areas (relocating switches and lowering bench heights), installing emergency alarms. [4]

There are a number of words in common use that are confused with home modifications. For example, home modification is more than home improvement, home renovation or remodelling; those three terms refer to changes made to housing for purposes other than disability.

Other more closely related terms that are interchanged with home modifications in literature include combinations of home/housing/environment/residential coupled with modification/adaptation/intervention. Each of these terms has a nuanced meaning analysed in further detail by Bridge (2006). [5] However these terms have in common a context of housing, health and care for people with disability or impairment. Home modifications directly impact the accessibility to and within a home and are considered one aspect of the complex relationship between housing and health. [6] Home modifications are also the subject of ongoing public health and economics research [7] because of their potential to support aging in place and substitute for caregiving. [8] In addition to aging in place and caregiving, there is some evidence that home modifications can reduce falls in the home. [9]

Related Research Articles

<span class="mw-page-title-main">Assistive technology</span> Assistive devices for people with disabilities

Assistive technology (AT) is a term for assistive, adaptive, and rehabilitative devices for people with disabilities and the elderly. Disabled people often have difficulty performing activities of daily living (ADLs) independently, or even with assistance. ADLs are self-care activities that include toileting, mobility (ambulation), eating, bathing, dressing, grooming, and personal device care. Assistive technology can ameliorate the effects of disabilities that limit the ability to perform ADLs. Assistive technology promotes greater independence by enabling people to perform tasks they were formerly unable to accomplish, or had great difficulty accomplishing, by providing enhancements to, or changing methods of interacting with, the technology needed to accomplish such tasks. For example, wheelchairs provide independent mobility for those who cannot walk, while assistive eating devices can enable people who cannot feed themselves to do so. Due to assistive technology, disabled people have an opportunity of a more positive and easygoing lifestyle, with an increase in "social participation", "security and control", and a greater chance to "reduce institutional costs without significantly increasing household expenses." In schools, assistive technology can be critical in allowing students with disabilities to access the general education curriculum. Students who experience challenges writing or keyboarding, for example, can use voice recognition software instead. Assistive technologies assist people who are recovering from strokes and people who have sustained injuries that affect their daily tasks.

Occupational therapists (OTs) are health care professionals specializing in occupational therapy and occupational science. OTs and occupational therapy assistants (OTAs) use scientific bases and a holistic perspective to promote a person's ability to fulfill their daily routines and roles. OTs have training in the physical, psychological, and social aspects of human functioning deriving from an education grounded in anatomical and physiological concepts, and psychological perspectives. They enable individuals across the lifespan by optimizing their abilities to perform activities that are meaningful to them ("occupations"). Human occupations include activities of daily living, work/vocation, play, education, leisure, rest and sleep, and social participation.

In common usage and medicine, health, according to the World Health Organization, is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity". A variety of definitions have been used for different purposes over time. Health can be promoted by encouraging healthful activities, such as regular physical exercise and adequate sleep, and by reducing or avoiding unhealthful activities or situations, such as smoking or excessive stress. Some factors affecting health are due to individual choices, such as whether to engage in a high-risk behavior, while others are due to structural causes, such as whether the society is arranged in a way that makes it easier or harder for people to get necessary healthcare services. Still, other factors are beyond both individual and group choices, such as genetic disorders.

<span class="mw-page-title-main">Accessibility</span> Modes of usability for people with disabilities

Accessibility is the design of products, devices, services, vehicles, or environments so as to be usable by people with disabilities. The concept of accessible design and practice of accessible development ensures both "direct access" and "indirect access" meaning compatibility with a person's assistive technology.

