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All health begins at home in the community
Published in Ben Y.F. Fong, Martin C.S. Wong, The Routledge Handbook of Public Health and the Community, 2021
All levels of society, from single persons and families to government and non-government organisations, can implement smart and sustainable strategies that will make safe, comfortable and healthy homes a key component of the global and regional public health architecture with easy-to-implement design, pertaining local geographical and cultural uniqueness. Healthy homes designed and situated in neighbourhoods connected to quality health care, schools, jobs and easy accessibility will provide the foundation for better wellness outcomes. Home modifications should be innovative, attractive, and appropriate for home setting in a simple and effective approach (Walsh, 2019).
Therapists’ Interventions among Practice Settings
Published in Amy J. Litterini, Christopher M. Wilson, Physical Activity and Rehabilitation in Life-threatening Illness, 2021
Christopher M. Wilson, Amy J. Litterini
As described in Chapter 4, the astute therapist should also consider the patient’s current level of performance, concurrent functional limitations, as well as the anticipated future disease trajectory. In addition to identifying key home modification recommendations, the execution or completion of these modifications is a key and ongoing role for the therapist practicing in the home health setting. Again, a valid, reliable outcome measure to quantify in-home performance is warranted such as the I-HOPE or the SAFER-HOME assessment.19,20 Home modification recommendations will often require advocacy for the patient including assisting in identification of needed equipment and coordination with the individual’s support network to facilitate installation. In some scenarios, this may be inherent in the living location if the person lives in an independent living facility or any other senior apartment where modifications may be regulated or facilitated through the institution’s administrators. If an individual resides in their own home, this may be completed by family or friends to accomplish things like installing rails or grab bars. Finally, the proactive therapist can also work closely with their local municipal senior center or local governmental or non-governmental organizations to procure and sometimes even install recommended equipment. This may include local fire departments, city halls, or religious institutions that operate a loan closet for equipment. Some organizations even have volunteers or funding mechanisms to assist with an installation of these devices (see Chapter 5).
Older Adult Falls: Epidemiology and Effective Injury Prevention Strategies
Published in James M. Rippe, Lifestyle Medicine, 2019
Ann M. Dellinger, David A. Sleet, Jeanne Nichols
Home modification. Home fall hazards are common, and home visitation and modification by an occupational therapist has been shown to reduce both the fall rate and number of fallers.30,32,37,57,61–62 The trial reported by Cumming61 showed a 36% reduction in the proportion of people falling, although only among those with a history of falls. Occupational therapists are trained to teach people safer ways of negotiating their environment; therefore, home visits by occupational therapists are likely to entail more than working through a checklist to remove tripping hazards and the like. Referral to occupational therapy for home modification can be an effective part of a multifactorial fall prevention strategy. The AGS/BGS Guideline gives grade A recommendations (a strong recommendation that physicians provide the intervention to eligible patients) for home environment assessment and intervention for older persons who have fallen or who have risk factors for falling, and for mitigation of identified home hazards, with evaluation and intervention to promote safe behavior.30
The unique experience of home for parents and carers of children with disabilities
Published in Scandinavian Journal of Occupational Therapy, 2018
Tammy Aplin, Heloise Thornton, Louise Gustafsson
It should be noted however that not all families have the resources or information to provide these opportunities and that families’ values and attitudes influence the opportunities that are provided [21,22]. Concerns over safety and social stigma for example can limit modifications that are made to families’ homes, and values around family roles will influence the opportunities children are provided with to engage in activities, for example activities such as cooking and cleaning may be seen as parent roles [21]. The findings show the extent to which families use their own resources, when available, to support their children. Similar to previous research [9,22], families in this study reported encountering monetary constraints and were placed under financial hardship to cover the costs of supporting the participation of their child. This suggests that there is a gap in the service provided to parents and their needs in providing optimal support for their children. In a 2012 scoping review of research investigating parent’s enablement of their children’s participation it was highlighted that little is known about the information, guidance and support that is needed by parents to facilitate participation [22]. With regard to home modifications it seems further financial assistance is required as a starting point.
Clients’ Perspectives of the Effectiveness of Home Modification Recommendations by Occupational Therapists
Published in Occupational Therapy In Health Care, 2018
Guby Wai Chu Lau, Mong-Lin Yu, Ted Brown, Cassandra Locke
Occupational therapists conduct home assessments for clients to facilitate timely, safe, and cost-effective discharge from the hospital (Lannin, Clemson, & McCluskey, 2011; Sim, Barr, & George, 2015). During home assessment visits, occupational therapists evaluate potential barriers that may impact clients’ safety and accessibility (Daley, Cristian, & Fitzpatrick, 2006) and make recommendations for home modifications that empower clients to overcome their disabilities, maximize independence, and promote safety and quality-of-life at home (Black & Dillon, 2006; Sim et al., 2015). Common home modifications include bathroom and kitchen modifications; rail, platform step, and ramp installations; threshold removal; increasing lighting; decreasing clutter; and removing falls hazards such as loose throw rugs (Niva & Skär, 2006; Stark et al., 2009; Sørensen, Lendal, Schultz-Larsen, & Uhrskov, 2003; Tse, 2005). In many jurisdictions, the home modifications recommended by occupational therapists are completed by external agencies or individuals (e.g., city council employees, private contract builders, or carpenters). In Australia, clients can only access government funding for home modifications with recommendations made by an occupational therapist. For example, in Victoria, the State-Wide Equipment Program (SWEP) provide funding for home modifications and requires an occupational therapist to complete and submit the application form with clinical justifications, and eligible client can receive the maximum lifetime subsidy of $4000 AUD (State-Wide Equipment Program, 2017).
He’s in There Somewhere! Reflecting on the Past, Present, and Future of Disorders of Consciousness
Published in AJOB Neuroscience, 2018
Unfortunately, during this period of time many TBI rehabilitation services have also changed. With increasing penetration of managed care insurance in the 1990s and stringent guidelines on functional progress, average lengths of stay are markedly shorter. Patients still requiring considerable physical and nursing care may be sent home to overwhelmed families with little support. Equipment and home modifications may take months to fabricate. TBI specialized therapy options may be limited in home health therapy and outpatient settings. There may be pressure to discharge the patient quickly if progress is not documented on a weekly basis (based upon the fallacious concept of the “plateau”), rather than recognizing that neurorecovery after brain injury can be uneven and slow, and can continue for a long period of time.