Frequently Asked Questions
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Q. Who is an Occupational Therapist (OT) and why are they ideal to become an Accessibility Consultant?
An OT is a licensed health care professional who helps clients increase their abilities to perform Activities of Daily Living (ADL) and related mobility, and to improve functional use of the hands and arms. ADLs include bathing, dressing, bathroom skills, cooking, etc. OTs teach clients to compensate for limitations and build upon strengths through therapeutic activities, adaptive techniques and use of assistive devices.
OTs’ education and expertise is invaluable to help reduce the effects of medical conditions, disease and injury on people’s ability to function in their daily lives. OTs’ goals are to learn purposeful and meaningful skills, to help clients function as safely and independently as possible.
OTs who become Accessibility Consultants learn building principles, how to read blueprints, and structural aspects of remodeling and construction. Training includes universal design principles, structural adaptations, and barrier-free products. Accessibility Consultants learn construction terminology for effective collaboration with builders and remodelers, to ensure proper integration of accessible designs, products and features. These skills build directly upon OTs abilities to address challenges that limit clients’ functioning and safety at home.
Accessibility Consultants who are OTs are uniquely qualified to identify home modifications that are most beneficial to each client, based on their abilities and limitations. With the “client centered” approach of OTs, family members and other people in their lives are involved to help ensure an inclusive and supportive team.
Q. What is the difference between an Occupational Therapist Accessibility Consultant and a CAPS remodeler?
Please see above FAQ for the description of an Occupational Therapist with training as an Accessibility Consultant. Our Accessibly Consultant works directly with contractors to ensure modifications and adaptive equipment are incorporated according to exact specifications for successful outcome of the project.
Certified Aging in Place Specialists (CAPS) are remodelers and builders who have taken the National Association of Home Builders (NAHB) course on technical, business management and customer service for home modification. This course teaches them standard and recommended adaptations to the home that can accommodate typical physical changes that often occur as we grow older. They are specialists in the field of home remodeling or construction but have no medical or health care training.
AARP and the NAHB both recommend an Occupational Therapist provide a home assessment to evaluate a person’s daily routine, mobility and manifestations of illness and injury, to determine which modifications will be most beneficial to them. An AARP publication on home modifications states that an OT “is essential for making recommendations that will enhance function and safety… to meet both current and future needs. Such assessments save money in the long run by helping to avoid mistakes in product selection and design solutions.”
Q. Will accessible modifications increase or reduce the value of our home?
Homes with accessible features and universal designs have enhanced value, much like homes with first floor master bedrooms now preferred by so many home buyers. Interest in accessible homes is developing as a recognizable trend in today’s real estate market. One reason is the desire and benefits of “aging in place.” In addition, baby boomers and young families with strollers and packages also prefer no-step thresholds, wider doorways and roll-in showers to bathe their children and pets with greater ease and safety.
Visitability, similar to accessibility, is another movement in which virtually all homes, not merely those for people with disabilities, provide a few specific features making the home easier for all people of all ages and abilities to visit. Accessibility allows visitability, so family members and friends of all generations are equally comfortable, able to enter and have access to facilities with ease and safety. For example, have one exterior entrance with a zero threshold and 36” wide door and a first-floor bathroom with a minimum of 32” wide door and a “comfort height” toilet of 17”-19” tall.
Q. What modifications are helpful for younger adults with neurodegenerative conditions such as Parkinson's, ALS and Huntington’s disease?
Home accessibility for neurodegenerative conditions must address maximum energy efficiency with functional mobility and Activities of Daily Living (ADL), since limited endurance so greatly hinders productive activity. It is beneficial to incorporate “adjustable” modifications that can be adapted as needs change over time.
People with neurodegenerative conditions often have goals in line with America’s growing trend towards enjoying the comforts of home. The key to accessibility is to match the right modifications with the client’s personal priorities, desires and needs, which can empower and create opportunities for them to help achieve the highest possible quality of life.
Our Accessibility Consultant has much experience working with neurodegenerative conditions as an OT, therefore understands the trajectory of these illnesses and their symptoms. By offering various appropriate adaptive products, assistive devices and accessible designs options, we strive to actively involve the client in the decision-making process. This helps ensure greater success in identifying beneficial changes to attain the greatest comfort and function in the home setting.
Q. Can a home be modified specifically for someone with Alzheimer ’s disease or dementia?
Accessibility adaptations for the home can be explicitly chosen and incorporated for people with memory impairment and related limitations. Since dementia may also be a secondary symptom of other illnesses, accessible modifications must address multiple needs to benefit the care of the person. Because memory problems impair judgment and safety, modifications help reduce risk of injury and accidents, which give more peace of mind to clients, families and caregivers. It is very important for our Accessibility Consultant to have good collaboration and input from family and caregivers to address all concerns that may arise during the course of the day or night.