<span class="mw-page-title-main">Occupational therapy</span> Healthcare profession

Occupational therapy (OT) is a healthcare profession that involves the use of assessment and intervention to develop, recover, or maintain the meaningful activities, or occupations, of individuals, groups, or communities. The field of OT consists of health care practitioners trained and educated to improve mental and physical performance. Occupational therapists specialize in teaching, educating, and supporting participation in any activity that occupies an individual's time. It is an independent health profession sometimes categorized as an allied health profession and consists of occupational therapists (OTs) and occupational therapy assistants (OTAs). While OTs and OTAs have different roles, they both work with people who want to improve their mental and or physical health, disabilities, injuries, or impairments.

<span class="mw-page-title-main">Geriatrics</span> Specialty that focuses on health care of elderly people

Geriatrics, or geriatric medicine, is a medical specialty focused on providing care for the unique health needs of the elderly. The term geriatrics originates from the Greek γέρων geron meaning "old man", and ιατρός iatros meaning "healer". It aims to promote health by preventing, diagnosing and treating disease in older adults. There is no defined age at which patients may be under the care of a geriatrician, or geriatric physician, a physician who specializes in the care of older people. Rather, this decision is guided by individual patient need and the caregiving structures available to them. This care may benefit those who are managing multiple chronic conditions or experiencing significant age-related complications that threaten quality of daily life. Geriatric care may be indicated if caregiving responsibilities become increasingly stressful or medically complex for family and caregivers to manage independently.

The International Classification of Functioning, Disability and Health (ICF) is a classification of the health components of functioning and disability.

<span class="mw-page-title-main">Elderly care</span> Care serving the needs and requirements of senior citizens

Elderly care, or simply eldercare, serves the needs of old adults. It encompasses assisted living, adult daycare, long-term care, nursing homes, hospice care, and home care.

<span class="mw-page-title-main">Geriatric dentistry</span>

Geriatric dentistry is the delivery of dental care to older adults involving diagnosis, prevention, management and treatment of problems associated with age related diseases. The mouth is referred to as a mirror of overall health, reinforcing that oral health is an integral part of general health. In the elderly population poor oral health has been considered a risk factor for general health problems. Older adults are more susceptible to oral conditions or diseases due to an increase in chronic conditions and physical/mental disabilities. Thus, the elderly form a distinct group in terms of provision of care.

<span class="mw-page-title-main">Long-term care</span> Services for the elderly or those with chronic illness or disability

Long-term care (LTC) is a variety of services which help meet both the medical and non-medical needs of people with a chronic illness or disability who cannot care for themselves for long periods. Long-term care is focused on individualized and coordinated services that promote independence, maximize patients' quality of life, and meet patients' needs over a period of time.

<span class="mw-page-title-main">Caregiver</span> Person helping another with activities of daily living

A caregiver, carer or support worker is a paid or unpaid person who helps an individual with activities of daily living. Caregivers who are members of a care recipient's family or social network, and who may have no specific professional training, are often described as informal caregivers. Caregivers most commonly assist with impairments related to old age, disability, a disease, or a mental disorder.

The U.S. Centers for Disease Control and Prevention defines aging in place as "the ability to live in one's own home and community safely, independently, and comfortably, regardless of age, income, or ability level".

As populations age, caring for people with dementia has become more common. Elderly caregiving may consist of formal care and informal care. Formal care involves the services of community and medical partners, while informal care involves the support of family, friends, and local communities. In most mild-to-medium cases of dementia, the caregiver is a spouse or an adult child. Over a period of time, more professional care in the form of nursing and other supportive care may be required medically, whether at home or in a long-term care facility. There is evidence to show that case management can improve care for individuals with dementia and the experience of their caregivers. Furthermore, case management may reduce overall costs and institutional care in the medium term. Millions of people living in the United States take care of a friend or family member with Alzheimer’s disease or a related dementia.

Family caregivers are “relatives, friends, or neighbors who provide assistance related to an underlying physical or mental disability for at-home care delivery and assist in the activities of daily living (ADLs) who are unpaid and have no formal training to provide those services.”

