F E AT U R E
How OTs Can Help Turn a House Into a Home Eve Vickerson, Myositis Association Australia Liz Ainsworth, Occupational Therapist and Access Consultant, Home Design for Living
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house is a physical structure, whereas a home is all about living. A home offers comfort, meaning, safety, and a feeling that you belong. It is a springboard for life. Occupational therapists with specialist environmental modification knowledge and skills can help older people and people with disabilities turn their houses into homes. As well as maintaining or improving people’s essential physical health, safety, and independence requirements, home modifications can result in a range of outcomes that are often much broader than what may have been expected at the outset. The following are two case studies on home modifications proposed by an occupational therapist. In each case, the home modifications have aimed to contribute towards greater personal autonomy and control for both people involved. The case studies include two people living with myositis and are being showcased to coincide with Myositis Awareness Month in May. Myositis is a group of rare muscle diseases involving inflammation within the muscle tissues. Over time, it can cause significant muscle loss with a comparable decline in strength, dexterity, and mobility. People with this condition may acquire mobility and other equipment and rely on the help of carers and paid support workers over time. Because most homes are not designed to cater for people’s changing needs, environmental barriers tend to emerge, requiring a home modification and equipment response. 22 otaus.com.au
Case Study One: Changing Needs Over Time Background Jim is a retired veterinary surgeon who lives with Inclusion Body Myositis (IBM), a form of the disease that currently has no effective treatment. Initially, Jim modified his house by installing a ramp and handrails. At this stage he was walking with the assistance of a walker. As the disease progressed, he encountered a change in his physical and functional status and acquired different types of equipment. A particular issue of concern was the lack of access provided by the bathroom. Home Modification Features A significant component of Jim’s home modifications was improvements to the bathroom. The environment created ‘excess disability’ to the extent that he was abandoning tasks and being at risk of having accidents and injuries. Important design considerations were: • To provide a level access shower • To maintain cost-effectiveness by keeping as many areas in their current location to prevent changing the plumbing • Jim’s handedness for access and use of each item in the room (e.g. grabrail, cupboard with door and drawers, power points, etc.) • To comply with the waterproofing requirements of the Building Code of Australia that applied at that time.
As a result of the need to have a level access shower and the requirements of Queensland state legislation and the National Construction Code (Building Code 2019), the whole bathroom needed to be altered to include: • Adequate space leading up to, and around, each area for Jim (and his carer) • Asbestos removal • Level access for walking and wheeling using mobility equipment without the need to negotiate a small step at the doorway • ‘Slip resistive when wet’ flooring for wheeling and walking–for Jim, his carer, and for family using the area • A slimline sink, microtrap, and lever handle on single-lever mixer tap for ease of use in standing and then sitting. A shallow sink prevents reaching low into a deep sink, a microtrap ensures the pipework does not scrape on the knees, and a lever handle ensures ease of reach and a sink height that suits all users. • A wall-hung cupboard beside the sink to prevent any water damage to the base and to provide turning circle space under the cupboard suitable for feet on footplates • Drawers below the bench for easy storage access. The drawers featured easy-glide runners with stops and D-shaped handles to allow good grasp given Jim’s hand size and function. • Level access shower with a continuous shower track and safety glass to contain the water • A handheld shower and lever tap