It is most beneficial for these often subtle modifications to be put into place in the home as early as possible, so loved ones become familiar with them well before their disease advances, when mobility and abilities become more difficult. Specific features for those with dementia include addressing hazards and clutter, home safety and security, assistive devices for daily activities and related mobility, visual cues and comfort.
Our Accessibility Consultant also provides a check list of simple safety measures and changes to the home environment to reduce the risk of injury or falls, specific to dementia. Examples include locking access to household products that may be hazardous and doors leading to basement or garage stairs, eliminating rugs, lowering water heater temperature to prevent scalding, etc.
Q. When should we have the Accessibility Consultant do an assessment of our home to enable us to “age in place?"
AAPR’s 2010 study found that more than 80% of people over age 50 want to stay in their homes for as long as possible. It is never too early to plan and be prepared for an unexpected change in health or medical condition that affects our daily lives. It is wise to make modifications when someone needs increased assistance or when new safety concerns arise, such as a near-fall or more serious injury. Also, when planning to upgrade or remodel a bathroom or kitchen, accessibility modifications can easily be incorporated in the development phase, with designs quite inconspicuous and often with minimal additional cost. Once our Accessibility Consultant identifies specific recommendations, they can be prioritized to be phased in over time, if desired.
Q. What if we have a very limited budget but want to make accessible home modifications?
Whenever possible, our Accessibility Consultant provides options for recommendations that are most economical, so homeowners can determine which suits their budget. We have many resources to help find the most cost effective products and accessible designs to help meet each individual client’s needs and budget.
When our Accessibility Consultant meets with the client and family to assess the home environment, recommendations that are given can be listed in stages of priority, based on the client’s or family’s needs, safety and / or finances. This way, the client and family can determine which changes they wish to implement on their own time frame. The Accessibility Consultant can schedule a follow-up appointment at a future time, to help identify the most beneficial modifications in a sequential manner as needs increase over time.
Q. Are home modifications tax deductible?
Yes, for federal income taxes, they are deductible under medical expenses if the cost is greater than 10% (younger than 65) or 7.5% (older than 65) of Adjusted Gross Income to quality. The deductible amount is considered to be: (cost of improvement – value increase from improvement). You may need “before” and “after” Broker Price Opinions to substantiate. The web site link is https://www.irs.gov/publications/p502/index.html for additional information and a list of types of changes that are considered to be typical and add no value to the home, thus are easier to deduct (i.e. not likely to be challenged by IRS).
Q. How involved is the Accessibility Consultant in the home modification process, once they have made their recommended changes?
Ideally the home modification process includes: Evaluation of needs, identifying and implementing solutions, training clients once new adaptations are in place, and assessing the outcome to ensure successful understanding, use and benefits. This comprehensive process from start to finish is based on how all therapists, physical, occupational and speech-language, practice their profession in treatment planning and implementation.
Ongoing coordination with the builder or remodeler throughout the construction / renovation process is extremely valuable to ensure clear understanding of all details of modification, addition or new construction and proper installation of adaptive equipment. For builders and remodelers skilled is accessible modifications, less collaboration is usually required during construction or installation.
At times, some clients only wish to learn which recommendations will be beneficial to make their home environment accommodate their particular medical and functional needs. Some clients decide not to have the Accessibility Consultant coordinate with the contractor during installation or after modifications are completed. When clients and families chose to use a phone interview as follow-up, this precludes our Accessibility Consultant’s expertise in ensuring the modifications are installed properly, and that the client, family and caregivers understand the safest and proper implementation of the new home modifications.
Q. How does universal design in the community differ from accessibility modifications in the home?
Universal design (UD) is defined as “all products and environments to be usable by all people to the greatest extent possible without the need for adaption or specialized design.” The American Disability Act (ADA) of 1990 states that public, commercial and government facilities must make their buildings and grounds accessible to all people with all type of disabilities. UD guidelines are used with their broad range of specifications to accommodate people of all ages, people without disabilities and people with disabilities.
An accessible home, on the other hand, is custom tailored for the client’s mobility, abilities and limitations, activities and interests, with features chosen to address their personal goals and priorities. It is imperative that home modifications are explicitly selected and based on each client’s medical conditions, physical and cognitive abilities, and which address their current and future needs. These details enable the home to be adapted with accessible features, products and adaptive equipment that correspond specifically to the client and their ability to function in daily life at home.