<span class="mw-page-title-main">Intellectual disability</span> Generalized neurodevelopmental disorder

Intellectual disability (ID), also known as general learning disability in the United Kingdom and formerly mental retardation, is a generalized neurodevelopmental disorder characterized by significantly impaired intellectual and adaptive functioning. It is defined by an IQ under 70, in addition to deficits in two or more adaptive behaviors that affect everyday, general living. Intellectual functions are defined under DSM-V as reasoning, problem‑solving, planning, abstract thinking, judgment, academic learning, and learning from instruction and experience, and practical understanding confirmed by both clinical assessment and standardized tests. Adaptive behavior is defined in terms of conceptual, social, and practical skills involving tasks performed by people in their everyday lives.

Caregiver syndrome or caregiver stress is a condition that strongly manifests exhaustion, anger, rage, or guilt resulting from unrelieved caring for a chronically ill patient. This condition is not listed in the United States' Diagnostic and Statistical Manual of Mental Disorders, although the term is often used by many healthcare professionals in that country. The equivalent used in many other countries, the ICD-11, does include the condition.

An informal or primary caregiver is an individual in a cancer patient's life that provides unpaid assistance and cancer-related care. Due to the typically late onset of cancer, caregivers are often the spouses and/or children of patients, but may also be parents, other family members, or close friends. Informal caregivers are a major form of support for the cancer patient because they provide most care outside of the hospital environment. This support includes:

Ableism is discrimination and social prejudice against people with physical or mental disabilities. Ableism characterizes people as they are defined by their disabilities and it also classifies disabled people as people who are inferior to non-disabled people. On this basis, people are assigned or denied certain perceived abilities, skills, or character orientations.

Chronic disease in Northern Ontario is a population health problem. The population in Northern Ontario experiences worse outcomes on a number of important health indicators, including higher rates of chronic disease compared to the population in the rest of Ontario.

Family support is the support of families with a member with a disability, which may include a child, an adult, or even the parent in the family. In the United States, family support includes "unpaid" or "informal" support by neighbors, families, and friends, "paid services" through specialist agencies providing an array of services termed "family support services", school or parent services for special needs such as respite care, specialized child care or peer companions, or cash subsidies, tax deductions or other financial subsidies. Family support has been extended to different population groups in the US and worldwide. Family support services are currently a "community services and funding" stream in New York and the US which has had variable "application" based on disability groups, administrating agencies, and even, regulatory and legislative intent.

References

  1. Gitlin, L. N. (1998). Testing home modification interventions: Issues of theory, measurement, design and implementation. In R. Schulz, M. P. Lawton, & G. Maddox (Eds.), Annual review of gerontology and geriatrics, 18: Intervention research with older adults (pp. 190–246). New York: Springer.
  2. Adams, T., Bridge, C., Carnemolla, P., McNamara, N., Quinn, J. & Svenger, M. 2014 "Consumer Factsheet: Arranging Home Modifications" Home Modification Information Clearinghouse, University of New South Wales.
  3. Belardi, Linda (2016-04-06). "Home modifications reduce reliance on care: study". Community Care Review. Retrieved 2016-05-09.
  4. "Home modifications". Carer Gateway. Commonwealth of Australia. Retrieved 2016-05-09.
  5. Bridge, C., Computational case-based redesign for people with ability impairment: Rethinking, reuse and redesign learning for home modification practice. VDM Verlag Dr. Muller. Germany 2006.
  6. "WHO - Housing and Health". who.int. Archived from the original on March 7, 2011.
  7. Pynoos, J., & Nishita, C. M. (2003). The cost and financing of home modifications in the United States. Journal of Disability Policy Studies, 14(2), 68-73.
  8. Anderson, W., & Wiener, J. (2013). The Impact of Assistive Technologies on Formal and Informal Home Care. The Gerontologist, gnt165.
  9. http://www.euro.who.int/__data/assets/pdf_file/0018/74700/E82552.pdf [ bare URL PDF ]