About Occupational Therapist trained in home modifications

An Occupational Therapist (OT) trained as an Accessibility Consultant is uniquely qualified to assess for and design home modifications, based on each client’s functional abilities and limitations. OTs’ education and experience is essential for understanding medical and physical manifestations of illness, injury and aging. The combination of these skills is ideal to determine which home modifications will be most beneficial to each client.

One key factor is OTs’ ability to project a client’s probable future needs, by understanding of the trajectory of disease and disability over time. OTs can identify specific modifications that help overcome everyday challenges a client faces today and in days to come. Occupational Therapy is a skilled treatment that provides instructions to compensate for limitations and build upon strengths.

OTs teach alternative ways to perform Activities of Daily Living (ADL), such as bathing, dressing or simple meal prep and related mobility. Clients learn adaptive techniques and use of assistive devices and durable medical equipment (DME) to improve their ability to function as independently and safely as possible. Instructions and education include family and / or caregivers who may assist the client.

OTs trained as Accessibility Consultants learn building principles and materials, how to read blueprints and structural aspects of remodeling and construction. Training includes barrier-free products and fixtures, universal design principles and structural adaptations. Building and construction terminology is taught for effective communication and collaboration with builders and remodelers.

Other interdisciplinary team members with whom consultation is coordinated may include architects, designers, realtors and case managers.

The OT Accessibility Consultant’s assessment and recommendations result in enhancements to the home, tailored to target the environmental barriers that limit a client’s mobility and ability to function. Their expertise is ideal to create practical solutions that promote maximum independence, safety, comfort and peace of mind.

OT-Accessibility home modifications recommendations may include:

  • At least one no-step entry into the home with an entrance door at least 36” wide
  • Access to outdoor areas, including garage or carport, walkways, porch and patio
  • Accessible, barrier-free bathroom: shower, toilet and sink with accessible features and fixtures, grab bars and space for freedom of mobility and transfers
  • First floor bathroom with shower and bedroom OR access to other floors with a stair lift or elevator
  • Multi-level counters and sink heights in bathroom, kitchen and other utility rooms used
  • Cabinets, closets and appliances designed to enable easy access and functional reach
  • Slip-resistant floor options and low threshold transitions at doorways and between changes in room flooring
  • Space needed for freedom of mobility with assistive devices through doorways, halls and throughout the home
  • Ramp, vertical lift, stair lift and elevator recommended when appropriate.


  • Minor home modifications…
  • Room or home renovations…
  • Accessible designs for construction of a new addition or a new home…

About Carroll Fernstrom, OTR/L

Carroll T. Fernstrom, OTR/L began training as an Accessibility Consultant in 1995, as a natural extension of her work as an Occupational Therapist (OT). She has taken 4 courses on accessible home modifications taught by OTs for OTs. Having lived and worked in Wake County for 15 years, she has developed extensive resources in the community.

Carroll has excellent interpersonal and professional communication skills and enjoys working with clients and families and collaborating with contractors to create accessible homes. Her experience as an OT spans more than 25 years. Her career has focused primarily on neurological disorders, strokes, pulmonary diseases / COPD, arthritis, disorders of the hand and arm, and memory impairment. She specializes in safety and reducing risk of falls and injuries at home and in the community.

She has been self-employed for much of her career. Carroll has an intuitive ability to design enhancements that are tailored for maximum independent function, safety and comfort, without sacrificing aesthetics. Whether working as an Accessibility Consultant or an OT, Carroll believes it is imperative to integrate each client’s own goals and priorities…what he or she wants and needs to do.

Carroll takes pride in her work in creating accessible home environments for clients and families. She continues to provide the highest quality of service that is “client centered”. Results of her recommendations are solutions that focus on improving each individual person’s everyday life and peace of mind at home.

Courses taken on Accessibility Consulting by OTs for OTs

  • Improving Health & Participation of Older Adults through Home Modifications
    American Occupational Therapy Association, Charlotte, NC 2014
  • Occupational Therapy & Home Modification: Promoting Safety & Supporting Participation
    American Occupational Therapy Association 2011
  • Accessibility Consultation and Environmental Modification 
    AOTSS, New Orleans, LA 2008
  • Functional / Environmental Assessment and Home Modifications 
    AOTSS, Baltimore, MD 1995