The Role of Therapists in Assessment of Home Safety By: Nicole M Boyko, MSPT Sept 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